I met a young doctor last week at Korle Bu. He graduated in 2023. Top of his class. He should have been saving lives. Instead, he was selling medical insurance.

He had been waiting 16 months for a housemanship slot.

He is not alone. He is part of a lost generation of Ghanaian doctors — trained, qualified, and left in a queue.

There was a time when being admitted to medical school in Ghana was like being handed a golden ticket. Two medical schools — Legon and KNUST — admitted 50, 100 students a year. Your lecturers knew your name. Your cadaver group was five people. And when you finished, the path was clear: housemanship next month, permanent registration next year, government job the year after.

No queue. No wahala. The country needed you.

Today, the story is completely different. And we need to talk about it honestly.

*We now have too many medical schools and too few jobs.*

Ghana today has not two, but over twelve medical schools. Public: UG, KNUST, UDS, UCC, UHAS. Private: Family Health, Accra College of Medicine, K-SMS and more coming.
Proposed medical school in UER and Savannah region etc.

Each year we admit over 1,200 students. Add another 400 Ghanaians who trained in Ukraine, Russia, China and Cuba and come back to write MDC exams. So every year, about 1,500 new doctors knock on the door.

But the door is small. Very small.

Korle Bu, Komfo Anokye, 37 Military, Tamale Teaching Hospital, Cape Coast Teaching Hospital — our accredited housemanship centres — can take only about 400 to 500 house officers at a time.

Do the maths. 1,500 graduates chasing 500 slots. 1,000 left standing every year.

The result is a national scandal we have normalised: *the queue for housemanship.*

I have met doctors who have waited one year, two years. They sit at home. Their skills decay. They forget how to cannulate, how to resuscitate. They become depressed. Some give up and go into banking, telecoms, or travel abroad.

And it does not end there. If you are lucky to get housemanship, you finish your two years and then you wait again — this time for *financial clearance.*

You are a fully qualified doctor. You have done your housemanship. You have your permanent registration. But the Ministry of Finance has not given clearance, so the hospital cannot pay you. You work as a volunteer. You do locum for GH¢150 a day. You are owed 14 months salary.

Let us be honest about what this means: A young man enters medical school at 18 in 2020. He finishes at 24. He waits 1.5 years for house job. He waits another 1.5 years for clearance. He gets his first proper salary at 27 or 28. He has lost almost 4 years of his life in queues.

No other profession treats its brightest this way. Not lawyers. Not engineers. Only doctors.

And we wonder why they leave?

We blame brain drain. We say our doctors are unpatriotic for writing PLAB and USMLE and leaving for the UK and US. But let us ask: If you train for six years, pay GHS 80,000 a year in a private school, graduate, and then the State tells you “there is no vacancy, wait,” what would you do?

Brain drain is not the disease. It is the symptom. The disease is our planning failure.

We have a paradox that should shame us: Ghana has a severe shortage of doctors — 1 doctor to 7,500 people, when WHO says we need 1 to 1,000 — and at the same time we have unemployed doctors. How can both be true? Because we produce doctors but we refuse to absorb them.

Our district hospitals in Upper West, North East, Oti, Savannah — they have no doctors. Meanwhile, 1,000 doctors are sitting in Accra and Kumasi waiting for a posting letter. That is not a shortage. That is a system failure.

Who is to blame? All of us.

Universities admit students because fees bring money. They do not ask, “Will there be a job for this student in six years?”

The Ministry of Health plans employment based on budget, not based on need. “We don’t have clearance” is now a permanent excuse.

The Medical and Dental Council gives quotas but some schools exceed them and nothing happens. MDC knows exactly how many doctors we will produce in 2030, but it did not control how many we admitted in 2024.

We are all working in silos.

Look at how the UK does it. In the UK, the number of medical school places is decided by Health Education England, and it is equal to the number of Foundation Year 1 jobs. One graduate, one job. No queue. In the US, 94% of medical graduates get matched into residency automatically. They don’t have “waiting for house job.”

We can do the same. It is not rocket science.

What do we need to do?

*First, stop opening new medical schools.* We have enough. A moratorium until we can employ the doctors we already produce.

*Second, make housemanship capacity equal graduate output.* If we graduate 1,200 doctors, we must have 1,200 housemanship slots. Accredit more regional hospitals. A district hospital with a surgeon, physician and obstetrician can train house officers.

*Third, automatic financial clearance.* If you finish housemanship, you are automatically employed. No 18-month wait. The Ministry of Finance should give clearance in bulk, based on MDC’s list of graduates.

*Fourth, track students from Year One.* Every medical student should get an MDC index number from day one. Then we know in 2026 exactly how many doctors will graduate in 2032, and we can budget for them. This is what the GMC does in the UK.

*Fifth, post doctors where they are needed — with pay.* If you cannot find a job in Accra, we will pay you well to go to Bawku, to Yendi, to Kete Krachi. Full salary plus rural incentive. Not volunteer work.

If we don’t do this, we will continue to subsidise the NHS. Ghana spends millions to train a doctor for six years, then the UK harvests him after a 2-year wait. That is the most expensive gift we give to Britain every year.

I am not against expanding medical education. Our population is growing by 700,000 people a year. We need more doctors. But expansion without absorption is cruelty.

We tell the brightest SHS student — the one who got 8 A1s — “Go and do medicine, you will serve Ghana.” She sacrifices her youth, her parents sell land to pay fees, she graduates, and then we tell her to wait.

We are breaking the social contract.

Medicine used to be a calling with a clear path. Now it has become a lottery. You buy a ticket that costs six years and GHS 400,000, and after that you may or may not get the prize.

The question we must answer as a country is simple: Do we want doctors, or do we just want medical school graduates?

If we want doctors, we must employ them. If we want to keep producing graduates for export, then let us be honest and call our medical schools what they have become: pre-PLAB coaching centres.

Our young doctors are not asking for much. They are not asking for luxury cars. They are asking for what every professional deserves: after six years of sacrifice, let me work, let me serve, let me earn.

Is that too much to ask?

The writer is a medical doctor and ENT surgeon in Accra.

 

Source:  DR. KUUZUME