Foreign doctors can’t register in SA to help with Covid-19 crisis

Source: City Press, 18/07/2020

But their plight isn’t a new one.
Foreign-trained doctors who spoke to City Press last week say
they’ve long decried the arduous process of registration with the
medical profession regulator.
It’s taken one doctor almost two years to have her application
processed and, even now, she’s still a long way from legally and
fully practising in local hospitals.
Numerous reports have previously detailed not only the foreign
doctors’ difficulties in registering with the HPCSA, but those of
doctors who were born in South Africa, but trained abroad.
In May, the matter reached the courts in an effort to order the
HPCSA to allow 38 of these doctors to write and pass the board
exam, which would qualify them for internships at local hospitals.
What’s made the medics’ plight more urgent has been watching the
toll the pandemic is taking on those hospitals, many of which are
short-staffed and have increasing numbers of Covid-19 patients
filling their wards each day.
City Press understands that many foreign-trained doctors volunteer
at hospitals and work free of charge, pending the completion of
their registration applications, to keep their skills sharp and
gain workplace experience
However, the arrival of 187 Cuban medical specialists brought in
for their primary healthcare expertise â€` at a hefty price tag of
R239 million â€` to help the local response to the virus has
embittered the other foreign-trained doctors, as the Cubans’
registration process took just three to 10 days on average,
effectively bypassing all the red tape others have to negotiate.
This has been explained to be as a result of the bilateral ties
between South Africa and Cuba, dating back to the early 1990s.
According to the HPCSA, there are currently 306 foreign-trained
doctors who’ve applied for registration, but need to write the
board exam before they get it.
Meanwhile, these medics are doing all they can to help combat the
infection crisis, by whatever means.
City Press understands that many foreign-trained doctors volunteer
at hospitals and work free of charge, pending the completion of
their registration applications, to keep their skills sharp and
gain workplace experience.
One doctor living in Johannesburg who’s applied for HPCSA
registration says: “I started the process of registering with the
HPCSA in 2018, after having graduated and qualified in Germany and
worked at three university hospitals there.
`It’s been a very expensive and bumpy road trying to register here
â€` I’ve easily spent €4 000 [R70 000] having all my documents
including qualifications, affidavits and certificates of good
standing translated and vetted via Epic [a global translation
company] and sent to the HPCSA. Many doctors get frustrated and
simply give up because it’s such a challenging process.”
Currently, the HPCSA requires doctors with foreign qualifications
to use the US-based Educational Commission for Foreign Medical
Graduates’ Electronic Portfolio of International Credentials
Services to have their medical credentials verified.
The agency uploads their documents, which are then cross-confirmed
by the graduating university and the feedback is given to the
HPCSA.
“All documents need to be translated and uploaded to that
platform, which is quite expensive â€` about $80 to $100 [R1 330 to
R1 600] per document.
`They send an email to your university. The university then
contacts you and also wants money to verify that it’s really you.
They send their feedback to Epic and then a report is sent to the
HPCSA. You pay for that report too.
`The process usually takes one year to 18 months. That’s how long
it took me,” says the doctor.
“There are many documents that are wanted and what’s frustrating
is that some of them are only valid for about three months. By the
time you get all of them together, you’ll find some are no longer
valid. I think I had to renew my certificate of good standing
three times â€` and each time it cost me R2 000.”
In an article in the May edition of the SA Medical Journal by
Jehane Michael le Grange, Sean James Dickenson and Jacques Robert
Jeppe Davis (all of whom are international medical graduates
themselves), the results were published of an online survey that
yielded 644 responses showing that there were 458 foreign-trained
doctors in the country.
These doctors are either unemployed or working in non-medical
roles â€` and almost all of them are keen to help overburdened,
exhausted hospital staff cope during the Covid-19 outbreak.
But it’s not that simple.
City Press understands that at least 120 foreign-trained doctors
wrote the first round of board exams for this year in January.
According to HPCSA spokesperson Priscilla Sekhonyana, of the 120
candidates, only 74 passed.
“Subsequent board exams were suspended because of Covid-19, as the
HPCSA couldn’t guarantee that candidates wouldn’t be exposed to
risk of infection. However, the board is currently exploring the
safest way possible to hold exams during the pandemic and
lockdown,” she says.
While other countries such as the UK reportedly provided temporary
registration to 11 800 doctors in March to improve its capacity
for the Covid-19 response, and the US’s Harvard University also
contemplated the early graduation of medical students to add to
the health worker force, the SA Medical Association’s chairperson,
Dr Angelique Coetzee, says South Africa currently has no plans for
such concessions, despite the surge in infections,
hospitalisations and deaths in several provinces.
She explains that the problem isn’t just bureaucratic or
logistical, but ethical.
The professionals who spoke to City Press said they wanted to draw
attention to the issue of registration and the processes required
â€` particularly during the present surge of Covid-19 cases in the
country
“South Africa hasn’t changed any regulations for Covid-19, or
lifted moratoriums in terms of registration processes. The problem
is that many of these people aren’t truthful and say they’re
qualified when they aren’t, so they need to follow the guidelines
for registering,” she says.
Sekhonyana adds that, while she didn’t know the exact costs
prospective foreign-trained doctors incurred during the
application and registration process, she acknowledged that these
might indeed be high.
“However, it’s necessary to ensure that practitioners who are
finally registered are competent to serve South Africans
effectively and safely. The HPCSA has a legislative duty to
protect the public and no cost is too high to ensure proper
verification,” she says.
Regarding the Cuban specialists, Sekhonyana confirms that these
doctors were registered on the basis of the two governments’
agreement, which was based on earlier assessments that found Cuban
medical training to be equivalent to that offered by South African
universities.
The professionals who spoke to City Press last week said they
wanted to draw attention to the issue of registration and the
processes required â€` particularly during the present surge of
Covid-19 cases in the country.
The doctor who qualified in Germany said: “We always knew we’d
have to undergo a process for registration, but now â€` during the
pandemic â€` they’re still not allowing doctors in South Africa to
help and contribute. Yet we hear the president saying that the
country’s short of medical professionals.”