Overseas-trained doctors secure major court victory against SA health regulatory body

Overseas doctors have won a significant court victory that frees them from the HPCSA’s “frustrating” rules and regulations that hampered their chances of entering the local medical fraternity

Overseas doctors have won a significant court victory that frees them from the HPCSA’s “frustrating” rules and regulations that hampered their chances of entering the local medical fraternity

Published Jul 3, 2022

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THE Health Professions Council of South Africa, the statutory body regulating the country’s health-care profession, was at the receiving end of a landmark court ruling recently.

The council in recent years has been accused of “frustrating” and deliberately blocking the integration of South African doctors, who trained at overseas institutions, into the local medical fraternity.

Overseas doctors have won a significant court victory that frees them from the HPCSA’s “frustrating” rules and regulations that hampered their chances of entering the local medical fraternity

Doctor Kimira Rugnath and 93 others brought a class action lawsuit against the council, in which its medical and dental professional board and the minister of health were respondents.

The doctors were affiliates of the South African Internationally Trained Health Professionals’ Association (SAITHPA), the organisation that led their fight for reintegration into the local health system.

Judge Brenda Neukircher handed down judgment in the matter in the Pretoria High Court two weeks ago.

According to the applicants, some of the council’s rules and regulations were stumbling blocks to their registration as medical practitioners in South Africa.

After registering with the council and its medical and dental professional board, they were required to pass a board exam for eligibility to secure internships at medical facilities and complete their community service before they could practise medicine.

The board exams are made up of theory and practical components.

A key registration requirement was that the applicant’s university of study be listed in the World Directory of Medical Schools, and that the qualifications obtained from that institution be verified and authenticated by the US-based Educational Commission for Foreign Medical Graduates.

The second respondent uses the commission’s verification process to authenticate credentials of foreign-qualified graduates who wish to practise medicine in the country.

Another registration requirement was that accreditation letters be procured from two international medical councils that recognised the applicant’s qualifications.

Regulations on exams caused further grievances.

Foreign-trained doctors were given three attempts to pass the board exam. An attempt constituted one theory and possibly two practical exam sittings. When a graduate failed the practical aspect for the second time, that doctor was the expected to start another attempt, beginning with the theory exam.

A fourth attempt was possible, at the board’s discretion, after a one-year delay.

The applicants were dissatisfied with the entire board exam process.

The doctors questioned why they were refused access to their exams scripts and the marking memorandum, in spite of their requests being made in compliance with the the Promotion of Access to Information Act.

The foreign-trained doctors’ association had previously raised this matter with the Office of the Public Protector. Although the public protector, after investigating their claims, ruled that such information be released, but the respondents did not comply with this ruling.

Judge Neukircher ordered that the requirement that candidates repeat the entire process of writing the board exam should they fail the practical component be reviewed and set aside.

Accordingly, the judge held that that ruling should become effective immediately for all applicants who had been asked to write their theory papers this month.

Candidates will also no longer be required to obtain accreditation letters from two international medical councils that recognised their qualifications.

She ruled that candidates should not be prevented from expressing their views on the practical exam, and the remark of their scripts should be allowed when the sitting was not video-recorded.

The respondents were ordered to honour the public protector’s decision to make available information requested by applicants in this matter and others who make similar requests in future.

They were also instructed to enrol all 94 applicants in this matter for their respective theory or practical exams .

Advocate Rene Govender, the SAITHPA’s legal desk chairperson, said the ruling was “unprecedented”.

“We have tackled a number of hindrances delaying our members attempting the board examinations, and the court has ruled in our favour on all issues.

“It is unfortunate the success of the action has been marred by the (council’s) refusal to provide our members with copies of their examination assessment records, according to the order.”

Govender said they would proceed with contempt proceedings.

Dr Geremie Nayager, also an affected person, said he was happy because the order ensured foreign-trained graduates were able to get into the system.

Nayager said he had confidence in their legal team, but was concerned that it had been required to go the legal route to have proper board examination processes put in place.

“The (council) does not realise the damage they are doing to our already crippled health-care system,” Nayager said.

Dr Pranav Singh said the court outcome provided relief to many.

“This victory is a life-changing one, on the basis that doctors who have studied abroad will now get a fair opportunity to write the exam.”

Singh, who studied in Mauritius, and had to overcome many obstacles before he was able to write the board exams, said all they wanted was “a fair opportunity”.

Christopher Tsatsawane, the council’s head of corporate affairs, promised to provide a response tomorrow.

SUNDAY TRIBUNE