EDIT 4 July 2021: Hi! This remains one of the most popular posts on my blog, but please note that it was first written in 2013. While I like to think that my advice here is broadly applicable, things can and do change all the time. Do be sure to have a look around social media and get opinions from current medical students, too. As always, I am happy to help.
I think South Africans have a better grasp of American medical training than they have of training in our own country (thanks, Grey’s Anatomy). This is an attempt to lift that shroud of mystery. (If you already know all that and want a step-by-step guide on the application process, click here.)
Please note that South African medical training is not standardised per se, and that I speak only from my experience and the bits that I have picked up from friends at other schools. There is variation and I cannot be held accountable for any misunderstandings. This post serves as a starting point only: if you are considering medical school, you should do additional research (links below).
What is the South African medical qualification?
Our equivalent of the M.D. is MB.ChB, or Medicinae Baccalaureus, Baccalaureus Chirurgiae (Bachelors of Medicine and Bachelors of Surgery). One South African University (Witwatersrand) styles their degree as MB.BCh, but it is essentially the same.
Can you study medicine straight after school?
Yes! In fact, most South African med students enter medical school straight after high school. Some take gap years and some do a year or more of a Bachelors of Science, either by choice or in order to have a better chance of acceptance.
How many years is the degree?
If you go to medical school straight after high school and pass all your years on the first try, you will study for six years. Only one university (UFS) still offers the five year program. Two others recently returned to the six year program. Many schools also have an Extended Degree Program, where students complete the first year in a two-year period. This is especially useful for students from disadvantaged backgrounds who just need some catching-up time.
Do you need a prior undergraduate degree to apply?
No undergraduate degree (or part of a degree) is necessary.
…But there are prerequisites
To have one’s application considered, one must have Science, Biology (now called Life Sciences) and pure Mathematics (Math Lit is not accepted). A while ago Biology was not required, but I think most schools now require it. The science component in public schools include both physics and chemistry. In addition, all-round high grades are required. Schools like their students to be well-versed in non-academic activities (I’ll write more about this in the future). The National Benchmark Tests must also be written.
What is the format of the training?
Every medical school in South Africa follows a slightly different format. I’ve written about many aspects of my syllabus here. Our first two years of study are overwhelmingly theoretical. We have many classes in basic sciences, statistics, academic writing and some introductory pathology and pharmacology during the first year, in order to bring everyone up to speed. During the second year, body systems are addressed with vengeance, and each comprises anatomy, physiology, pathology, etc.
We also have dissection (using cadavers) and histology practicals. Additionally, first and second years participate in “Intro to Clinical”. This module was pretty weak in my junior years, but it has gone from strength to strength and in my opinion now provides a solid clinical foundation.
What about clinical rotations?
At my school, clinical rotations begin in the third year. We rotate as follows: four weeks theory, four weeks practical, repeat. Third years have five core rotations, namely Obstetrics, Paediatrics, Internal Medicine, General Surgery & Trauma and Family Medicine.
Our “Final Year” begins in the middle of fifth year and extends to graduation and the end of sixth year. We call this “Student Internship”. Theory is over and for those 18 months we simply rotate through practical postings – encountering some new ones such as urology and anaesthesiology (all of these we will have completed as theory blocks in earlier years).
As I have mentioned before, all schools vary a little in this respect.
Is it a good degree?
Absolutely. South African medical schools are known for their excellent hands-on training. We want for a lot resources and research, but our students graduate with an excellent skill-set.
And after medical school?
We graduate as doctors at the end of the sixth year. After this, we have two compulsory years of Internship. This is not the same as the American internship, it is more like the UK housemanship. For these two years, we are expected to work as a qualified doctor – which we are, albeit very junior. You are placed at a public hospital (for which you apply during final year, a little like the matching process). You rotate again through various disciplines, as the most junior doctor on the team, and look after the medical students if you happen to be at a training hospital. To some extent, housemanship is a further training opportunity. For example, we assist in C-sections during medical school, but we only learn how to them solo during housemanship.
The Community Service Year (or “Zuma” year, named for Nkosazana Dlamini-Zuma who was Minister of Health when this began) is another compulsory year, usually taking place during the third year after graduation. Here, you are again placed in a public institution, but often at clinics as one of the only doctors. You are now considered a lot more senior and have many more responsibilities too.
Only after these three years are you allowed to practise privately or consider specialising. A doctor who is specialising is called a “registrar” as opposed to a resident. A specialist is called a consultant. I don’t know too much about the whole process, as it is even more shrouded in mystery!
But basically one can either specialise by doing a Master’s degree through a tertiary institution, or by writing the Royal College exams.
July 2021: Edit to add that I got this completely wrong. Suffice to say that “how to specialise” is a post that still deserves to be written.
What about international opportunities?
It is difficult, but possible for a South African medical graduate to work overseas. Most African and Asian countries will allow it without any further exams. North America generally require you to either write the USMLEs or to be a specialist. In Europe it varies – again, this is something a little too far in the future for me to really know a lot about.
What about non-citizens?
We do have a few non-South Africans studying with us, especially from other African nations. Note that the South African government does not subsidise the studies of non-citizens, and your tuition fees are likely to be considerably more (again, there might be some variation, especially if you are from a neighbouring country). The best approach for a foreign student is to contact the relevant school’s office for international students first. We also get MANY elective students, and you are always welcomed in that capacity too.
These are the links to the medical faculties of the various South African universities. Note that these websites are frequently confusing. It is often better to request a prospectus and application directly from the university’s site for prospective students. Chatting to a current student at an institution is also very useful.
Edit: click here to be taken to a follow-up post on applying to med school in South Africa.