Pressure: Health Minister Aaron Motsoaledi. Picture: SUPPLIED
Pressure: Health Minister Aaron Motsoaledi. Picture: SUPPLIED

A question mark hangs over the future of SA’s massive programme for training medical students in Cuba, which will see about 700 fifth-year students returning home in July to complete the last leg of their training.

Health Minister Aaron Motsoaledi told Business Day the programme was so large it was a headache for both countries and a decision had been taken in the National Health Council to scale it back temporarily. The programme would lapse for three years to relieve pressure on the system but would not stop entirely, he said.

"The Cuban government is not ... coping with these numbers, the provinces in their budgeting systems did not factor it very well, and it is too much for the South African universities to absorb. It means increasing the final-year medical students by 60% at a go," he said.

SA’s medical schools graduate about 1,800 students a year, says Martin Veller, who chairs the South African Committee of Medical Deans.

Critics have questioned the wisdom of training doctors in a country with a different disease burden at greater cost than home-grown students

The scale of the Cuban-trained students returning in July posed a challenge to medical schools and provincial health departments, he said. A total of 750 students were trained in Cuba since the programme’s inception in the mid-1990s.

Veller said medical schools were concerned about the challenges of integrating such a large number of students at under-graduate level and were worried about the provinces’ capacity to provide the training platform needed for their internships and community service posts.

All of SA’s medical schools are expected to take some of the Cuba trainees.

The minister has promoted the programme as a way to overcome the failure of South African medical schools to produce enough doctors to meet the country’s needs.

Critics have questioned the wisdom of training doctors in a country with a different disease burden at greater cost than home-grown students.

Western Cape health department spokeswoman Marika Champion said 20 Cuban-trained students were destined for the University of Cape Town and another 20 for the University of Stellenbosch in 2018.

Their return would place strain on the province’s doctors and specialists, who would be required to supervise these extra students. But the bigger concern was the cost of absorbing them as interns and community service doctors further down the line, she said.

The minister conceded the programme was more expensive than medical training in SA and said this was one of the factors that counted against it. The Cuban-trained doctors received training that had greater emphasis on preventing disease than SA’s curative-based system.

The programme began in 1996 and for over a decade saw fewer than 100 students depart each year. It was expanded in 2012 when 1,000 students were sent to study in Cuba. At that stage, SA’s eight medical schools were graduating about 1,200 doctors a year and only about 300 Cuban-trained doctors had completed their studies.