South Africa's Health: New South Africa's doctors: a state of flux

Over 25 000 doctors are registered in South Africa, and they serve a population of about 40 million. The doctor to population ratio in South Africa is higher than that in countries like Mozambique, Nigeria, and Chile but lower than that in other countries like Brazil, Greece, and Britain (table 1). The number of doctors who are actually in practice is probably fewer because of emigration. The exact number of doctors who have left South Africa is not known. Dr David Green, director of Profession Development for the Medical Association of South Africa, said that doctors who leave the country continue to be members of the association and often provide another South African address, making it difficult for the association to know if they have left. Some data are available for the period before 1989.1 In 1986, the number of doctors registered with the South African Medical and Dental Council dropped from 20477 to 20229, largely because of migration, and in 1987, 72 family practitioners and 21 specialists migrated.

White men dominate the profession, but this is changing. Data available for 1985 show that 94% of specialists and 83% of non-specialists were men, and that 88% of all doctors were white.1 The number of non-white students admitted to medical colleges has increased in the last few years. Professor J R van Dellen, dean of the faculty of medicine of the University of Natal, and Professor J P de V van Niekerk, dean of the University of Cape Town Medical School, provided data that show a definite increase in the numbers of non-white students admitted to their colleges (fig 1,2).

The distribution of doctors is skewed …