How govt will use Shs35b to deploy medical interns
Minister of Health Dr Jane Ruth Aceng. Photo/Roland D. Nasasira
What you need to know:
According to the Ministry, the government has allocated Shs35 billion to facilitate the deployment and allowance payments for medical interns and Senior House Officers (SHOs) during their 12-month internship placement
The Health Ministry has cited inadequate funding and the limited number of supervisors and hospitals with the required capacity as major hindrances to deploying all medical degree holders for internships.
According to the Ministry, the government has allocated Shs35 billion to facilitate the deployment and allowance payments for medical interns and Senior House Officers (SHOs) during their 12-month internship placement. Notably, SHOs are experienced doctors pursuing specialized training, and they receive compensation for their clinical services in hospitals, thereby addressing service delivery gaps.
The Ministry stated that this funding is only sufficient for 1,500 medical interns and 743 SHOs. However, there are 2,706 interns eligible for deployment and 743 SHOs.
“This Financial Year 2024/25, the Ministry of Health was allocated UGX 35,661,600,000 to cater for both Medical Interns and SHOs. The cost of deploying one intern for one year, inclusive of allowance and PAYE tax, totals UGX 15,600,000,” explained Health Minister Dr Jane Ruth Aceng.
Details from the Ministry indicate that the allowance for each medical intern is Shs1,000,000 per month, with PAYE tax adding Shs300,000 per month, totaling Shs1,300,000 (inclusive of taxes) per month.
“This allows an intern to receive a net amount of Shs1,000,000 per month. Therefore, each intern requires Shs15,600,000 per year,” Dr. Aceng said, adding that SHOs receive a similar amount in allowances each month.
For the 743 SHOs over the 12-month period, the Ministry will use Shs11,590,800,000 from the Shs35.6 billion.
“The funding released last year was Shs46 billion, which included arrears and supplementary funds for shortfalls. This year, only Shs35,661,600,000 has been allocated, a reduction of Shs10,338,400,000,” Dr Aceng explained.
“With the available budget allocated this year (Shs35,661,600,000), less Shs11,590,800,000 for SHOs, and less Shs670,800,000 for the 86 continuing interns who joined late, only Shs23,400,000,000 is available for the deployment of the current interns.”
“Considering the expenditure of Shs15,600,000 per intern per annum, this money can only deploy 1,500 interns. Against this background, the Ministry can only deploy the cohort of 2023 and previous years, totaling 1,435 Medical Interns,” she added.
Dr Aceng said that for the remaining 65 positions available, priority will be given to Dental Surgeons (22), with the remaining 43 positions going to Government-sponsored pharmacists from the 2024 cohort, who are in short supply.
“This year, we have received communication from the Ministry of Finance, Planning, and Economic Development to operate within the available resources with no anticipated supplementary funds,” she said.
However, calculations indicate that Shs18.8 billion is required to deploy all the interns, raising questions about the government's priorities in managing the Shs72 trillion budget for this financial year. Medical interns need to undergo this internship to receive their permanent practicing licenses.
Mr Jim Mugunga, the Finance Ministry spokesperson, stated, “We allocate money based on the resource envelope. I am not aware of a single need that can be 100 percent funded.”
Dr Aceng noted that last year they deployed 1,901 medical interns, a number she described as too large for effective supervision, affecting the quality of training.
“Due to the enormous pressure to deploy all the interns last year, we deployed an excessive number of interns (1,901) that overwhelmed the system,” she explained.
“This created challenges with some trainers having to supervise 5-6 medical interns, resulting in sub-optimal learning, overcrowding, and difficulties accessing medical supplies, equipment, and devices. Effective medical internship skills transfer relies heavily on hands-on experience to build the confidence of newly graduated interns so they can work independently after being signed off.”
Solutions
Prof Medi Kawuma of the Health Service Commission suggested that the government expedite the regulation of student enrollment in medical courses to address the problem. He noted that many medical schools are producing underprepared graduates.
“You find a school with 100 students given two dead bodies to study and dissect. That is not enough. Some don’t have a chance to hold a knife and dissect. In our time, we had three medical students assigned one dead body to study and dissect,” he said.
Prof Kawuma also highlighted that delayed internship deployment means students are deployed later, after forgetting much of what they learned. Medical interns undergo a 12-month placement to obtain a permanent practicing license from their respective professional councils.
Dr Aceng recommended prioritizing internship training and allocating adequate funding based on the number of students enrolled in universities and communicated to the councils after training.
“There is an urgent need to recruit more specialists/supervisors in hospitals and open more internship training centers to accommodate the growing number of interns. The Ministry urges all universities to communicate the number of students (potential interns) at the beginning of the last year of training in line with the Government budgeting cycle,” Dr Aceng said.
“There is an urgent need for the Ministry of Education and Sports to expedite the process of completing the Education for Health Training Policy. We thank all eligible interns and the public for their understanding as we strive to improve the healthcare system in Uganda,” she added.
Infographics
Total funds for medical interns and SHOs in FY 2023/2024: Shs46 billion
Total funds for medical interns and SHOs in FY 2024/2025: Shs35.6 billion
Total funds available for medical interns in FY 2024/2025: Shs23.4 billion
Total funds available for SHOs in FY 2024/2025: Shs10.3 billion
Funds for 85 continuing medical interns: Shs670 million
Total funds required to deploy all interns: Shs42.2 billion
Additional money required to deploy all interns: Shs18.8 billion
