New medical school squeeze

2014-04-01 00:00

BUDGET-RELATED cuts by the provincial Health Department will impact on service delivery and further endanger the future and status of the University of KwaZulu-Natal medical school.

In November last year a memorandum was sent out by the provincial Department of Health to heads of various departments at the medical school informing them of a reduction in the intake of registrars in January thus reducing the number of registrars from 93 to 40.

A registrar is a medical doctor undergoing advanced training in a specialist field, ranging from anaesthetics to urology. Training has to be completed within a four-year period.

Twenty disciplines are affected by the reduced intake, including anaesthetics, cardiothoracic surgery, family medicine, general surgery, obstetrics and gynaecology, oncology, paediatrics and psychiatry. The largest reduction is in general surgery from 16 to four, followed by paediatrics, from 11 to six and psychiatry, from four to one.

According to the memorandum from Priyaneshree Maharaj, manager of corporate governance and ISC at the department, the reduced intake was necessary in “accordance with the available financial resources.”

“This revised intake impacts on the department’s overall ability to remain within budget. An exercise in reprioritisation will be done to accommodate this intake.”

There is usually another intake of registrars in July but according to the memorandum circumstances around “the needs of the department” as well as those of the various disciplines “could result” in this intake being cancelled. If the July intake does not take place the number of registrars will be further reduced.

The reduction of registrars will reduce the number of doctors available in the public sector and thus impact on service delivery. It will also mean that fewer specialist doctors will be trained in the province, which is already experiencing a shortage of specialists.

A consequence of the reduction in the number of specialist graduates will further impact on the future teaching capabilities of the UKZN medical school. It will also see a reduction in the number of people doing post-graduate studies, which will diminish the amount of research and the related publication of papers. This not only brings in income to the university but is contrary to its marketed image as a “research-driven” institution.

Fewer registrars and resultant specialists will further impact on the teaching capabilities of the UKZN medical school already hit by the breakdown of the Joint Medical Establishment relationship that saw the DOH fund undergraduate and post-graduate programmes.

This has led to the freezing of posts at the medical school, numbered at over 300 either vacant or frozen, and including heads of department, following the lack of funding by the provincial Department of Health. This could see degree programmes lose their accreditation.

The medical school previously had an arrangement with the department of health known as the “Joint Medical Establishment”, which saw the Health Department finance the salaries of many of the school’s teaching staff. This relationship broke down seven years ago and attempts to resurrect it have been unsuccessful.

Departments without heads include medicine, obstetrics and gynaecology, radiology, oncology, paediatrics and cardiothoracic surgery. The department of ear, nose and throat (ENT) has stopped teaching due to staff shortages and the staff from the family medicine department are now teaching ENT courses.

This means the quality of training at the UKZN medical school has become severely compromised, to the point that the accreditation of degree programmes by the Health Professions Council of South Africa (HPCSA) is in jeopardy and academics at the school fear that when the HPCSA undertakes a routine accreditation review in August and discovers this situation it could lead to a withdrawal of accreditation. If that was to happen the school could be closed.

Both the Department of Health and the university were sent a detailed list of questions regarding these matters. The Health Department had not responded by the time of going to press and the university issued the following statement: “The university senior management views this matter in a very serious light and have been in contact with relevant authorities at a national level.”

Representatives of the university met with the Department of Health yesterday. The outcome of the meeting was not known at the time of going to press. Today university representatives will be meeting with the Department of Higher Education.

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