Durban - KwaZulu-Natal health MEC Dr Sibongiseni Dhlomo told final year medical students from the University of KwaZulu-Natal on Tuesday that making sacrifices for the good of their communities should be viewed as a priority.
Dhlomo was speaking to students and other stakeholders at the Nelson R Mandela School of Medicine during a seminar on the Decentralised Clinical Training Platform (DCTP) for students, the first of its kind in the country.
The programme is a joint venture between the provincial health department and UKZN and seeks to increase the number of “fit for purpose” medical students exiting the facility each year.
According to the DoH, South Africa is in need of an additional 20 000 doctors.
DCTP places students in accommodation for up to two weeks in areas near to hospitals, clinics and other facilities, with a focus on rural areas and primary health care facilities.
The country has an existing programme, initiated in 2013, where South African students are taught in Cuba but receive clinical training upon returning to South Africa.
According to Professor Fanie Botha, UKZN will receive 340 students returning from Cuba in 2018 that need to go through local clinical training. In 2019, an additional 280 students will return from Cuba. All of the students will have to be absorbed into training programmes.
With an upgrade of South Africa’s medical training programmes, it is hoped that students can be trained on home soil and increase the number of fit for purpose doctors needed, particularly in rural areas.
The seminar offered a platform for students who had taken part in pilot programmes around the province to give feedback.
Students involved in health sciences such as dental therapy and optometry weighed up the positives and negatives of their experiences and said they found the programme exciting and informative.
“A two hour drive was worth it because we got to interact with people in rural areas who had never before seen a health care practitioner,” said optometry student Mohammed Dandri.
But medical students called for an immediate halt to the project.
Speaking on behalf of fifth-year medical students, class representative Phumelele Yeni said that the programme was problematic for some students.
Yeni said that at a meeting of fifth-year students held on Friday, “students agreed that we are extremely unhappy with the current decentralisation programme, based on our experiences this year”.
“The final year students of 2017 should not be subjected to this programme. We felt that we continuously raised concerns and gave extensive feedback during the year but most of our concerns weren’t addressed,” she said.
Yeni said the shortfalls of the programme included standardisation in teaching, minimal student facilities, such as inadequate libraries or libraries that were too far from the student accommodation.
Yeni said there were also “accommodation issues throughout the year” and no support services. She said students were psychologically affected by continuously having to move around on a rotation basis. “It is problematic and provides tremendous stress to our group. It has impacted us negatively psychologically, financially and academically,” she said.
Dhlomo conceded that the department had to “plead” with medical students to do a rotation in distant, rural hospitals, and the answer was simply “No, I am not going there. I will do my rotation at King Edward”.
He said that some of the best medical training he received was from nurses in rural areas.
He acknowledged that the programme had challenges with infrastructure, wifi access and distance to shops and said that these would be addressed.
It would be impossible to have 500 final year medical students rotating around an urban, well-equipped facility like King Edward, he said.
“If you are doing an internship at King Edward, you do not learn as much as you would if you were sitting at KwaMagwaza hospital in Melmoth,” he said.
Doctors had to be faced with survival situations and exposure to various communities and medical situations was vital.
“In rural settings, you get an opportunity to see raw pathology. You will be the first health care professional to deal with it. The learning that you get in these facilities is unparalleled,” he said.