Durban - Medical professionals with foreign qualifications – including South Africans who studied abroad – are finding their chosen career paths hindered by stringent local rules and red tape.
Despite major skills shortages in the medical sector, many are unable to practise here. Stringent board examinations and administrative delays have been cited as some of the reasons.
“We are South African citizens but we can’t qualify. To practise elsewhere we first have to qualify in South Africa so this is the end of our careers,” said Ricky*.
Like many South Africans Ricky* and his sister Sunitha* studied outside the country, because of the shortage of university spaces here.
According to the Department of Higher Education and Training there were more than 36 000 applications for just 1 770 first-year medical school places this year.
The Durban siblings studied dentistry in Mauritius but their dreams of being dentists have been shattered after years of study, because they failed the South African board examinations.
What also irked them was having to write the exams in the first place, because they said the South African Qualifications Authority had regarded their foreign degree as being equivalent to a South African one.
After delays, including the loss of Sunitha’s application, they wrote the exams in September 2012.
Ricky said the first time he and his sister wrote, only 10 of the 25 candidates passed the exams. They pursued the matter, eventually getting a court order to have their papers remarked, although only three of the nine papers were remarked.
The siblings rewrote the exams at the end of November last year but again failed. They said only three of the 20 candidates passed.
Applicants are given only two chances to successfully complete the Health Professions Council of South Africa (HPCSA) dental exams.
Other medical professionals who contacted the Daily News said the HPCSA regulations were unfair, forcing them to find alternative work after years of studying.
Naeem Bhayla, 37, who works as a manager at the dental unit at Amajuba Medical Hospital in Volksdrift, has been battling to register for private practice because he studied in India.
“I returned to South Africa in 2005 after studying for four years and was told I couldn’t register as I had to study for five years,” he said.
Bhayla explained that the Indian course has fewer holidays so, although it is the same length, it is completed faster than in South Africa. Despite this he had to return to India for a year of internship.
On his return to South Africa in 2007 he eventually wrote the board exams after administrative delays that he said cost him an unnecessary R3 000, and managed to pass.
“I needed to register with the HPCSA to get a job but the HPCSA said I needed a job to register,” he said.
After overcoming this hurdle, Bhayla applied to write his independent practice registration exam in 2009 that would allow him into private practice. However his application was lost and he was registered to write in 2010.
“I got an SMS asking why I wanted to write the exam as I could be fast-tracked if I just e-mailed my documents through, which I did,” he said.
Bhayla has still had no luck registering for private practice.
“I’m a South African citizen in a competent practice. I can authorise others to get into private practice but I can’t (practise),” he said.
Advocate Phelelani Khumalo, the acting chief executive and registrar of the HPCSA, confirmed that dentists have two chances to sit for the examination, held once a year, while doctors have three tries, with exams held twice a year. Each exam costs R3 498 and is of “comparable standard” to that written in South African universities, he said.
Khumalo said that the board exam had always been obligatory for foreign-trained professionals and allowed them to practise in the public sector. A further exam was needed to practise in the private sector.
“The HPCSA is mandated to protect the public and to guide the professions; it has to ensure that the standard of education is equivalent to the South African qualification and (that) practitioners who obtained a foreign qualification (have) the necessary knowledge and expertise to practise their profession,” he said.
However, not all medical qualifications are recognised by the HPCSA.
“The council has agreements with various tertiary institutions across the globe and, depending on the institution studied at, the practitioner might be required to sit for the board examination,” Khumalo said. “There are more than 170 institutions across the globe accredited with the council.”
Khumalo said the examination scripts were marked by examiners and thereafter moderated to ensure that marking was fair and consistent.
Students sent to Cuba by the national Department of Health, however, do not have to write the exams as there is a government-to-government agreement allowing them to be registered upon their return.
Of the 1 413 candidates who wrote the exam from 2009 to 2013 only 473 passed.
Khumalo said possible reasons for the high failure rate included the academic level of the curriculum; substandard medical facilities used for training; language barriers and a different approach to health care.
*Pseudonyms have been used to protect their identities.