Abstract
Over the past decades, South Africa has undergone rapid demographic changes, which have led to marked increases in specific cardiac disease categories, such as rheumatic heart disease (now predominantly presenting in young adults with advanced and symptomatic disease) and coronary artery disease (with rapidly increasing prevalence in middle age). The lack of screening facilities, delayed diagnosis and inadequate care at primary, secondary and tertiary levels have led to a large burden of patients with heart failure. This leads to suffering of the patients and substantial costs to society and the healthcare system.In this position paper, the South African Heart Association (SA Heart) National Council members have summarised the current state of cardiology, cardiothoracic surgery and paediatric cardiology reigning in South Africa. Our report demonstrates that there has been minimal change in the number of successfully qualified specialists over the last decade and, therefore, a de facto decline per capita. We summarise the major gaps in training and possible interventions to transform the healthcare system, dealing with the colliding epidemic of communicable disease and the rapidly expanding epidemic of non-communicable disease, including cardiac disease.
Highlights
Training of doctors and healthcare personnel in South AfricaBetween 2000 and 2012, the number of medical students enrolling per annum increased by 34%, with a major and deliberate demographic shift towards more female students and African blacks.[14,15] Subsequently, the number of graduating doctors has increased by 18% in the same time period
Over the past decades, South Africa has undergone rapid demographic changes, which have led to marked increases in specific cardiac disease categories, such as rheumatic heart disease and coronary artery disease
The South African Heart Association (SA Heart) National Council members have summarised the current state of cardiology, cardiothoracic surgery and paediatric cardiology reigning in South Africa
Summary
Between 2000 and 2012, the number of medical students enrolling per annum increased by 34%, with a major and deliberate demographic shift towards more female students and African blacks.[14,15] Subsequently, the number of graduating doctors has increased by 18% in the same time period. The ratio of physicians per 1 000 population remained the same (0.77 in 2004 vs 0.76 in 2011) and is failing to keep up with the growth of the population.[15]. In response to the fact that the academic health workforce in South Africa is aging, numbers are shrinking, and there is a decline in clinical research capacity and output, two new research training tracks within the professional MB ChB programme have been created.
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