This follows the introduction of community service for medical doctors, pharmacists and dentists.

The professions are radiographers, physiotherapists, speech and hearing therapists, occupational therapists, environmental health officers, dieticians, clinical psychologists and professional nurses.

Sibani Mngadi, spokesperson for health minister Dr Manto Tshabalala-Msimang said they were planning to introduce the community service for all the professions, except the professional nurses, by 2003.

He said the professional nurses would be included by 2007. “This is because of the vast number of people involved,” he said.

Dean of the medical school at the University of Cape Town, Professor Nicky Padayachee said the move was long overdue.

“We have been saying for a long time that the focus on doctors should change to a focus on the team. The bedrock of the health service is also no longer the doctor, but the nurse. All you have to do is look at statistics that reflect for example how many people in rural areas die of a preventable condition such as an ear infection,” Padayachee pointed out.He said there were certain factors that needed to be taken care of. There needed to be proper consultation with the community service candidates beforehand and an undertaking to place them in one of the preferred areas they chose.

Padayachee said it was also important not to separate married students, treat disabled students in a humane manner and ensure there was adequate supervision and equipment to train community service professionals.

Professor Max Price, Dean of the medical school at the University of the Witwatersrand said it had always been an unfair situation to single out medical doctors for community service.

“We feel that graduates in general, such as lawyers and engineers, should also participate in community service.”

Price said it was important not to implement community service in a clumsy manner and to ensure that the allocation process was fair.

On the issue of representivity and the perceived high dropout rate at South African medical schools, Padayachee said it was important to note that the rates varied from one institution to another.

He said UCT had extremely low dropout rates. He said most of their dropouts were due to students changing their minds about their career choice.

“We have been very successful in getting black students. In fact our intake last year was 70% black.”

Padayachee said UCT graduated the second largest number of black students last year behind Medunsa.

“We are flexible on our entry criteria, but extremely tough on our exit criteria. Many of our black students from disadvantaged schools perform better than their counterparts from private schools three years into the course.

“I have told a few doctors that most of use would not get into medical school these days, never mind graduate,” he said.

Price said the dropout rate was high because the entry standard had been lowered.

“The dropout rate is higher among the black students, but we are trying to remedy it.” Price said.

He said Government was yet to fund the Academic Development Programme forcing the university to fund the programme by sourcing donor funding.

Both Deans welcomed the move to include more students from the Southern African Development Community. Price said it would, however, mean that there would be less space for local students to study medicine.

Padayachee, however, said UCT would not exclude any local black student in favour of a SADC student.

He said the university had always accommodated SADC students and would continue to do so.

“Many of those countries have no medical schools and UCT is working closely with Botswana, Mauritius and Namibia, assisting them to set up their own medical schools,” Padayachee said.

“The fact is that our development is linked to that of our neighbours.” –
Health-e News Service