In this post I’ll be addressing how the medical education and hospital structure differs here in South Africa as compared to the US. Like many other countries, SA students enter medical school immediately following high school. They complete 6 years of university, with the last two in clinical training (akin to our 3rd and 4th year clerkships). After graduation they complete two years of “internship” which are similar to our year of internship. Internship is followed by a year of community service, in which the doctors are required to spend a year serving the community wherever they are placed. After this, they doctors are now called “medical officers” and can practice independently. Some choose to then become “Registrars,” which from my understanding is similar to a resident in the US. Fellowships can also be completed if one wants to become a specialist or “consultant,” as they are known here. Physicians in the “medical officer” stage of their career are trained in general medicine and basic surgery, which could include cesarean sections or appendectomies if necessary. In the hospital, students see patients and report to the intern or registrar, who reports to the medical specialist or consultant. Students and interns here perform many of the tasks and procedures that would normally be completed by nurses in the US. My colleagues are all competent at drawing blood, starting IVs, taking ECGs, etc. Nurses here are known as “nursing sisters” or just “sister,” but apparently this has nothing to do with the religious version of sisters.
The medicine practiced here is much more “clinical medicine” than is seen typically in the states. The physicians here give us flack, probably deserved, for relying on CT scans and other technology to make our diagnoses. They discuss a lot of clinical signs that I’ve never heard of. That’s ok, though, I’m sure I’ll learn something! If you want a CT scan here, the patient must be transferred to another facility. Strokes are diagnosed based on clinical presentation alone. I really need to brush up on my neurology! There also doesn’t seem to be such a push for a quick discharge as there is in the US. I’m sure I’ll uncover more differences as I go along.