It’s one of those things I like to take stock of every now and then. If I was in grade 12 right now - having to decide with a degree of foresight - whether to study medicine, would I do it? And while there are a number of things that contribute to your decision (some softer feel good reasons and others more pragmatic), ultimately you’ve got to ask whether there’s actually work for you to do at the end of what you’re studying.
The question we’re answering is narrow and practical: will I be placed for internship, will I be placed for community service, and will there be a medical officer post at the end of it?
The short answer is yes, yes, and probably not.
Internship: yes.
This is about as close to guaranteed as anything in the system gets. Every graduate of the most recent cohort was placed — 2,197 of them — and the year before ran at a similar number. Internship placement is a statutory requirement handled through a national allocation process, and it does its job. What it does not promise is where. The allocation runs on an algorithm against your ranked choices, and while the department reports that roughly nine in ten applicants get one of their top five, that leaves a real minority who do not, and in one recent cycle a single medical school reported more than a hundred final-years missing their top five while surplus posts apparently existed elsewhere.
So: you will be placed, and you may well be placed somewhere you did not choose, in a province you have never lived in.
Community service: yes, with a caveat.
Also statutory, also allocated centrally, also delivered. The most recent midyear round placed everyone eligible. The caveat is that the shortfalls are real but small - one recent annual cycle opened with about two hundred fewer posts than people, which provinces closed by converting existing posts, roughly in time. Seventy-seven people declined their placements, mostly because they were rural. This is certainly not as well or as easily managed as the internship places and the government often manages to ‘officially’ place everyone on a technicality rather than in the true sense of everyone having a post.
A medical officer post afterwards: no, for most people, not straight away.
Here is where the dynamic changes. Of the 1,891 doctors who finished community service in December, 411 had work by the end of January. That is roughly one in five. The budget had funded eight hundred posts against something like eighteen hundred people looking, so slightly under half the need, and even that assumes the funded posts actually get filled, which historically has not been the case - one earlier round of eight hundred funded posts produced 270 appointments.
Sure, the January snapshot is not a final outcome. But it is not merely a lag, either: the union’s survey of unemployed doctors tallied 1,260 respondents, some of whom had been out of work for more than two years. The best figure I could find for an earlier cohort suggests around sixty per cent eventually landed a funded post, which means something like four in ten did not, and this is a bit of napkin maths because it is not in the Department of Health’s interest for them to honestly declare or clearly articulate the full stats.
If you assume the reason is money, you’d mostly be right. Treasury gave health a real increase of well under one percent in the last budget, provinces have been absorbing cuts for four years, and there are something like two thousand vacant medical officer posts nationally.
And this is the part I don’t think lands properly when people talk about unemployed doctors, because it sounds like a jobs story and it isn’t only that.
Finishing community service doesn’t mean you’ve finished training. If you want to specialise - and a lot of people going into medicine do - the road is medical officer post, then registrar post, then consultant. Both of those first two rungs are state posts.
There is no private version of registrar training; you cannot go and specialise at a private hospital on your own money. The state owns the only door.
So a missing medical officer post isn’t a gap year. It’s the specialist track closing. And the obvious fallback - go into private practice as a GP and wait it out - isn’t a holding pattern either. It’s a different career, and the time you spend there isn’t accruing the state-side experience a registrar application is looking for.
The bigger picture - it is a specialist who does not exist four years later. The Colleges of Medicine broke their usual silence in February to say exactly that, which is not a thing professional bodies do casually.
Which brings me to the candid message I’d give an eighteen-year-old. Matric, six years of MBChB, two of internship, one of community service: you only find out whether there is a post for you about nine years after you commit. The first two placements are near-certain because they are statutory and algorithmic, and those you can more or less bank on. The third depends on an annual budget decision and a provincial hiring authorisation, and while I can’t predict what either of those looks like in 2035, the trend is not favourable.
Reflexively I want to say “don’t study medicine.” But a more nuanced take is that you are signing up for nine years of near-guaranteed training followed by an entry into a market where specialisation is gated by state posts the government does not consider itself obliged to provide - or in the health minister’s words “there is nothing like absorption” after community service.
Plan for the ninth year now. Not when you get to the ninth year.