Overseas-trained doctors ‘blocked’

THE Health Professions Council of South Africa (HPCSA), the statutory body regulating the country's health care profession, has been accused yet again of having an agenda and “deliberately” frustrating the efforts of South African doctors who have studied overseas to integrate into the local medical fraternity.

The South African Internationally Trained Health Professionals Association (Saithpa), an organisation that has assisted hundreds of doctors since 2018 with overcoming the HPCSA’S integration hurdles, made the allegation.

In its time, Saithpa has secured various court victories and out-of-court settlements which forced the HPCSA to make changes to some of its pathway policy guidelines for integration.

There were instances when the HPCSA was found to be in contempt of court judgments but eventually toed the line and prevented further sanctions.

Release of the exam scripts of doctors who wrote HPCSA’S recent board exams – a requirement for internship in South Africa – is the subject of Saithpa’s latest scrap with the regulatory body.

Saithpa claimed that since the HPCSA’S board exams had been facilitated at the University of Kwazulu-natal, their members’ pass rates had dropped drastically.

Advocate Rene Govender, Saithpa’s legal desk chairperson, said previously their affiliated members achieved pass rates of 60% to 80%, but these had dropped to 40%.

Prior board exams were written at Gauteng’s Sefako Makgatho University.

“It’s shocking because many of these doctors were high-flyers throughout their student years, some of whom have landed bursaries and studied at leading overseas universities.”

Govender said failure was a new experience for many of the affected doctors.

She suspected something sinister was at play because the HPCSA, custodians of the exams, refused students access to their scripts to review and verify alleged shortcomings.

Govender said they were prepared to approach the courts for relief, as they had done successfully in the past.

She said “copyright” over the exam scripts was the reason tendered by the HPCSA for not releasing them.

“The scripts belong to the students because they wrote the exam, it is their record. This issue has become laughable.”

Govender said they approached academics about assistance with empirical analysis of the scripts.

The exam issue was among others raised in their latest letter to President Cyril Ramaphosa, which once again called for his immediate intervention as the HPCSA continued to lay “hindrances” in the path of their members.

The letter said the HPCSA continued with its “ineffectual and inept

handling of the curriculum review process”, where the returning doctors’ qualifications were scrutinised, and delayed their right to register and practise in the country.

Yet their qualifications had already been verified by the Education Commission for Foreign Medical Graduates (ECFMG) which is a key requirement for registration with the HPCSA. Govender said: “The ECFMG sets the goal standard for authentication and verification of qualifications from global medical training schools recognised by the World Health Organization.

“Once their qualifications become ECFMG accredited, it’s a seamless registration process for board examinations in countries like the UK, US, Canada, Australia, but not South Africa.

“Here it is a meaningless and frustrating process, which the ECFMG has already done.”

She said those processes could last six months for some, while others waited a few years and even went to court in some instances.

Saithpa also asked the president to investigate the HPCSA’S high board exam charges.

To complete their board exams, doctors must first write a theoretical paper and pass in order to qualify for the practical paper, which is usually written a few months later.

It costs R13 000 to write each paper. “We demand a complete audit of the funds paid to the HPCSA in lieu of board examination fees and the manner in which it was utilised.”

She said it was a “crying shame that doctors remain unemployed when the health system is crying out for doctors”.

“Account to our nation where the money to employ these doctors has disappeared. Account to the nation why foreign doctors are given employment opportunities at the expense of South African doctors.

“We call on you to do the right thing and accede to our demands.”

A Johannesburg-based parent, who spoke to the Sunday Tribune on condition of anonymity, said she was “shocked” to learn that her son recently failed the board exam,

“I don't believe it. The examiners had interactions with the student doctors and commended them on how well they performed, but the results came out showing something else.”

The mother said her son, who has reached his thirties, had been frustrated by six years of delays from the HPCSA to get on its internship programme, whereas he could have used the time to pursue another medical qualification.

She suggested that due to largescale failures in recent board exams, examiners had the power to moderate papers and offer marks as compensation so that more candidates could pass.

“As parents, we still have to support our adult children, which is difficult. People are mistaken that parents are financially well off. We’re sitting with huge debt and loans that we struggle to pay.

“We feel stuck in this system. We have provided a goldmine for the medical fraternity. Everything is paid for. These are a bright lot of doctors who studied at some of the world’s best universities,” she said.

A student doctor, who completed his studies in 2019 and is still waiting for an internship opportunity, also failed his theory board exam written in March.

“I admit I made some silly mistakes, but was satisfied I had fared well enough to at least pass. The failure came as a huge shock. It’s the first time I failed an exam in my life.”

The HPCSA and the Presidency did not respond to questions.