South Africa, Cape Town – Medical students are willing to pay up to R100 000 for internships at preferred hospitals across the country. This happens between medical students and has been taking place on Facebook and messaging apps such as Telegram.
The Western Cape, Gauteng, and KwaZulu-Natal are among the most coveted spots for final-year medical students to fulfil a two-year internship followed by a year of community service before they can become fully-fledged doctors.
Some students offered financial incentives of thousands of rands to swap hospital posts with other students while some attempted to auction placements to pay off student loans.
Medical students could land positions in hospitals found in rural areas or major cities. On Facebook, a group called “Swapping Out: Medical Internship and Commserve in SA” has about 4 800 members and as many as 1 800 in the Junior Doctors Association of South Africa (Judasa) 2021 Internship Cycle group on app Telegram.
This is where the horse-trading takes place. This week, screenshots of medical interns in the groups offering to sell their allocations were posted on social media.
In the Judasa group on Telegram, one student, whose messages have since been deleted, posted a message on behalf of a friend who offered R100 000 for someone to take her spot in Bloemfontein in exchange for a place in Potchefstroom or Gauteng.
The message read: “First come first serve. Her parents are lawyers and everything will be done above board and a formal contract will be set. The money will be transferred and reflect on the same day. Cash can be arranged if you prefer.”
Another student, also in the Judasa group, began the bidding for her Potchefstroom placement at R40 000. “Any hospitals welcome as I’m using this initiative to help pay student loans. Bidding will remain private for protection.”
One student placed at Frere Hospital offered to swop his spot for any other hospital and sweetened the offer with an R80 000 purse.
One intern doctor looking for community service placement made it clear she didn’t have money but was willing to offer an UberEats meal or pay for dinner at a restaurant as a token of appreciation.
Numerous interns confirmed this was an ongoing practice among medical school students and interns at hospitals. One intern said they had been aware of it during their six years of studying and at one point considered it to secure an allocation.
Dr. Akhtar Hussain, Public Sector Chair of the South African Medical Association (Sama), said the payments were unethical and unacceptable. “We don’t support that and it needs to be investigated,” he said. “We need to go in deeper, this is corruption.”
Hussain said he had heard of the practice. “They have their own groups,” he explained. “If somebody wants to go to Gauteng, Pretoria to Cape Town, or one wants to go to Durban. These are mutual transfers to their places of choice. As far as money being involved, I have heard these kinds of rumours, but nobody has come forward and said ‘I paid for this transfer’.”
Dr. Kerrin Begg, Deputy Dean of Undergraduate Affairs at UCT’s Faculty of Health Sciences said: “I can understand that students are still feeling extremely stressed, but certainly we would not condone payment or any that for positions. It’s contrary to everything we would advocate.”
Tiyara Arumugam is hoping for a community service placement in her home province KwaZulu-Natal. She interned at Pietermaritzburg Hospital Complex which provides primary, secondary, and tertiary healthcare services and is comprised of Northdale hospital, Edendale hospital, and Grey’s hospital.
“I need my community service placement or it would be like the last few years didn’t matter. I won’t be allowed to further my career and be able to practise medicine without my community service but we have to be placed, the Department of Health cannot just forget about us. I need this swap and have to stay in KZN,” she said.
Arumugam said she had attempted to do a three-way swap but has not had much luck.
“If you’ve found someone whose got a placement you want, but who doesn’t want to move to yours, it’s possible to arrange the swap if you can find someone to complete the loop and you’ll end up doing a three-way swap. Swaps are possible so long as you close the loop.”