Away from media attention, a crisis in the National Internship Committee (NIC) of the ministry of health has been brewing.
trueBy Barnabas Atwiine
Away from media attention, a crisis in the National Internship Committee (NIC) of the ministry of health has been brewing, created by the ‘problem’ of Uganda having ‘too many’ doctors to deploy for medical internship training.
Medical internship is a one year program, during which newly qualified doctors do work under direct supervision by specialists in hospitals. It’s the most important period of medical training as young doctors get the opportunity to put their mainly theoretical knowledge into practice.
The training is supposed to be intense to allow them learn how to work under stressful and difficult conditions, so that they raise their threshold for fatigue and learn how to priotise and organize their work. Its successful completion is a pre-requisite for one to be registered by Uganda Medical and Dental Practitioners’ Council (UMDPC) for medical practice.
This program that was primarily intended for medical doctors has come to be extended to graduate nurses and pharmacists. It has for long been dogged with many problems, mainly delayed and inadequate payments of allowances, among others. However, recent events have further exposed how much the health ministry can be so poor at planning.
The ‘problem’ was created by a response by universities to the call to increase the doctor-patient ratio and access to quality health care for all Ugandans. As a result Gulu and Kampala International Universities started medical courses and traditional medical schools of Makerere and Mbarara maximized their intakes; thereby increasing demand for the internship program.
On the other hand, space in hospitals to accommodate the increasing number of graduates was not correspondingly expanded. In fact, hospitals that were hitherto good internship centres, such as Mutolere, Kabale and Kagando Hospitals, among others, couldn’t admit interns anymore as they could no longer retain specialist doctors to supervise them.
Hence many young, energetic and enthusiastic graduates have been denied the opportunity to do internship. Many have had to wait 2 to 3 years to be admitted, rendering them unemployed and frustrated in the process. As a result, many young doctors are moving outside the country to do their internship, defeating the very purpose of increased training. After a lot of pressure on the NIC, many interns have now been lumped into the few internship centres without caring about the resources and facilities to adequately train them.
This may, in the end, create further problems of unleashing half-trained health workers unto the population. My suggestions both for the medium and long term solution to this crisis are as follows:
-Encourage and support more hospitals, especially upcountry ones, to employ and retain specialists, who, in turn will supervise intern doctors.
-Incorporate private-for-profit hospitals into the program. Hospitals like International Hospital Kampala (IHK) among others could take up a number of interns.
-Make graduate training for medical specialists free of charge so as to create a critical mass of medical specialists in all areas to deploy in many more health facilities, including district hospitals.
These and perhaps other measures should have been instituted in tandem with the obvious increase in medical school enrollment. Then we would have avoided this crisis that makes internship training a bottleneck for a much needed increased health care work-force as it has now become.
The writer is a paediatrician
Internship crisis: Finally, Uganda has ‘too many’ doctors