In Uganda, it has become commonplace for medical interns to stage protests, which often result in arrests and detentions, particularly when their internship period approaches.
These demonstrations stem from delays and irregularities in the deployment process, prompting interns to call for government action. The persistent nature of these protests raises concerns about whether a permanent solution to this issue will ever be found.
Medical interns, including doctors, pharmacists, and nurses who have graduated from medical school, are required to complete a one-year placement in a hospital to obtain a permanent practicing license. However, this process is often marred by prolonged waiting periods and, in some cases, lack of deployment, leaving the future of many interns in limbo.
This year, protests erupted once again due to issues with intern deployment. Out of over 2,000 interns, only 1,263 were successfully placed, while the remainder faced uncertainty. Additionally, 12 doctors from the initially deployed group were recalled by the ministry of Health, as indicated in a letter from the director of Health Service, further reducing the number of deployed interns and fueling the protests.
Deputy Speaker of Parliament Thomas Tayebwa has voiced concerns about the numerous complaints from medical students seeking parliamentary intervention. He highlighted the students’ frustration and questioned why they must wait for an extended period after graduation while their peers have already been assigned to hospitals.
“I have received several complaints from medical intern students. Many have bombarded my social media accounts. We are all aware of these issues as some of you support these students or have people from your areas affected. They face numerous challenges,” Tayebwa said.
He emphasized the urgent need to address the deployment issue, noting that the current situation damages the government’s image. In a policy statement dated August 2, 2024, Minister of Health Dr Ruth Aceng revealed that the government currently lacks the financial and technical capacity to deploy the 2024 cohort of medical interns.
With a budget of Shs 35 billion for the 2024/25 fiscal year, the ministry of Health can only support the deployment of 1,500 interns. Dr Aceng noted that there are 2,076 interns and 743 postgraduate medical doctors eligible for deployment. She explained that it costs Shs 1.3 million per month, or Shs 15.6 million annually, to deploy one intern. As a result, the available funds will only cover 1,500 interns.
“Against this background, the Ministry can only deploy the Cohort of 2023 and the previous year’s totaling 1,435 medical interns,” Aceng said.
She added that the remaining 65 positions will be allocated to 22 Dental Surgeons and 43 government-sponsored Pharmacists from the 2024 cohort, as these professionals are in short supply. The ministry’s response raises concerns about whether additional accredited internship facilities will be available to accommodate the 2024 and 2025 cohorts without provoking further protests.
Wilson Bahinga, one of the medical interns, highlighted that the continued under-deployment is due to a backlog caused by a combination of insufficient budget allocations and the increasing number of graduates from both public and private medical schools.
“Private universities have multiple intakes, resulting in a higher number of graduates seeking internship placements, which creates a situation where the Ministry of Health cannot accommodate all qualified interns due to budget constraints, which is almost Shs 18 billion short of what is needed,” he said.
Bahinga noted that despite the ministry’s awareness of annual graduation numbers, it has not adequately planned for the necessary resources to deploy all interns. This has led to a recurring cycle of backlog each year.
“We are always left in a limbo state because you can’t work anywhere without a medical license, and yet the minimum requirement to get it is through internship. Does the government want us to sell groundnuts after graduating?” he asked.
Bahinga emphasized that the lack of deployment affects their professional growth and compromises the healthcare system, as there are not enough medical personnel to meet patient needs. He vowed that they will continue with peaceful protests as a means of advocating for their rights and addressing the ongoing issues surrounding their deployment.
Amina Namukabya, a pre-medical intern, stressed the urgent need for the ministry of Health to adopt a more equitable and inclusive approach to deploying medical interns to address the backlog and ensure all qualified graduates can begin their internships.
“I advocate for a systematic review of the selection process that considers the number of graduates from all universities, rather than favoring some as it was this time,” she said.