Medical graduates protest to demand internship placement

When medical officers protested in Nakuru City on January 15, 2024. [Kipsang Joseph, Standard]

Medical graduates protested outside Afya House, Nairobi, on Monday, over delays in internship placement.

The medical graduates including dentists, pharmacists, physicians donning white medical coats and protective hairnets marched in solidarity to protest the delay in their postings for compulsory professional training and licensing by the Ministry of Health.

Association of Medical Students of the University of Nairobi (AMSUN) chairman, Muinde Nthusi, said the graduates had completed their rigorous medical training but are yet to be placed for internship.

"As recent graduates of Medical schools in Kenya, we wish to draw attention to the systemic delays in the posting of medical, pharmacy, and dental interns by the Ministry of Health," Nthusi said.

He said the guidelines for internship posting require that medical students get placement a month after completing their studies.

“We have been waiting for more than eight months to get posted, this entire process should have been done months ago. That is why we decided to protest,” said Nthusi.

The procedure for posting interns is detailed in the National Guidelines for Internship Training of Medical and Dental Officer Interns (2019).

“Interns shall be posted within a month upon successful completion of their training and passing of the final examination, graduation notwithstanding; or passing of Council’s Internship Qualifying Exams,” the guidelines read in part.

Medical graduates said they completed their studies and licensing exams months ago but are yet to receive internship placements from the government.

“Internship is the minimum requirement for a healthcare practitioner to be licensed, without a license one cannot practice anywhere. Without the internship, we are left in some sort of a limbo with nowhere to go, apart from doing petty locums where we get paid peanuts,” said Walter Oluoch, a medical student, who is due to graduate in April.

The demonstration was organized by the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) in response to growing concerns from medical graduates.

Despite being cleared for deployment by the Medical Practitioners and Dentists Council and Pharmacy and Poisons Board, the graduates say their career progression has stalled.

In December 2022, there was a standoff between graduate doctors and the national and county governments over internship placement.

Health Cabinet Secretary Susan Nakhumicha directed that medical interns be posted in batches starting in January 2023.

Now in February 2024, a similar standoff is happening with graduate doctors seeking internships.

In a letter addressed to the Ministry of Health on January 12, KMPDU expressed disappointment and highlighted the violation of sections of the Collective Bargaining Agreement (CBA).

According to the CBA, the KMPDC and PPB should clear all medical officers, pharmacists, and dentists for posting to internship centres within 30 days.

"The timely posting of interns is not only a contractual obligation of the ministry but also a crucial (aspect) of the effective function of our healthcare system. The delayed deployment of these healthcare professionals hampers their licensing as doctors as well as the delivery of essential medical services to the public," KMPDU said in the letter.

The letter warned of the union's intention to take appropriate measures if the ministry fails to address the issue promptly, in line with its commitment to protect the rights of its members and the public.

The KMPDU also highlighted the impact of the delays on the Universal Health Coverage (UHC) agenda and a January 4, 2023 agreement by the Ministry of Health, Council of Governors (CoG), and KMPDU on the timely posting of medical interns.

"We believe that prompt action on your part will not only fulfill the terms of the existing CBA but also contribute to the fulfillment of the Kenya Kwanza UHC agenda as well as the MOH/COG/KMPDU agreement," the letter stated.

According to a letter from the Ministry of Health, State Department for Medical Services, a meeting was held between representatives of doctors awaiting internships and the Ministry of Health.

The meeting agreed on several issues regarding the posting of medical interns, among them, internship postings for 2023/2024 Financial Year:

The Ministry of Health has posted 4,129 medical interns for the 2023/2024 financial year, covering the period ending June 30, 2024.

Postings for the 2024/2025 financial year will begin on July 1, 2024, upon completion of the current 2023/2024 financial year interns.

The Ministry of Health agreed to post all 3,759 graduate doctors seeking internships in the 2024/2025 financial year, based on lists submitted by various medical professional regulatory boards.

Total 2024/2025 projected Internship posts: 849 medical officer Interns, 72 dentist officer Interns, 289 pharmacist Interns, 1,134 nursing Interns, 145 Bachelor of Science in Clinical Medicine, 1,270 Diploma in Clinical Medicine.

To address challenges with the internship programme, the Ministry of Health also agreed to fast-track the proposed National Internship Policy that is currently under governmental review.

KMPDU urged the Ministry of Health to address the posting delays so the qualified graduates can start their supervised internships at public hospitals and clinics.

The union warned that the uncertainty and waiting idled too long could trigger brain drain.