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Opinionista

I’m an unemployed doctor, like many medical peers, despite SA’s health skills shortage

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Dr Sunhera Sukdeo MBChB graduated cum laude in medicine from the University of KwaZulu-Natal.

I am sitting at home unemployed. But I am not alone. There are currently almost 800 unemployed medical doctors in South Africa while the people of our country are travelling for two to three hours and sitting in queues for five to six hours waiting to see a doctor.

A 93% aggregate with nine distinctions: that was what it took me to get into the University of Kwazulu-Natal’s Nelson R Mandela School of Medicine as a female South African of Indian descent. I got a R20,000 discount for my first year of medical school and my father paid every cent in full for the subsequent five years.

My father, also a South African of Indian descent, was born in South Africa. He lived in a one-bedroomed home with his five siblings and parents. He worked as a common labourer but was blessed with the strength, courage and determination to open his own business – his highest level of education being a matric certificate. His blood, sweat and tears is what got me a private school education and put me through medical school.

Read more in Daily Maverick: The public health sector needs as many health professionals as possible, but budgets are tight

I managed to complete my six-year medical degree cum laude. That still didn’t earn me any discounts or favours. I was lucky enough to be placed within Kwazulu-Natal for both my internship and community service.

My ultimate goal is to become a paediatrician and serve and help the children of this country who need dedicated doctors. To aid me on this journey and to get a head start, I wrote an extra exam for paediatrics and passed this with distinction as well. 

Towards the end of community service, the rat race to find a job began. It is common knowledge in the medical field that government posts are hard to come by due to funding. There simply is no money to pay doctors – despite there being a shortage of doctors. In 2022 our doctor-patient ratio was 1:3,198. The recommended ratio by the World Health Organization is 1:1,000. 

Government posts are advertised on the government website and applicants who meet all requirements are free to apply. Many of the adverts for paediatric posts included a disclaimer saying that preference will be given to “African males”, but everyone is encouraged to apply.

Feeling slightly deterred, I applied anyway. I did not get any feedback from any of the eight posts I applied for in Kwazulu-Natal and two posts in Gauteng. 

The facility at which I completed my community service was thoroughly impressed with my work and level of commitment and offered me a post. Two weeks later a directive from the district office of the Department of Health was received: all new posts that become available were to be held for bursary holders.

And the food was figuratively snatched from my mouth. 

It is now January 2024. I am a cum laude medical doctor. I am sitting at home unemployed. But I am not alone – most of my peers are in the same boat as I am.

There are currently almost 800 unemployed medical doctors in South Africa while the people of our country are travelling for two to three hours and sitting in queues for five to six hours waiting to see a doctor.

Read more in Daily Maverick: Newly qualified SA doctors shut out of jobs owing to budget constraints — union

My options are: 1) go around GP practices and private hospitals and beg for any number of locum hours available; 2) sit at home and wait for a government post to become available (for months? Years?); 3) open my own GP practice (take a loan? Sell a kidney?) and let go of the dream of ever specialising; or 4) leave the country and find someplace that actually wants the skills and knowledge that I have. 

With matric results having been released, seeing the enthusiastic smiles and optimistic plans for the future of many of the top achievers, brings a sadness to my heart. Nine years ago, that was me. Excited to be one step closer to realising my dreams.

If I knew then what I know now, would I still have chosen the path I have? After sacrificing nine years of my life to be sitting unemployed, would I still have accepted the offer to study medicine?

Almost a month into unemployment, with debit orders looming, the answer is probably no. I don’t come from a privileged enough background to be able to sit and wait indefinitely for the government to realise my potential.

I have the passion and drive to want to serve the children of my country, but am now being forced into the private sector just so I can have some form of income.

I am a South African citizen. My family and I have worked hard to get to where we are. But we are always left behind. We have doctors who are able, willing and ready to work; we have patients desperate to get the treatment that is their basic human right. We have our government, failing us in every way possible. DM

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  • Bill Gild says:

    This story is nothing but tragic, but raises a question: how was this young Dr’s father, a “common labourer”, by her description, able to afford paying the balance of her medical school fees? I would have thought that she would easily have qualified for a NSFAS bursary.

    • Stephen Browne says:

      Please read again, slowly, carefully. You took the time to post this comment but not to read.

    • J vN says:

      The dad started his own business. In spite of only being a labourer, he didn’t sit around feeling sorry for himself like his daughter’s doing above. No, he made something of his life and built a business, so successfully that he could afford the astronomical class fees. His daughter, on the other hand, for all her bragging about how she aced her degree, seems to have far less drive than her dad did. She has everything going for her, but still she expects the state to sort her out with a job, instead of following her dad’s excellent example and starting her own small enterprise. What about starting a small practice in a small premises, in a lower-cost area and working her way up?

      • Jagdish Makan says:

        Why is this young lady being personally attacked for highlighting the inefficiencies of this incompetent and corrupt government?
        Sure, she has options and I’m sure she will definitely make a career decision and or even leave the country where her skills will be best appreciated.
        Do not condemn the messenger. She has the guts to speak truth to power, at least acknowledge that. Highlighting the situation won’t help her personally, she’s now a target, but hopefully this will put pressure on the authorities and others in her situation will benefit from her speaking out.

        • Ben Harper says:

          Erm, complaining about being unemployed but has not once tried to apply in the private sector instead says she’s now being “forced” into the private sector.

          • Wayne Kitching says:

            Maybe she is idealistic and wants to help to provide good healthcare to poor people.

      • Ben Harper says:

        Exactly!

        • Malesh Make the change says:

          Don’t you think she’s applying to the pediatric registrar posts available. How do you know of there are pediatric registrar posts available across all provinces? I’m a health professional. I rarely see it. Maybe you know something I dont

      • Malesh Make the change says:

        You expect the youth to live in a country where if our government FAILS to provide jobs ;becuse they are making their pockets full; to start there own business?

        Second point. She is a medical doctor wanting to specialize as a pediatrician. Do you know government decided on who can specialize. It’s called a registrar post. And they make it available or not. How would her starting a business solve the problem in how she can specialize?

  • Concerned Parent says:

    I am disappointed that she has already given up from just 10 applications. Why 8 in KZN and 2 in GP when this country has 9 provinces? How about 90 applications, i.e 10 in each country, before deciding to uproot to another country? As mentioned, there are 800 qualified doctors in this race.

    • Tanya Cromme says:

      Fair point

      • Malesh Make the change says:

        She is an intelligent girl. She should leave to a country that gives her the fairness and provide her a job for her skills. Instead of suffering here with our government

    • Gill Davidson says:

      Because the ANC government reduced the health budget by 4 and a half % in the last budget, all available posts in the public sector hospitals have been frozen. In spite of the huge need for doctors in our state hospitals, the situation is shocking – both for doctors who are working abusive hours in the state hospitals, and also for patients, who must wait for many hours to be seen, or arrive at dawn to get into a queue. And they talk about NHI?? They couldn’t run a bath, let alone an NHI. Poor service by our incompetent government, failing us at every turn and in every service they are meant to deliver under our constitution.

    • Ben Harper says:

      yet she hasn’t even tried the private sector, in fact she says she’ll be “forced” to try the private sector.

      No sympathy

    • Steve Swartz says:

      800 hundred doctors are out of work despite the need for them… we have too few funded posts because we can’t afford it and spend money elsewhere. She will find a hob eventually but the bottom line is that we can’t afford the health system we need.

  • H K says:

    And we are expected by our “Government” to be proudly South African?

  • Chris Stanbridge says:

    Rhamaposa you should be ASHAMED !!!!

    • JC Coetzee says:

      You are at the receiving end of yet another failed institution in South Africa. In this case healthcare. And the only solution on the table is a name change. Does anybody know how the proposed NHI will provide this young person with a future?

    • L T. says:

      But nothing shames him. Not his money stuffed sofa, not his useless Minister of Electricity, not his keffiyah, not his blood money from Iran/ Hamas, not his invitation to Putin to attend BRICS……..He is totally without shame.

  • Barrie Lewis says:

    Consider going into politics. South Africa desperately needs qualified, capable and honest people in government. And of course go on doing whatever locum work you can find. Good luck and congratulations; we love and respect people like you. Getting there was tough, the step will be too. No easy rides in SA now.

  • Alison Dell-Coetzee says:

    Hi Sunhera thank you for your heartfelt and eloquent piece, and congratulations to you and your family for your wonderful achievements! You can all truly feel proud despite the fallow space you find yourself in now. Best wishes to you for wherever your career takes you, don’t allow our government’s failures to constrain you for one minute! Get out there and practice, even if not in our country.

  • John Kannemeyer says:

    Sunhera, this is an absolute disgrace, I feel for you and your family. My daughter works in the UK as a nurse in the NHS and they are crying out for skilled staff both doctors and nurses, there are many options you can take but leaving SA is probably the hardest thing to do.

  • Ralph Wortley says:

    Have you tried the private sector? They go on merit not political affiliation.

    • Jagdish Makan says:

      Graduates prefer to work in the public sector to gain experience. Regardless of the crazy hours and hard work, the experience gained here can never be matched in the private sector. Many stay on and give back to the country, others leave and pursue their own careers, it’s their own choice afterwards

      • Ben Harper says:

        Really? First world problems in a 3rd world country. Shame after a whole 10 applications she’s lost heart and now “forced” to enter the private sector.

        To quote a favourite of mine Candice Owens – Life’s hard, get a helmet

  • Fanie Rajesh Ngabiso says:

    Well done on writing this, I empathize entirely with your position.

    Health care is one of the more important failings of our dysfunctional government, one directly resulting in needless death of citizens.

    I wish you all the best, and I would say that the national health scheme may help, but I could start laughing uncontrollably…

    To all South Africans suffering under this government: vote for change that can really help you. Do this by voting for a party that really delivers services and not one that blusters, promises and relies on falsely promoting racism for political gain.

  • L T. says:

    This is yet another example of a Failing State. No money to fund public service doctors with millions of desparate poverty stricken people requiring medical attention. Wait, I have an idea – get Hamas and Iran to fund a few hundred medical posts as part of their next inducement to bring spurious cases against a non – failed, democratic, successful state trying to protect its people. Now that the finances of the ANC have been sorted out, why not spread some blood stained money where doctors can work and get paid and people can get medical attention. ……

  • Middle aged Mike says:

    I’m sorry to hear of your situation. Heard about the daughter of a friend of my wife’s whose in the same situation and found it hard to believe.

  • Kevin Jacobs says:

    I’m so sorry that you have to suffer because of in inept and corrupt government. Things will hopefully change when they are voted out this year.

  • Andrew C says:

    If the government cannot even employ 800 desperately needed doctors, how on earth will the NHI work? Perhaps they could divert the hundreds of million rand a year spent on protecting cabinet ministers to health. Knowing that a pissed off citizen may come after you might just sharpen the minds of our ministers.

  • Malesh Make the change says:

    1. Vote our government out. This is an important election year. They exploit the funds. Lack good financial control. And cannot provide jobs to the graduating youth even though we need those positions filled.

    2. With the current government. The only way you will get the government job is to bribe the official whose hiring at the post. Sad truth

  • Michele Rivarola says:

    Emigrate there are many countries that will welcome you with open arms. That is the tragedy of SA we export knowledge notwithstanding our extremely limited resources because of stupid politically driven policies. SA would rather employ a substandard Cuban trained medical graduate than a locally trained top of the class medical graduate.

  • Con Tester says:

    The ANC.

    The gift that keeps on taking.

  • R S says:

    Have you tried your luck in the Western Cape?

  • Anthony Kearley says:

    This is crying shame, that a diligent young professional should be left out in the cold. I know zilch about the medical industry so please forgive my naivete for asking: since it is never a good idea to wait for any government to provide employment, would it be feasible to do house calls to old age retirement villages or group homes, on a weekly rotation basis. I would imagine there is little startup cost needed for that. Not your specialization, but I suspect there is a need.

  • Geoff Coles says:

    Absolutely shocking. So the Health Ministry wants to give preference to African males…. Are they allowed, was this Dr Crisp’s idea of his new NHI

  • Henry Coppens says:

    There is no money for extra medical staff. Or that is what we are told and is probably true. But WHY? Quite simply, it is because there are too many people employed, not just in public health, but in the entire public sector AND who are paid far, far, too much for what they deliver, if anything.

  • Matthew Quinton says:

    Try the Western Cape, you probably have a higher chance of success here.
    If you haven’t found work here within 3 months (1 quarter), apply for work in Germany or the UK where you WILL be employed and you WILL be hired based on your marks and not a racist quota.

    Don’t buy into the whole “leaving SA is so hard” BS. I am living half in Europe and half in Cape Town now and it was super easy. I CANNOT see myself as a south african any more.. I am a human from earth.

    South Africa as a whole is frankly a shithole and an embarrassment. Break this unneccessary loyalty to the concept of a country which no longer exists. Go where you will be treated with the respect that your hard work deserves.

  • Johan Buys says:

    Well done Doc!

    With any luck this article leads to an opportunity, there are towns where the locals are running private and public facilities in combination – effectively the public part is a mess and the local private sector took over.

    Something that needs looking into by journalists : I was once told that the department of health spends, when measure across national provincial plus metro layers of officialdom, more on administrators in our health system than on first line medical staff. Main reason being the eye-watering salaries paid to the deployed cadres : by now there must be hundreds paid more than R2m a year and they apparently do NOTHING if this young doctor cannot be applied somewhere.

    • Ben Harper says:

      Ah but she doesn’t really want to work in the Private Sector and hasn’t even tried she stated she’s now being “forced” to enter the private sector

  • Beyond Fedup says:

    Awful! I will draw a lot of flak for saying this – emigrate. You will be welcomed with open arms and paid well too in the process. The truth also is that you are also a minority in this country and opportunities are not a on a level playing field. Merit counts for nothing as the NDR rules supreme and it won’t stop. In this abominable government and besides all the corruption, nepotism and thieving, their priorities are all wrong. They can increase the VIP protection for themselves whilst cutting critical funding for health etc. It won’t get better and they will still be in power as that is the way in Africa with liberation movements that are well past their sell by date.

  • Brian Doyle says:

    This is a sad commentary on the BEE employment regulations that the ANC have forced businesses etc to adhere to. If you are not Black you are so far down the pecking order, even though you have the more than necessary qualifications, you may as well emigrate. A very sad state of affairs

  • Heinrich Holt says:

    Forgive my ignorance, this question is because I really don’t know. What is the capital outlay to start a GP practice, and what is the operating cost per month?

  • Tim Bester says:

    Perhaps Dr Crisp prefers Cuban doctors?

  • krad Melder says:

    Welcome to the world of BEE. It would be worse if you were a white male. You were not Black enough to be considered for a bursary, even though you should have had one by merit. Others with much lower grades and lower achievement will walk over your back to the bursaries and jobs simply based on their skin colour. And now this same racist ideology is a barrier to employment. This is a detriment to the entire nation because people of merit and skills are kept out for simply being the wrong colour by the same people who complain about racism.

    As white people have realised, your only options are: 1) the private sector, at lower salary than government jobs, less security and benefits, no pay increases, and expectations of performance without 0888-1600 hours filling a seat; 2) start your own practice (difficult without experience and reputation and probably years of investing with little to no income to build it up); 3) leave, although your qualifications may not be recognised everywhere. That or leave.

  • Peter Holmes says:

    By going into a (junior) partnership with an experienced, older GP (preferably in the Western Cape) you will not be giving up your dream of specialising in paediatrics. Practice for a few years, and then specialise. Determination (which you appear to have in spades) will get you there. Your future is in your hands, nobody else’s.

  • Rod H MacLeod says:

    Don’t agonise – take option 4. With your stated academic record, you’re going to be really well paid and live in a civilised society where women are respected. you don’t need the stress of your own practice, and anyway, you’re not destined to be a GP.

  • phillippa de villiers says:

    Whoa, whoa, Whoa Sunhera. I hear your frustration and yes, you deserve better – you all do. We all do! Being a freelance artist in South Africa taught me that you’re only as good as your last gig and you actually can’t rely on your achievements to speak for you. “My options are: 1) go around GP practices and private hospitals and beg for any number of locum hours available; THIS IS NOT EXACTLY A WASTE OF TIME BECAUSE THEN MORE PEOPLE GET USED TO WORKING WITH YOU – WORD TRAVELS FAST 2) sit at home and wait for a government post to become available (for months? Years?); NO, DON’T DO THAT. NEVER SIT AT HOME AND WAIT. PUT ON YOUR BEST SMILE AND GO TO YOUR CLOSEST HOSPITAL WITH TEN COPIES OF YOUR CV 3) open my own GP practice NAAH, RATHER IDENTIFY THE SPECIALISTS WHO MOST INSPIRE YOU AND SEND THEM YOUR CV/VOLUNTEER TO BE THEIR ASSISTANT(take a loan? Sell a kidney?) and let go of the dream of ever specialising; DON’T EVER GIVE UP, YOU OWE IT TO YOUR DAD AND EVERYONE WHO EVER BELIEVED IN YOU or 4) leave the country and find someplace that actually wants the skills and knowledge that I have. YOU CAN, BUT ALWAYS KEEP A RETURN TICKET. WE WANT THEM, WE NEED THEM, PLEASE DON’T GO! YOUR PASSION IS RARE AND WE NEED IT. PLEASE DON’T PUNISH US BECAUSE OUR BUREAUCRACY IS SO INEFFECTIVE.

  • Stefan Schmikal says:

    A friend of mine had a similar problem, her solution was to move to Canada (which also has a severe medical professional brain-drain problem) in a small rural town.

    After a couple of years she felt compelled to return home and had saved more than enough money to set up her own practice.

    Might not the best option for SA in the short term but at least it didn’t turn out to be a total loss. Also beats languishing in unemployment….

  • Tristan Snijders says:

    A quick Google search would reveal a plethora of private sector opportunities for medical doctors in South Africa. First step would be to leave KZN – it’s a complete shambles.

    • C Moola says:

      All 800 trained medical doctors sitting at home just needed you to tell em how it’s done. That’s cute.
      Google. Who wudda thunk? Nine Distinctions, 800 doctors, … and none of them thought to… Google.

    • Tee Mo says:

      Dude. You’re being obtuse. She doesn’t want to work in the private sector. She wants to give care to the millions of South Africans who can’t afford the private sector. She will probably end up in the private sector though.

  • Fellow Dr None says:

    Sunhera in the end you need to decide how much you are willing to sacrifice for this country. Your story it really resonated with me- the financial debt my parents incurred to put me through med school, the loans I paid off afterwards, the struggle to get a job even as a specialist pediatrician. My heart and soul is in Africa, but if your hands get cut off by bureaucracy and your soul stifled by policy makers that are in for political gain only it is very hard to keep motivated and keep on trying to pursue those dreams. We’re off to Canada in a few weeks, and whilst I know the grass isn’t necessarily greener at least someone is willing to look after the grass that side. If you want to stay, fight hard, keep on sending job applications out, even if it far from home and at hospitals where things aren’t going well.
    Just a few notes for those not in the medical profession- you can only specialise in pediatrics through the government and at public hospitals. No amount of volunteering in private practice will secure you a post to specialise. Working for free at a government hospital isn’t so easy- someone needs to supervise you and you will most likely just be allowed to stand around and not touch/do anything. Setting up a GP practice is EXPENSIVE.
    I wish you all the best Sunhera, do not be discouraged.

  • Steve Swartz says:

    Sad to see the bright young doctors so desperately needed in the public sector and posts frozen due to budget cut after budget cut. State capture consequence….

  • eish Effedup says:

    “forced into the private sector” shame , what a terrible thing to happen to you.

  • Theresa Avenant says:

    Ben Harper – Maybe you should apply for a job with Not the Nine O’Clock News show. The nice people in Britain are always looking for a laugh.

    • C Moola says:

      Guy has the EQ of a clay brick.

    • C Moola says:

      News is just out that 800 qualified doctors are not being employed in public health posts because of a shortage of funds.

      The department cites budget constraints for not hiring qualified medical doctors.

      The state hospitals are not replacing retiring doctors.
      Together, these factors mean that the state cannot absorb newly qualified doctors.

      While the healthcare budget has been gradually cut, the Department of Health has not had a clear understanding of the resources the department needs and how this may change in the future.

      The state has been shaming and scapegoating doctors for going to the private sector but there is no money to absorb those doctors.

      This leaves the public healthcare sector in a dire state due to a shortage of staff, and those that remain are overwhelmed.

      Yet, newly qualified doctors often want to work in under-resourced public health care. They want to make a difference. They want to serve and be healers. And they want to specialise in fields of medicine that suit their needs and interests.
      It is criminal that fully-trained medical doctors cannot find work in a critically under-serviced healthcare system. The health system isn’t actually healthcare – it is a health bureaucracy crumbling under dead weight, chronic resource mismanagement and bungled planning, where the vulnerable poor and sick are the victims.

  • Pat Collett says:

    Can any of the bright sparks with their comments explain to me how the NHI is going to work if our government cannot afford to pay the doctors?

  • Tee Mo says:

    People are missing the point of this piece. It’s not about her. She’s highlighting the state of our system. Of course she can get a job in the private sector. Probably very easily. And she can be another brain drained away to greener pastures overseas. That’s not the point.

    This piece is about the fact that we have unemployed doctors, and millions who need care, but never the twain shall meet. Why? Probably because we’re sitting with a bloated health administration, filled with political appointees, tender swindlers taking extra long lunches and creating bogus invoices for shell companies. We don’t hire doctors because like that senior politician told De Ruiter “everyone’s got to eat”.

    This young woman probably won’t get a job in the public sector after speaking out. But good for her.

  • P C Hem says:

    She has only applied for 10 posts and she is talking about selling a kidney to start a business! The fact that she can’t get the exact job she is looking for at the moment should not deter her from applying for other posts.

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