Department of Medicine mirrors South Africa

Lack of funding for specialist training posts is turning the Department of Medicine at UCT and Groote Schuur Hospital into a "wasted plant", operating at only a quarter of its capacity to train much-needed medical specialists and sub-specialists, according to Professor Bongani Mayosi, head of the department.

Ahead of the 90th anniversary celebrations of his department in February, Mayosi said the department has the capacity to double the training of specialists and quadruple the training of sub-specialists, but the lack of funding for registrars and senior registrars is stymying its efforts.

"Take the area of nephrology (kidney diseases) as a case in point," he explained.

"We have four full-time nephrologists, but we are only funded to train one sub-specialist in that field. The four nephrologists are not even reproducing themselves. It takes two years to train a sub-specialist in nephrology, so it takes eight years before they can produce something that is of replacement value to them. That is really a waste of a plant."

Mayosi said the country needs more doctors, more specialists, and "we can achieve the doubling of production of medical specialists and sub-specialists within two to four years".

A call has been made by the national Department of Health to double the number of doctors produced in South Africa by 2014, but that decision must be backed up by appropriate funding, Mayosi said.

For the training of undergraduate doctors, however, the department is operating at 100% capacity, and needs to increase staff and physical facilities to provide the capacity to train more undergraduates.

Having been at the helm of the department for four years, Mayosi said there has been measurable evidence of progress, though it is still early days.

"There has been an increase in the number of full-time research specialists (which should translate to an increase of clinical PhD students), there has been an increase in the number of research papers produced, and the National Research Foundation-rated scientists have doubled in number."

But the real achievement has been the way the department has been working as a united force, and as a growing organisation that seeks to meet the needs of the country.

Turning to the history of the department, Mayosi said the department has moved from training white males almost exclusively when it was established, to "a home for all" that celebrates the new South African ideal.

"This department mirrors the history of South Africa."

For stalwart Emeritus Professor Solly Benatar, former head of the Department of Medicine (1980-1999), a highlight has been re-growing and sustaining the department in the early 1980s after the exodus of staff in the mid-1970s following the Soweto riots. "Several cohorts of fine physicians were trained who have gone on to be prominent clinicians and academic leaders locally and internationally."

Benatar sees the department playing a central role in all aspects of healthcare, medical education and research in the future.