Review
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World J Gastroenterol. Feb 28, 2010; 16(8): 948-952
Published online Feb 28, 2010. doi: 10.3748/wjg.v16.i8.948
Gastroenterology training in private hospitals: India vs South Africa
Chris Jacob Johan Mulder, Amarender Singh Puri, Duvvur Nageshwar Reddy
Chris Jacob Johan Mulder, Department of Gastroenterology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
Amarender Singh Puri, Department of Gastroenterology, GB Pant Hospital, New Delhi 110002, India
Duvvur Nageshwar Reddy, Asian Institute of Gastroenterology, Hyderabad 500082, India
Author contributions: Mulder CJJ wrote the paper; Puri AS and Reddy DN contributed data and helped to design the paper.
Correspondence to: Chris Jacob Johan Mulder, MD, PhD, Professor, Department of Gastroenterology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. cjmulder@vumc.nl
Telephone: +31-20-4440613 Fax: +31-20-4440554
Received: July 20, 2009
Revised: August 26, 2009
Accepted: September 2, 2009
Published online: February 28, 2010
Abstract

In South Africa, nurses and doctors are emigrating in significant numbers. Job satisfaction, safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression, creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India, which has a population of more than 1 billion people, is struggling with similar problems. For the past 10-15 years, private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss, based on the current status and projected specialist and subspecialist personnel requirements, the future structure and logistics of training needs. This is required in all subspecialities including gastroenterology, as has been done in India. It is hoped that as a consequence well-trained doctors, similar to those in India, might move to provincial hospitals in rural areas, upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa, as India already is for South-East Asia.

Keywords: Brain drain; Gastroenterology; India; Manpower; Private hospitals; Specialist training; Subspecialties; Teaching hospitals