The struggles of junior doctors in South Africa
DR YASHIKA SINGH
BECOMING a doctor in South Africa is quite a long journey marked by dedication and sacrifice, only to then face an uncertain future in a healthcare system struggling to absorb us. This reality has broader negative implications for the country's healthcare system.
The path to becoming a doctor in South Africa begins with six years of study and completing this degree is just the beginning. After graduation, junior doctors are required to complete a two-year internship, followed by a one-year community service placement.
These years are crucial for developing hands-on medical experience but come with significant personal sacrifices. Many junior doctors are placed far from their homes, partners, families, and support systems. This separation can be emotionally taxing, leading to feelings of isolation and burnout.
These feelings are exacerbated by the long working hours, and the realities of working in resource limited settings. The constant relocation often disrupts personal lives.
After completing the mandatory internship and community service, junior doctors face yet another hurdle - securing permanent employment. Many of us aspire to become specialists, which requires entering registrar programmes.
However, the competition for these posts is fierce. South Africa produces a high number of medical graduates each year, but the healthcare system has not expanded job opportunities to match this growth. As a result, many qualified doctors struggle to secure medical officer or registrar posts, leaving them unemployed or stuck in career limbo. This bottleneck delays specialisation, wastes valuable skills, and discourages many from pursuing long-term careers in the public health sector.
The lack of available posts has forced some junior doctors into desperate situations. In an alarming trend, some have resorted to volunteering their medical services for free, hoping this unpaid labour will eventually lead to a permanent position, particularly in the Western Cape Department Of Health. Yet, there is no guarantee that these sacrifices will be rewarded.
The health minister's suggestion that doctors either leave the country or move into the private sector reflects a lack of commitment to addressing these systemic issues. While the financial issues are noted, it is still disheartening considering South Africa's ongoing need for more specialists to serve its growing and diverse population.
The situation is made worse by the poor working conditions junior doctors face. Long, exhausting shifts often extending to 30 hours during on-call duty are the norm. These excessive working hours put doctors at risk of burnout and compromise patient care due to fatigue-related errors. Additionally, junior doctors have not received meaningful salary increases for several years, despite rising living costs, and despite working through the Covid-19 pandemic.
As a result, South Africa is experiencing a significant brain drain. Many junior doctors are leaving the country in search of better opportunities abroad. Countries like Ireland and organisations such as cruise ship medical services offer more stable jobs, better working conditions, and higher salaries. The exodus of skilled healthcare professionals not only wastes the country’s investment in training them but also leaves the healthcare system understaffed and overburdened. This loss is particularly damaging in rural and underserved areas where medical expertise is desperately needed.
Addressing this crisis requires urgent intervention. The government must invest in expanding medical posts, considering creating more opportunities for specialisation, or innovating ways to improve the health care budget.
South Africa cannot afford to lose its young doctors. They are the future of the country’s healthcare system, and their struggles must be acknowledged and addressed. Only through meaningful reforms can South Africa hope to build a stronger, more resilient healthcare system that benefits both its doctors and its people.
Dr Singh, a medical officer, works in the public healthcare sector.
** The views expressed do not necessarily reflect the views of IOL or Independent Media.