The untold story about Medical Internship in Uganda

The authors are Kasadha Nasser (L) & Lilian Nuwabaine (R) - Photo/Courtesy

Medical internship is a fundamental part of all medical degrees awarded by different universities all around the world aimed at bridging the gap between classroom theoretical lessons and the real practical life of a profession. Without it, may render such a professional deficient of key skills of clinical practice.

The internship program of medicine, pharmacy, dental surgery, and nursing & midwifery programs in Uganda is embedded in different curricula of respective study programs and embraced by the internship policy of Uganda, giving the government the mandate to coordinate and finance the program in different available facilities at its disposal.  All the incoming interns are forwarded by their respective regulatory councils to the internship committee headed by the Director-General Health services, ministry of health for deployment to different internship centers around the country under the watch of the Permanent secretary-Ministry of Health (MoH)

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As the welfare of the “fortunate” medical interns has continued to worsen over time, including but not limited to poor housing conditions, poor remuneration and unrealistic working conditions, to some other groups of interns it is beyond the above with a lot of profound inequalities including complete blockage to access internship. 

Every human life deserves to land in the hands of properly mentored professionals for better health outcomes. This is just in line with vision 2040 & the internship policy of the inter-ministerial committee which requires all medical graduates to undergo at least one year of internship to argument classroom training with hands-on experience before being fully registered and licensed to practice as health professionals.   

Internship goes beyond money and nice housing but a fully competent team of experienced staff well advanced in line of one’s training. These include specialized Medical officers, Medical clinical officers, dental surgeons, pharmacists, nurses & midwives. These practically groom the incoming professionals before they can practice independently.

On the other hand, the graduates of nursing and midwifery started enrolling for internships some years back but surprisingly, they are experiencing a shortage of specialized nursing and midwifery staff. This is simply because MoH, Public service and health service commission have not started recruiting nurses and midwives trained at master’s level hence leaving graduates nurses and midwives in a dilemma for clinical practice during internship. 

Despite the unfortunate state of the Ugandan health sector today,   there are still other medical graduates who haven’t completely made it to internship.  These are the graduates of Clinical Medicine & Community Health (BCMCH) yet its well prescribed in their accredited Curriculum by National Council for Higher Education & anonymously approved by the Ministry Of Health Top Management and Allied health Professionals Council in a meeting held at ministry health on 12th Feb. 2021 to start the internship.

The medical internship training is provided for in the 1995 constitution of the Republic of Uganda, specifically through article 30 provides that “all persons have rights to education”, Under objective XIV it provides that the state shall endeavor to fulfill the fundamental rights of all Ugandans to social justice and economic development and shall, in particular, ensure that all Ugandans enjoy rights & opportunities and access to education. In ensuring access to education, objective XVIII provides that the state shall take appropriate measures to afford every Ugandan citizen equal opportunity to attain the highest education standard possible.

As we move to embrace the East African community agenda, uniform training should be a priority to ensure free movement of trained medical professionals across the member states.

Clinical medicine and community health is the oldest program in this country referred to by HE The President of Uganda as his “doctors who remain in the country after graduation and treat citizens. However, the course had remained stagnant at diploma level for a very long time with no clear vertical career paths. Neighboring countries like Kenya has advanced in clinical medicine up to Ph.D. level with graduates undergoing mandatory government-sponsored one-year internship. Currently in Uganda, this cadre has progressed from Diploma to Bachelors’, Masters’, and Ph.D. in clinical medicine and community health.

We, therefore, recommend MoH & other stakeholders for the inclusion of graduates of clinical medicine & community health into the national medical internship program. Additionally, we also recommend MoH & the Ministry of public service to recruit specialized nurses & midwives to different internship sites to groom their internees 

Last but not least, we highly recommend for the improvement of the general welfare of medical interns (decent accommodation, attractive remunerations, & decent working conditions) of medical interns in Uganda 

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The authors are; Kasadha Nasser, Chairperson; BCMCH graduate society of Uganda. Tel- +256 703706927 (watsap & telegram) Twitter -@Nasser99kasadha, Kasadhanasser99@gmail.com  & 
Lillian Nuwabaine Luyima( BSc Nurse, MSN-Midwife & women’s Health specialist) & HIHA Midwife of the year 2021


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