Open letter to Ministry of Health on medics’ pay

Allow me to add my voice to the above discussion & make some suggestions  on the way forward.
Over 20 years ago we had only Makerere University medical school producing about 40-60 doctors per year. Mbarara University of Science and Technology was added & the total number of new doctors produced per year remained below 100. At that time, the government was largely interested in producing doctors to fill up positions in local and central govts. 

Over the years, medical training was liberalized, allowing many private medical schools to spring up and now producing annually about 2,000 medical workers (Doctors, degree nurses, pharmacists) who require internship attachment for a year before they can be registered by their respective councils to become employable. This number keeps going up each year. 

Over 90 percent of these pre-intern doctors/nurses/pharmacists have been self-sponsoring exorbitantly in private institutions for not less than four years. At this time, the country no longer produces health workers for public /government consumption but largely for the general market including local, regional and international.  

At the moment the unfilled posts in the public health service is not due to absence of the required cadres but largely related due to insufficient personnel wage envelope.

With such growing changes, MOH cannot continue being wholly responsible for this internship phase of medical training.  MoH cannot continue paying salaries for internships as this continues to be a very expensive recurrent cost. 

Instead MOH should only provide a subsistence allowance (not salary) to its previously government sponsored students and the rest should meet their living expenses during the internship period. MOH role in the internship phase should be limited to providing well facilitated internship sites that meet pre-set quality standards for quality internship training in terms of supervision and acceptable basics for proper patient care.

With the funds saved from the above position, MOH should recruit more specialists to beef up regional hospitals but also second specialists to district hospitals so as to improve supervision/ mentorship as well as increase the number of internship centers. 

The current internship centres, which are limited to regional and national referral hospitals and some few faith-based hospitals, are too few for the number of interns available. The national internship committee should continue deploying interns to fill up the pre-determined slots at the internship centres. The quality of medical training has declined so much that the NCHE, MOES, MOH must wake up to purge the glaring gaps in medical training.

As regards payment of SHOs, this group of doctors other than being trainees for specialization, they also provide mentorship and supervision to intern trainees & medical students & complement their supervisors’ responsibilities. As it is elsewhere, they should be considered for a reasonable living allowance. 

Currently, we have three postgrad training sites hence the numbers can be predicted & planned for in advance.

The issue of MOSG is humanly clear, their pay was not enhanced in line with their level of training & this was partly related to misunderstanding of their title. The title may be changed but their salary needs enhancement.

Name withheld.