Original Research

South Africa’s Psychiatric training capacity in 2008 and in 2018. Has training capacity improved?

Natalie Beath, Ugasvaree Subramaney, Zukiswa Zingela, Bonginkosi Chiliza, John A. Joska, Carla Kotzé, Suvra Ramlall, Soraya Seedat
South African Journal of Psychiatry | Vol 29 | a1988 | DOI: https://doi.org/10.4102/sajpsychiatry.v29i0.1988 | © 2023 Natalie Beath, Ugasvaree Subramaney, Zukiswa Zingela, Bonginkosi Chiliza, John A. Joska, Carla Kotzé, Suvra Ramlall, Soraya Seedat | This work is licensed under CC Attribution 4.0
Submitted: 04 September 2022 | Published: 30 March 2023

About the author(s)

Natalie Beath, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Ugasvaree Subramaney, Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Zukiswa Zingela, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
Bonginkosi Chiliza, Department of Psychiatry, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
John A. Joska, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Carla Kotzé, Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Suvra Ramlall, Department of Psychiatry, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Soraya Seedat, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Abstract

Background: There is a deficit of psychiatrists in South Africa, and to our knowledge, there is no situational analysis of training posts for psychiatrists in the country.

Aim: To compare the number of specialists and subspecialists in training and training posts available in 2008 and 2018.

Setting: South African medical schools with departments of psychiatry.

Methods: A situational analysis involving data collection through a survey completed by eight heads of academic psychiatric departments followed by a comparative analysis of the two aforementioned years.

Results: Data shows an 11% increase in funded and unfunded posts combined and a 9.3% increase in funded posts. The occupancy of funded posts decreased (92% in 2008 to 82% in 2018). When considering both funded and unfunded posts, only three more psychiatrists were being trained in 2018. Supernumeraries appointed in unfunded posts can be expected to return to their countries of origin. As such, a decrease in filled funded posts likely reflects a decrease in training psychiatrists destined to work in South Africa. While child and adolescent psychiatry was the only sub-speciality with accredited training posts in 2008, all sub-specialities included on the questionnaire had accredited training posts in 2018, and the number of accredited training posts in child and adolescent psychiatry doubled. That said, many of the posts were unfunded and vacant.

Conclusion: While there was an increase in posts from 2008 to 2018, many posts remained unfilled. As such, not only are additional funded training posts required but also strategies to increase post-occupancy and successful completion of training.

Contribution: This study is the first situational analysis of specialist and subspecialist training posts in Psychiatry in South Africa, at two time points over a 10 year period, that draws on academic heads of departments of psychiatry as respondents. The study highlights the nominal increase in funded training posts over this period, especially subspecialist training posts. The majority of Health Professions Council of South Africa (HPCSA) accredited subspecialities in Psychiatry have no funded training posts which is particularly concerning.


Keywords

South Africa; psychiatry training; medical training; specialist training; sub-specialist training.

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