Tag Archives: brain drain

Fewer South African doctors graduate

The number of doctors graduating from South African universities has dropped in recent years, despite a pressing need for more medical practitioners. A more than 6% decline in medical graduates between 2004 and 2008 – from 1,394 to 1,306 – has been blamed on lack of funds, staff shortages and poor facilities.

Another major problem is the control provincial governments have over medical schools, and deans are lobbying for the central government to play a more active role. A meeting is scheduled for 9 April in Durban where medical deans from across the country will air their grievances and follow up on issues raised at a similar meeting that took place last year.

The institutions with the biggest declines in graduates were the University of Limpopo, from 238 in 2004 to 150 in 2008, the University of the Free State from 167 to 109, and Walter Sisulu University from 119 to 103.

“It’s a bit of a circus at the moment,” said Professor Pieter Nel, programme director of health science at the University of the Free State medical school.

Nel told University World News the university generally had around 100 medical graduates a year. But in 2004, the number was much higher because of a cross-over of graduates after the school changed its programme from six to five years in 1999.

Still, the number is low, which Nel said was because of the poor state of health services in the Free State. Hospital wards and theatres had closed and training staff were in short supply. In 1999, there were around 2,000 hospital beds in the province, now there were fewer than 500.

“It’s chaotic,” he said. “The facilities they offer are terrible.”

The universities of the Free State, Limpopo and Walter Sisulu are all in provinces with acute shortages of doctors. The number of vacancies for doctors grew by 4% from 2008 to 2009 in the five provinces where comparative data were available: from 4,376 to 4,557 – with 1,815 of those vacancies in Limpopo.

“There’s been no forward thinking,” said Mike Waters, opposition Democratic Alliance’s shadow minister of health. Waters made the graduate numbers public after receiving a reply to a parliamentary question.

“The government hasn’t been actively engaging with universities to encourage them to increase the intake. So we wait for a crisis to happen,” he told University World News.

The government has proposed a three-scenario plan, from low-growth to high-growth, which involves increasing new intakes of medical students by 3% to 6% at some or all of the eight universities that offer the degree.

The low-growth plan would see an increase in graduates of only 175 (14%) from 2008 to 2020, while the high-growth scenario would achieve an increase of 800 graduates (63%).

Waters said even the projected high-growth scenario increase would be inadequate for South Africa’s needs and did not take the capacity problems at some medical schools into account.

Nel agreed. “We can’t do it with the current facilities and staff,” he said.

The Ministry of Higher Education and Training admits in its proposal that the challenges are great. Costs of employing additional academics and expanding classroom space will be high, and the increase in clinical training will burden already struggling provincial hospitals.

Waters said the private sector was ready to step in to help, and had offered to train doctors and provide the technology and infrastructure so sorely needed. But this possibility was not mentioned in the government’s three-scenario plan.

Some universities are faring better than others. The University of KwaZulu-Natal had the biggest jump in doctors qualifying, from 178 in 2004 to 224 in 2008, and the University of Pretoria increased from 180 to 200.

Some universities, such as KwaZulu-Natal, have maintained consistently high success rates despite similar funding problems and educational handicaps.

“Like other universities, 50% of our intake is from previously disadvantaged backgrounds,” said Professor A Willem Sturm, Dean of the Nelson R Mandela School of Medicine. “We try to compensate for their lack of foundation as best we can.”

But the problem goes beyond higher education. Fully 17% of doctors leave South Africa once they qualify and the reasons are diverse: the poor state of the nation’s healthcare system, the soaring crime rate – and vastly more lucrative job opportunities abroad.

Taken together, the decline in doctor graduation numbers and the brain drain points to a growing health crisis.

Source: universityworldnews.com,


Skills migration and the brain drain in South Africa

The loss of our highly skilled citizens to other countries through emigration has been a cause for concern in South Africa for many years. Contrary to popular perception, the brain drain in South Africa started long before the inception of the new government in 1994, and the figures suggest that the flow of professionals from this country continues to increase rapidly. At the same time, the number of highly skilled immigrants into South Africa ? a critical source for the replacement of skills lost through the brain drain ? is on the decrease.

Intuitively, a brain drain has a range of deleterious effects on a country’s economy. Amongst these are an adverse effect on economic growth and a reduction in a nation?s capacity to develop as a ‘knowledge society’ and therefore compete effectively in the global economy. A brain drain also constitutes a major loss of investment in terms of the education and training of its highly skilled professionals.

The fact of the matter, however, is that we do not have reliable data on the actual extent of emigration from South Africa. The figures reported in the annual migration reports produced by Statistics South Africa have been shown to represent a significant undercount of skilled emigration. Notwithstanding the current problems with the data, which are estimated to represent about only one third of real emigration, the official statistics do indicate some worrying trends.

For instance, over the past thirty years, the vast majority of skilled emigrants have been in the most productive age groups ? 25 to 45 years ? which means that the brain drain largely comprises South Africans who are already trained and established professionals. There has also been a steady increase in the number of professional women leaving South Africa, from about a quarter of all skilled emigrants in the 1970s, to just less than half in the 1990s. No doubt, this trend reflects the changing gender profile in the domestic labour market. The official statistics on emigration from South Africa do not provide a breakdown for the different ethnic groups in South Africa, but a recent survey indicates that white professionals are only slightly more likely to consider emigrating than are black professionals.

Of course, one of the critical questions in terms of the human resource base in South Africa is exactly which skills are we losing? The official statistics indicate that the greatest mobility of highly skilled people, both into and out of South Africa over the past decade or so, was amongst those in education and humanities occupations, followed by engineers and architects, and our top executive and managerial personnel. Emigration amongst those within the natural sciences and medical professions is also on the increase, while there has been a dramatic decline in the number of skilled immigrants in these occupational fields.

Perhaps not surprisingly, skilled South Africans who choose to emigrate head for some of the most advanced industrialised countries in the world ? the United Kingdom, the United States and Canada, and more recently, to Australia and New Zealand.

What makes skilled South Africans emigrate? During the apartheid era, political upheavals ? the Soweto uprising in 1976 and the States of Emergency in the late 1980s ? were a major driving force behind the exodus of professionals. More recently, however, research shows that the highly skilled are leaving because of crime, perceptions of a high cost of living and levels of taxation, and the perceived decline in the standard of public services, notably health and education delivery. At the same time, professionals in South Africa are eager to take advantage of the attractive salary packages and career opportunities in the advanced industrialised countries of the world.

In a way, these motivating factors are common sense. What they do not take into account, however, is the increasingly pervasive influence of globalisation on skills migration around the world. In essence, the global village offers an open market for employment and career opportunities to the highly skilled and, in recent times, the term ?brain circulation? has been used to capture the increasing flow of professionals around the world. In fact, the ability of countries like the United States to attract and retain large numbers of highly skilled migrants in the globalised labour market has contributed significantly to these countries? advancement.

The biggest challenges to the South African government are to find ways of keeping skilled South Africans at home ? although this requires a long-term approach to the improvement of safety and security and improved delivery of services ? and to develop policy which attracts the highly skilled from other parts of the world to our shores.

Source: hsrc.ac.za, mediaclubsouthafrica.com