Department of Gastroenterology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
World J Gastroenterol. 2010 Feb 28;16(8):948-52. doi: 10.3748/wjg.v16.i8.948.
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.
在南非，护士和医生大量移民。工作满意度、安全性和确保职业发展对于留住医生在南非共和国（RSA）从事职业至关重要。由于预算限制，许多医院没有升级。海外培训后回国似乎很困难。在 RSA，一名年轻的专科医生需要至少 13 年才能注册，而专科医生则需要 15 年。职业发展、在公立和私立医院培养更多的专科培训生，并缩短专业培训期是解决问题的潜在方法。拥有超过 10 亿人口的印度也在努力应对类似的问题。在过去的 10-15 年中，私立医院一直在协助医疗专家和专科医生职业的人力发展。目前，他们的私营部门培训了 60%的认可（亚）专科研究员。应该在 RSA 成立一个专门的专家培训国家工作队。它应该根据当前的状况和预计的专家和专科人员需求，讨论未来的培训需求结构和后勤保障。这在包括胃肠病学在内的所有专科都需要进行，就像在印度所做的那样。希望因此，像印度那样训练有素的医生可能会搬到农村地区的省级医院，提高医疗服务水平，并保持南非的医疗力量。南非应该成为撒哈拉以南非洲的典范，就像印度已经成为东南亚的典范一样。
