Unpaid specialist training is becoming an increasingly visible feature of South Africa’s public health system as doctors compete for a limited number of funded training posts. Some local doctors are working without salaries for extended periods to gain the clinical experience required to qualify as specialists.
Almost all of the clinical training required for specialisation and sub-specialisation takes place in the public sector. However, constrained provincial health budgets have limited the number of funded medical officer and registrar posts available.
As a result, competition for specialist training positions has intensified. Doctors may accept unpaid roles, variously described as supernumerary, volunteer or fellowship posts, to gain experience and strengthen future applications.