Older-doctor

South Africa’s ageing medical specialists

It is well known that South Africa doesn’t have enough doctors. What is less known is that the medical specialists are ageing within their field of speciality. Through internal analysis, based on Medpages data, we’ve highlighted the top 10 specialities with the highest percentage of medical specialists over the age of 60 – i.e. those possibly nearing retirement.

The graph shows that cardiologists are the most heavily represented, with 40% (or four in every ten) of all cardiologist specialists over the age of 60. They are followed by gastroenterologists, pulmonologists, ENT specialists and vascular surgeons.


Data source: Medpages.

Possible reasons for shortages of medical specialists

Restrictions on employing foreign doctors
Current healthcare policy minimises the opportunities for foreign doctors to become involved in South Africa’s healthcare sector. Poor administrative processes serve as a further limitation.

Not enough specialists being trained
South Africa’s limited capacity to train doctors prevents doctor supply from meeting demand. The Health Professions Council of South Africa decides whichacademic units should be trained each year. The limited number of specialists being trained does not meet the country’s current requirements. This is acute in several sub-specialist disciplines.

• No accreditation for private medical colleges
The private sector is prohibited from training doctors, except for a maximum of three months of clinical training at a private hospital at undergraduate level. Medical doctors can thus only be trained at South Africa’s eight public universities that offer degrees in medicine. Students receive their clinical training at academic hospitals affiliated with these universities. The lack of accreditation for private medical colleges places the full training burden on the public sector.

• They are emigrating
South African doctors work in a globally competitive market, and are highly regarded in other countries. In 2004, figures by the OECD 23 showed that New Zealand, Canada, Australia, the United Kingdom and the United States were the countries that attracted the most South African-­born doctors.

Conclusion

A very high proportion of medical specialists in South Africa are over 60 years of age, particularly cardiologists, gastroenterologists, pulmonologists, ENT specialists and vascular surgeons. This means there will probably be a shortage of specialists over the next 10 years as those currently working begin to retire. There is clear need for policies to reverse this trend, particularly in the field of training and the easing of restrictions on the employment of foreign specialists.

References:
Struwig, M., Dalmeyer, P. and Kruger, T. (2016) How to solve South Africa’s shortage of highly specialised doctors. Available at: http://www.timeslive.co.za/local/2016/02/05/How-to-solve-South-Africas-shortage-of-highly-specialised-doctorss

Exconex. (2015). Identifying the determinants of and solutions to the shortage of doctors in South Africa: Is there a role for the private sector in medical education? Retrieved from: http://econex.co.za/wp-content/uploads/2015/08/ECONEX_Doctor-shortage-and-training_FINAL1.pdf

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