Cuban healthcare workers, meanwhile, benefitted from a long-
standing, streamlined process with the HPCSA and one that - as of
at least 2018 - was also supposed to apply to other HPCSA-vetted
international medical schools. But today, a public list of these
schools that was supposed to be updated annually does not exist.
When Jehane Michael le Grange could not get a spot at one of South
Africa`s eight medical schools, he sought training in China, he
told Bhekisisa recently.
In the May edition of the South Africa Medical Journal, Le Grange
and others surveyed 644 internationally trained South African
doctors and found that about 70% were either unemployed or not
practicing.
Many doctors had either not taken the HPCSA exam, which were
postponed during lockdown, or were still waiting on results, he
told Bhekisisa.
All other healthcare workers other than nurses must register with
the HPCSA to practice regardless of where they trained. Nurses
register with the South African Nursing Council.
Le Grange said: `The irony is that the government wants to bring
in Cuban and Chinese doctors to help, while many of us who
qualified in China and are eager to help are already sitting here
twiddling our thumbs.`
Why Cuban doctors were able to bypass the queue
Health Minister Zweli Mkhize was quick to note the incoming Cuban
healthcare workers would complement existing drives to hire more
local workers during the Covid-19 outbreak. Earlier this year, the
Gauteng health department opened more than 400 such positions.
The non-profit Africa Health Placements spent more than a decade
recruiting foreign doctors to fill gaps in underserved rural
areas.
The organisation closed earlier this year, but its former CEO,
Stacey Ann Pillay, says it can take anywhere between nine months
and almost two years for foreign-trained healthcare workers to
complete the process to register in the country.
They must also first have their qualifications recognised by the
HPCSA, the national health department and the US Educational
Commission for Foreign Medical Graduates.
Timelines also depend on whether or not doctors` qualifications
are deemed to be at the same level as that offered by South
African medical schools. If not, doctors may have to compete for
scarce internship posts as well.
South African medical students have been training in Cuba since
1996 through the bilateral Mandela-Castro programme. As part of
this, the HPCSA reviewed Cuba`s medical school curriculum and
found it to be on par with that of South Africa. This allowed the
recently arrived Cuban healthcare workers to register with the
HPCSA within days instead of months.
`Not all foreign-trained doctors have to write the board exam,`
said

Deputy Health Minister Mathume Joseph Phaahla in a 28 April
briefing. He went on to explain that graduates of international
universities who have been similarly assessed by the HPCSA do not
need to take the board exams in order to register with the body.
In fact, a 2018 national health department policy stipulates that
a list of these universities should be updated and published
annually.
Yet, no trace of such a list exists. The HPCSA did not answer
repeated requests from Bhekisisa as to why.
Other international medical school graduates could get streamlined
registration in South Africa too … if the HPCSA were to release a
long-anticipated list of qualifying universities
In a 2019 presentation, the ministerial appointee to the HPCSA,
Tahir Pillay, suggested the body used a three-track system to
streamline applications from foreign-trained doctors based on -
for instance - proof of their institution`s national or
international accreditation and how many years they studied.
It is unclear whether the HPCSA considered this proposal.
But, as of 2019, a lack of clarity on which medical schools
qualified for streamlined registration, allowed dubious foreign
recruiting agencies to mislead students into thinking they would
be guaranteed registration, Pillay warned in his presentation.
Currently, the HPCSA evaluates foreign medical school curricula on
an applicant-by-applicant basis, says HPCSA spokesperson Priscilla
Sekhonyana. Those who do not meet South African standards are then
required to take the HPCSA board exam.
Ordinarily, the HPCSA offers board exams twice a year. But as long
as universities remain closed, these exams are likely to remain on
hold. As of late April, 120 people who had taken the last HPCSA
board exam in January were still awaiting their results, but
Sekhonyana says these results have now been released.
The delay, she says, was in part because the Medical and Dental
Professional Board, which approves results, was unable to meet
during the lockdown.
Although the HPCSA reported a backlog in processing board exams
from foreign-trained applicants in its 2019 annual report,
Sekhonyana says no such backlogs exist today - partly because the
HPCSA moved to allow part of the exam to be written online.
Meanwhile, foreign trained doctors such as Hoosein Alvi, who asked
not to use his real name, remain desperate to start work.
`A lot of the doctors even … said, look, we are even willing to
volunteer our services and that`s gone to deaf ears too.`
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