Evaluating perspectives and attitudes towards the South African medical internship programme

Résumé

South Africa’s healthcare system faces a quadruple burden of disease and marked social inequalities, necessitating an increased number of well-trained medical personnel. The internship period, a two-year programme where junior doctors transition from medical school to professional practice, is central to this. However, limited data exist on its effectiveness and suitability. Methods This survey-based study explored the expectations and perceptions of the South African internship programme among stakeholders in the Western Cape province.Results A total of 82 individuals responded, including 63 medical interns and 19 independent doctors and specialists (intern curators and heads of department). The majority of interns expected to gain procedural skills (n=57, 90%), diagnostic skills (n=56, 89%), and meaningful interaction with senior colleagues to enhance learning (n=53, 84%). Most interns felt their rotations prepared them for independent practice: family medicine (96%), anaesthesia (94%), psychiatry and mental health (86%), internal medicine (81%), paediatrics (76%), and obstetrics and gynaecology (71%). Only 38% felt surgery prepared them adequately. Respondents highlighted that shortening this rotation would further compromise readiness for independent practice.Regarding internship length, 68% believed reducing the current two-year programme to one year would be harmful, while 9% perceived no harm and 13% were unsure. If shortened, 83% expected less clinical exposure and 75% anticipated reduced teaching time. A 24-month programme was consistently viewed as offering greater benefit for skills acquisition than any shorter alternative.Conclusion The South African internship programme is largely regarded by interns and supervisors as effective in preparing junior doctors for independent practice. However, the surgery rotation is widely seen as insufficient. Acquisition of procedural and diagnostic skills remains a key priority and should continue to guide programme design. Most stakeholders favour maintaining the two-year structure, as it provides more substantial clinical exposure and training benefits than a shortened internship.

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