Health & Fitness

Levies can be a jab in the arm for internship

Medical personnel
Medical personnel attend to patients at Kenyatta National Hospital’s emergency wing. FILE PHOTO | NMG 

Following ongoing education curriculum reforms, labour relations debates across sectors are now focusing on unemployment and how industries prepare the younger generation to take up workplace roles.

Over the last few months, there has been quite some heated exchanges online between graduands, employers and policy makers. The crux of the issue is dwindling opportunities for provision of internship, lack of support during this period as well as expectations of those graduating from college.

For healthcare in particular, which unlike many other employment segments is a practical on-hands training, internships modelled around apprenticeships are our soul.

Across many countries, this non-mainstream learning approach is the norm. One gains more practical value during internship than in medical school. For this, doctors are lucky to be amongst the few whose internships are paid for.

Our profession was almost sacrosanct in terms of this guaranteed paid-internship. But recent changes in the population and employment dynamics means this may not be the case in the future, unless urgent action is taken.


More graduating doctors are leaving our medical schools every year, whereas fewer hospitals are providing the adequate facilities, resources and human personnel with ample contact time to hand-walk the new profession entrants. If not addressed, this has the potential for a generation of patchy internship training.

For medical associations and policy makers, the discussion is how to start planning to ensure the younger members get well- inculcated into the profession. This applies not just for doctors, but also the other health cadres like nurses, laboratory and pharmaceutical technologists.

It is not just the places, but also the mentoring personnel that is required. Increasing student numbers without a commensurate increase in training personnel is counterproductive. Case in point, the current teaching and referral hospitals shutdown and staff strikes.

Do patients in hospitals and health organisations have an obligation to ensure this lifelong supply chain is always maintained?

A similar situation was encountered in the hotel industry. In Kenya’s fledgling tourism industry days, maintaining a projected steady stream of professional hotel catering staff that meet international standards was a challenge. The proposal was to introduce training and catering levies. These guaranteed long term sustenance of training funding since it was a ring-fenced kitty.

To some extent, it helped address the concern until the industry had established adequate numbers. Though now consolidated under the Tourism Levy, it does serve as an example.

What lessons could the health sector learn from this approach?

The starting point is the non-profit hospitals that benefit from government trained personnel, but are tax exempt. Here is an opportunity for them to do good and guarantee future health workers to the ecosystem.

A shilling levy for every patient’s hospital visit could go to this fund.