Surgical training and capacity development in the South African internship programme
DOI:
https://doi.org/10.7196/SAMJ.2023.v113i8.137Keywords:
Surgery, Medical education, Doctor, Medical training, Health Sciences, Human resources for healthAbstract
Medical practitioners in South Africa manage a quadruple burden of disease. Junior doctors, who contribute significantly to the health workforce, must complete 2 years of internship training and 1 year of community service work in state health facilities after graduation to register as an independent medical practitioner. The aim of this article is to give a critical appraisal of the current national internship programme and why it was implemented, and outline suggestions for future changes. There is a compelling need to train competent, confident doctors while ensuring that the requirements and demands of our health system remain a central concern.
References
Mayosi B, Flisher A, Lalloo U, Sitas F, Tollman S, Bradshaw D. The burden of non-communicable diseases
in South Africa. Lancet 2009;374(9693):934-947. https://doi.org/10.1016/S0140-6736(09)61087-4
Obuaku-Igwe C. Health inequality in South Africa: A systematic review. Afr Sociol Rev 2015;19(2):96-131.
Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa:
Historical roots of current public health challenges. Lancet 2009;374(9692):817-834. https://doi.
org/10.1016/S0140-6736(09)60951-X
Malakoane B, Heunis JC, Chikobvu P, Kigozi NG, Kruger WH. Public health system challenges in the
Free State, South Africa: A situation appraisal to inform health system strengthening. BMC Health
Serv Res 2020;20(1):58. https://doi.org/10.1186/s12913-019-4862-y
Scheffler E, Visagie S, Schneider M. The impact of health service variables on healthcare access in a
low resourced urban setting in the Western Cape, South Africa. Afr J Prim Health Care Fam Med
;7(1):820. https://doi.org/10.4102/phcfm.v7i1.820
Wadvalla B-A. How Africa has tackled covid-19. BMJ 2020;370:m2830. https://doi.org/10.1136/bmj.
m2830
National Department of Health, South Africa. 2030 human resources for health strategy: Investing
in the health workforce for universal health coverage. Pretoria: Government Printers, 2020. https://
www.spotlightnsp.co.za/wp-content/uploads/2020/08/2030-HRH-strategy-19-3-2020.pdf (accessed
July 2023).
Health Professions Council of South Africa. Annual report 2019/2020. Pretoria: HPCSA, 2020. https://
nationalgovernment.co.za/entity_annual/2081/2020-health-professions-council-of-south-africa(hpcsa)-annual-report.pdf (accessed 2 July 2023).
Health Professions Council of South Africa. Brief overview: Guidelines for internship training:
edition. https://www.hpcsa-blogs.co.za/wp-content/uploads/2017/04/GUIDELINES-FORINTERNSHIP-TRAINING-2017-EDITION-19.2.17.pdf (accessed 2 July 2023).
Academy of Science of South Africa. Reconceptualising health professions education in South Africa:
Consensus study report. Pretoria: ASSAf, 2018. https://research.assaf.org.za/handle/20.500.11911/95
(accessed 2 July 2023).
Health Professions Council of South Africa. Handbook on internship training: Guidelines for interns,
accredited facilities and health authorities. Pretoria: HPCSA, 2017. https://www.hpcsa-blogs.co.za/wpcontent/uploads/2017/04/2017-IN-Handbook-Part-I-and-II.pdf (accessed 2 July 2023).
Bola S, Trollip E, Parkinson F. The state of South African internships: A national survey against HPCSA
guidelines. S Afr Med J 2015;105(7):535-539. https://doi.org/10.7196/SAMJnew.7923
Marteau T, Wynne G, Kaye W, Evans TR. Resuscitation: Experience without feedback increases
confidence but not skill. BMJ 1990;300(6728):849-850. https://doi.org/10.1136/bmj.300.6728.849
Clanton J, Gardner A, Cheung M, Mellert L, Evancho-Chapman M, George RL. The relationship
between confidence and competence in the development of surgical skills. J Surg Educ 2014;71(3):405412. https://doi.org/10.1016/j.jsurg.2013.08.009
Gous N. Doctors get a lifeline as government considers shortening internships. DispatchLIVE, 14 January
https://www.dispatchlive.co.za/news/2019-01-14-doctors-get-a-lifeline-as-government-considersshortening-internships/ (accessed 20 August 2022).
Africa T. Solidarity welcomes proposal to shorten medical internships. Independent Online,
January 2019. https://www.iol.co.za/news/south-africa/solidarity-welcomes-proposal-to-shortenmedical-internships-18784553 (accessed 20 August 2022).
Luke B. Medical internship training in South Africa 2020 and beyond: A transformational plan for
health service delivery. Readkong, 2019. https://www.readkong.com/page/medical-internshiptraining-in-south-africa-2020-and-beyond-2187329 (accessed 2 July 2023).
Meara JG, Leather AJM, Hagander L, et al. Global surgery 2030: Evidence and solutions for achieving
health, welfare, and economic development. Lancet 2015;386(9993):569-624. https://doi.org/10.1016/
S0140-6736(15)60160-X
Nkabinde T, Ross A, Reid S, Nkwanyana N. Internship training adequately prepares South African
medical graduates for community service – with exceptions. S Afr Med J 2013;103(12):930-934.
https://doi.org/10.7196/SAMJ.6702
National Department of Health, South Africa. Saving Mothers 2014 - 2016: Seventh triennial report on
confidential enquiries into maternal deaths in South Africa: Short report. 2019. https://www.westerncape.
gov.za/assets/departments/health/saving_mothers_2014-16_-_short_report.pdf (accessed 2 July 2023).
Medical and Dental Professionals Council of Zimbabwe. Education and training – 2022. https://
www.mdpcz.co.zw/the-profession/education-and-training/#1471916090876-cf7dc41e-9da4
(accessed 20 August 2022).
Teo A. The current state of medical education in Japan: A system under reform. Med Educ 2007;41(3):302308. https://doi.org/10.1111/j.1365-2929.2007.02691.x
General Medical Council of the United Kingdom. Check if your practical training (internship) is acceptable.
https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/check-ifyour-practical-training-internship-is-acceptable (accessed 20 August 2022).
Abdelaziz A, Kassab S, Abdelnasser A, Hosny S. Medical education in Egypt: Historical background, current
status, and challenges. Health Prof Educ 2018;4(4):236-244. https://doi.org/10.1016/j.hpe.2017.12.007
Centeno AM. The programs and context of medical education
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