Doctors take on ‘discriminatory’ Colleges of Medicine


Phume Peter Moletsane has given up appealing for his exam scripts to be remarked by the Colleges of Medicine of SA (CMSA).

Moletsane (53), a general practitioner in Kroonstad, Free State, says CMSA is also refusing him access to his exam scripts.

He is now considering enrolling with the Royal College of Physicians and Surgeons of Canada, but is unsure if his foreign qualification would be recognised by the Health Professions Council of SA (HPCSA) because HPCSA was not forthcoming when he asked what his options were in April.

The council has a contract with CMSA to administer exit exams for medical practitioners who want to be specialists. Successful completion of university administered research and CMSA exams are required for a specialist to register and practise in the country.

Moletsane wants to be a specialist in internal medicine and is studying at the University of the Free State.

Dr Phume Peter Moletsane

However, he has failed his CMSA exam twice – during the first semester in 2017 and again in the second semester last year.

“I failed both exams and have been denied access to my scripts on both occasions. We sit for exams with no set pass mark. The pass mark is determined after marking,” he said.

CMSA chief executive Lize Hayes declined to comment on Moletsane’s matter, citing confidentiality.

However, she referred City Press to a section in the medical care quality custodian’s policy, dated November last year, which allows appeals, but not reviews, and does not allow candidates to access their multiple choice questions (MCQ) scripts.

The policy was approved after HPCSA held a stakeholders’ meeting in October last year to discuss similar complaints pertaining to CMSA exams at its council chambers in Pretoria.

Moletsane was among six medical practitioners whose complaints led to the meeting. At the same meeting, universities raised similar concerns regarding the CMSA exams.

Hayes said, without making reference to Moletsane, that the recalculation of candidate exam papers was done after a formal request to do so.

“MCQ papers cannot be reviewed and are not made available to candidates, in line with international trends. A good bank is essential to running a fair and defensible examination,” Hayes said.

Moletsane said his requests to CMSA were about his MCQ scripts and that the policy had not changed anything.

“There’s nothing new; totally none,” he said.

At the HPCSA meeting, stakeholders alleged that:
  • There was a low throughput rate of local African specialists, coupled with unfair treatment and discriminatory practices towards African registrars, specialists and academics as a result of CMSA exams;
  • The exams lacked transparency, leading to a flood of litigations by black candidates against the manner in which scripts were marked and the issuing of results;
  • Black candidates were singled out and their fate was decided before exams, and sometimes performance in written exams was disregarded;
  • Black candidates were separated from their white counterparts on the basis of the command of English and were failed deliberately; and
  • There was gate-keeping, which directly inhibited the production of an acceptable number of specialists.

Recommendations agreed on at the meeting were submitted to the HPCSA board for consideration.

Some of the conclusions made by stakeholders were that the council failed its oversight role and its board was to consider reviewing the contract it had with CMSA because of lack of transparency in the administration of exams.

City Press has seen an email Moletsane wrote to HPCSA chief executive Dr Raymond Billa last month, asking whether there was an external body that was recognised by the council with which he could write his exams.

“Having tried to get a fair and transparent exam from CMSA without any success, I wish to be informed as to which examining body you recognise outside South Africa. I will make arrangements to be examined there, with the expectation of being registered after passing,” Moletsane wrote.

Billa said he had not been able to obtain information on his request on a local student wishing to write the exams of a foreign body without having studied in that country.

“The only consideration we make is for foreign-qualified practitioners after undergoing training in those countries and writing examinations in those countries, upon completion of their studies and training programmes.

“I am not aware of the specific condition as you have raised it.”

The HPCSA failed to respond to questions from City Press.

SA Medical Association board member Dr Eddie Ngwenya said medical registrars, who are represented by registrars’ organisations within his organisation, had also raised concerns relating to CMSA exam fees and assessment mechanisms, but these were being addressed with CMSA.

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