Author: Ivan Joseph Mbuga August 2, 2024
Medical Pre-interns expressing their dissatisfaction on their non-deployment
Photo by Joseph Nsamba. Link to Image:https://static.wixstatic.com/media/1ed941_3907345a3c6f455ab507c25b629ab347~mv2.jpeg
Summary:
Medical interns play vital role in Uganda's health system during their one year placement. Several challenges during internship are pointed out including stress, burnout, and challenging working environments. Facilitation for medical interns to cater for their needs during the placement has become a challenge and has spiked strikes in the past years but no steps have been taken to improve the situation
Background
Medical interns play a vital role in the health system in Uganda during their one-year deployment which is mandatory to get a practicing license (1). These include intern doctors, nurses, pharmacist and dental surgeons. Doctors and dental surgeons spend five years of training in the respective medical schools to get the necessary qualifications to register with Ministry of Health for internship deployment, similarly the nurses and pharmacist generally undertake four years for the bachelor qualifications. In order to acquire a full practicing license, every individual has to take this full year of mandatory traineeship under supervision.
Over the past years, there has been a growing number of medical schools and producing more interns, further more regulation of intake of students into private institutions is uncontrolled. This was further escalated by COVID-19 pandemic which distorted academic calendars and created backlogs within internship deployment. The ministry acknowledges the financial constraints with in the budget which can’t allow them facilitate all the interns. Last year ministry of health suggested deployment of medical interns without pay which attracted massive protests by medical interns. This was strongly rejected by the interns based on the high living conditions requiring food and accommodation. In a mixed method study conducted to understand internship experience in Uganda and Kenya (2), it was highlighted that challenges faced included burn out, stress, challenging working environments among others, which call for facilitation to enable them navigate through such challenges. A resolution was made to cut pay of interns from 2.5 UGX to 1.0 UGX to have interns deployed.
The crisis and dilemma
The recent deployment lists for medical interns which were released by ministry of health on July 29, 2024 sparked protests once again as a number of medical interns were left out. This year a total of 2541 pre-interns were registered waiting for deployment, but only 1263 were taken up, leaving over 1278 pre-interns in confusion. Such frustration is far reaching affecting the mental health of pre-interns and also colleagues still in medical school and further influences decision of young generation to join the profession. Non-deployment sparked off many debates among the interns on the next steps for the full year period, and many questions if the ministry of health really plans to receive them in advance as they progress through medical school. The number of medical interns released is quite overwhelming for the ministry of health to handle, further questioning relevant authorities to regulate admissions into medical school. The biggest dilemma also arises with from reports that the number of qualified medics present to care for the population is still low, requiring more to be trained.
According to Dr. Alex Lwesabula, one of the leaders of pre-interns and missed out on deployment stressed how they are going to be faced with life challenges and stressors when they go back home for a year of non-deployment and long term consequence on delaying their life dreams and careers.
According to Mr. Kenneth Akiiki, Under Secretary of Ministry of health reported that money available can support the placement of more than 2000 pre-interns(3) and more questions arise why only 1263 were deployed
The critical issue of regulating admissions to medical school and need to improve health financing are priceless measures that should be taken to prevent such frustrating instances in future.
References
1. Ogei E, Lewis C. Medical Training in Uganda: A Critical but Neglected Part of the Healthcare System. Cureus. 2023;15(6):e40044.
2. Zhao Y, Mbuthia D, Gathara D, Nzinga J, Tweheyo R, English M. ‘We were treated like we are nobody’: a mixed-methods study of medical doctors’ internship experiences in Kenya and Uganda. BMJ Global Health. 2023;8(11):e013398.
3. Abet T. Govt earmarks Shs35b for new medical interns. Daily Monitor. 2024.
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