25 years of training doctors at WSU: how - Walter Sisulu University

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as children, and we are the best! And more importantly, thank you for always being ‘your brother’s keeper’ and keep it up! I will do likewise. Last, but most certainly not least, this Lecture is lovingly and emotionally dedicated to my children: Olivia, Walter, Fiona, Timothy, and Clara –for I live only for you guys, and as intimated already, I have FAITH in you carrying that ‘Nshakira torch of Faith’. I also must mention here Ruth and Stella, the mothers my children for the vacuums you individually filled in the respective phases of my life; and for lovingly being part of the propagation of our genes; and Maggie, my source of love, companionship, solace, and all, for the past 5 years. BaCKGROUnD TO MEDICaL TRaInInG In SOUTH aFRICa Prior to the establishment of the Faculty of Medicine and Health Sciences at the then University of Transkei (UNITRA) in 1985, there were seven medical schools in South Africa, five (or 71%) of which catered for the Whites who constituted less than 15% of the country’s population 34 . 10 70 60 50 40 30 20 10 0 Black Coloured Indian White First year Final year South African first and final year medical students by race (1994) (de Vries and Reid, 2003) Indeed, nearly 10 years later in 1994, whites accounted for nearly 50% of first year and more than 60% of final year medical students in the country The said five medical schools were at: University of Cape Town (est. 1900), University of the Witwatersrand (1921), University of Pretoria (1943), Stellenbosch University (1956), and the University of the Free State (1969). University of Natal (1951) catered for Indians, Africans, and a sprinkling of Whites, while the Medical University of Southern Africa (MEDUNSA) (1978) trained mainly Africans and Indians, and had the largest undergraduate enrolment of any medical school in the country. In a summary of the Council Guidelines for the Medical School at UNITRA, Kriel and Coles 35 noted: “It is clear from international experience that medical schools in developed countries do not produce doctors who are equipped with the relevant skills, knowledge and attitudes to deal with the health care problems of …. communities in ….. developing countries. ….. The reasons for this phenomenon have been elucidated by curriculum research which has shown that the curricular process has a very fundamental impact on the manner in which students perceive their academic and professional tasks.
“It is therefore unreasonable to expect the Republic of Transkei to send its students to medical schools in the RSA to be trained as doctors, because they will either not return to practise in Transkei, or, if they do, they will not find (personal and) professional fulfilment in their work. “For this reason, the medical school at UNITRA has been established in order to relate its medical education to the health care needs of the country. It is therefore clear that this medical school should not follow the traditional medical education patterns of the RSA or western countries, but should study relevant models elsewhere in the world that have sought to address a similar situation to that pertaining in Transkei.” The Guidelines authors 35 were also quick to clarify upfront: “This does not mean a difference in the standard of education and training, but a difference in orientation. The challenge is to present the same basic science and clinical knowledge in such a manner that the graduate will be both motivated and able to work in urban and rural communities in Transkei.” As I and my colleagues30 recalled in an article published 5 years ago, the establishment of this Faculty had its vehement opponents, like Saunders36 with his (infamous) question: “where will the staff of sufficient academic standing be found?”, his prophecy of doom: “there is a danger of their obtaining fifth rate, First-World medical education”, and his unsolicited suggestion: “surely a school of public health to educate professionals to work in rural areas constitutes a greater need”. In spite of these, and the memorable but highly educative teething pains we experienced at the end of 1989, this faculty has now been in existence for a quarter of a century, has a multinational, highly qualified, efficient and effective academic staff, and with 925 doctors (and still counting) has probably produced more African doctors per year of existence than any other South African medical school, with the obvious exception of MEDUNSA and probably Natal. So, how have we made it? More importantly, how have we responded to the UNITRA Council Guidelines over the past quarter Century, and how have our responses contributed to our successes (or in rare instances, to our shortcomings)? First though, a look at those eight Guidelines: 11
Page 1: Walter Sisulu University PROFESSORI
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Page 9: every evening! Then there were my
Page 13 and 14: fallen short of those Guidelines /
Page 15 and 16: who, as of 2009 were in independent
Page 17 and 18: had 5.8% of our graduates, while Fr
Page 19 and 20: us refine our fulfilment of the abo
Page 21 and 22: how this is done. I am sure that ev
Page 23 and 24: in this regard the two gender group
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Page 27 and 28: Medicine, and say: “To those of y
Page 29 and 30: Bagumah, Dan Ncayiyana, Khaya Mfeny
Page 31 and 32: REFEREnCES 1. JAMES C. Unreliable M
Page 33 and 34: 25. KWIZERA EN, NGANWA-BAGUMAH AB,
Page 35 and 36: 53. KAYE DK, MWANIKA A, SEWANKAMBO
Page 37: 88. STROBEL J, van BARNEVELD A. Whe
Page 40 and 41: In 1985, Dr Kwizera was offered a C
Page 48: 48 Design: Mthatha Health Resource

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