What it took us to become specialist doctors in Kenya

Left: Dr Khalif Abdifatah during an interview on June 8, 2024, and Dr George Got, during an interview at his office in Kisumu, on June 07, 2024. 

Photo credit: Wilfred Nyangaresi | Alex Odhiambo

Studying medicine is often the peak aspiration of students who have passed their Kenya Certificate of Secondary Education exams. But there is a big hurdle that may hold back many from achieving their dreams. School fees. Compared to other professions, the cost of training a doctor is very high.

Dennis Miskellah, the deputy secretary-general of the Kenya Medical Practitioners, Pharmacists, and Dentists Union, says the fee burden is compounded by the fact that financing options are limited for post-graduate learners as the Higher Education Loans Board (Helb) only funds undergraduate students.

“The cost of training across all specialities averages around Sh650,000 per year, and this is because universities are still using the Differentiated Unit Cost (DUC) funding model. Sadly, one cannot access Helb financing,” Dr Miskellah says.

This means for a student undertaking a six-year undergraduate course, at least Sh3.9 million is required. This does not factor in the millions of shillings more needed for specialist training during post-graduate studies.

As such, medical specialists say studying medicine “is not for the faint-hearted.”

George Got, a senior specialist in the field of Otorhinolaryngology (ear, nose and throat), head and neck surgery at the Jaramogi Oginga Odinga Teaching & Referral Hospital in Kisumu, says the hardest part of his career journey was the financial cost. 

“I contemplated quitting severally because I faced intense financial pressure,” says Dr Got, adding, “That was before well-wishers and the government cleared the fees.”

Under the new Helb funding model, scholarships and tuition fees may reduce the fee burden for undergraduate students by about 95 percent, but some households lack any financial muscle to pay, and even when they do, they are unlikely to pay for post-graduate studies.

Sh20 million investment

Khalif Abdifatah, a Nairobi-based neurosurgeon approximates his total fees so far at Sh20 million.

“My education was a significant financial investment. I pursued my medical degree abroad, while for my neurosurgery training, I did it in Kenya, with specialised rotations overseas. The total cost was around Sh20 million, but it was a necessary investment for my career,” says Dr Abdifatah.

Besides the cost, the training is also laborious.

Dr Ogot says the postgraduate specialist training was the hardest. “It seemed like everything I knew was wrong, and every methodology I used to acquire knowledge did not work,” says the specialist who had initially wanted to study Economics and Finance and even enlisted at the University of Nairobi to study Bachelor of Commerce.

“But it was the one year I spent at a top private hospital in Nairobi as an accounts clerk that made me ask the Joint Admissions Board to change my programme to medicine and surgery,” he says.

27-year education journey

He would later enrol in the Bachelor of Medicine and Bachelor of Surgery (MB.ChB) undergraduate degree course at Moi University, Eldoret, in 2001, where he says it was just by a shred of luck that he cleared the training in six years without exams retake.

On the other hand, it took Dr Abdifatah 27 years, right from primary schooling to becoming a neurosurgeon.

He spent six years at the medical school, a year for internship, six years of residency in neurosurgery, and two years practising as a senior registrar.

BD medical

Studying medicine is often the peak aspiration of students who have passed their KCSE exams.

Photo credit: Shutterstock

The hardest part

“The hardest part was the lack of control over my time during training. Planning was nearly impossible, and I had to miss many social events and family gatherings. The sacrifices were significant, requiring immense discipline and focus. But in the end, all the hardships were worth it,” he says.

Having practised in his field of speciality for nine years now, three of which he has been a consultant, has Dr Abdifatah recouped his investment?

“Despite the substantial cost of my education, I have no regrets. The financial returns have been worthwhile, but the non-monetary rewards, such as the satisfaction of saving lives and the excitement of neurosurgery, are priceless,” he says.

Sense of civic duty

Although practising in private facilities is lucrative, many doctors still work in the public healthcare system owing to what they term unquantifiable contentment derived from discharging civic duty.

“As a specialist, especially in a field that is detailed and undeserved, like my speciality, one has to strike a balance, and the first balance is to be available so that Kenyans can get your services. This is best achieved by staying true and loyal as a civil servant and this explains why I have resisted the pressure to quit public service,” says Dr Got.

On his part, Dr Abdifatah says he is indebted to public duty because the government remunerated him during his residency.

“Private practice is undeniably lucrative. The income from a week in private practice can’t equate to a month’s salary from the government. I however must serve the government because during my residency, I received a government salary which bonds me to public service,” says Dr Abdifatah.

Investment call

The doctors nevertheless call on the government to pump more investments in public healthcare and review doctors’ pay, to motivate more Kenyans to join the health workforce and retain the current personnel seeking better opportunities abroad.

According to the latest Economic Survey published by the Kenya National Bureau of Statistics (KNBS), the number of health sciences students enrolled in universities last year rose 11.8 percent to 31,333 compared to those admitted in the 2019 intake.

Increased enrolment

Of the total, Medicine and Surgery accounted for the highest enrolment for undergraduate students at 8,602 followed by Nursing degree students at 6,685.

During the same period, the number of graduates and post-graduates in the field declined 18.1 percent to 5,814, signalling increased difficulties in training completion.

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