The State Of Registrars In Kenya Today; Why They Must Be Paid For Services They Render.

In line with the current affairs of this country, the health care in undergoing a myriad of changes some intended whereas other spontaneous. Since the formation and registration of the doctors Union, there have been tremendous developments whereby now the Kenyan doctors have a voice and indeed a representation. A group that has for long been isolated and neglected by the system is the registrars. These are doctors undergoing postgraduate training. This group carries out an indispensable task of running the Kenyas largest referral hospitals namely KNH and MTRH. A quick observation. The doctors in training, it appears lose their entitlements of being a doctor and indeed the basic constitutional guarantees are wiped out. Unfortunately it is an inevitable rite of passage for those who want to specialize in the field of medicine in the country. Its a whole world of contrast. Those colleagues who trained awhile back were governed by a different set of circumstances compared to what it is today. ALL the registrar were sponsored by the government. As pointed out registrars have been subjected to long hours of unpaid and often unappreciated work, which has been erroneously termed as learning. We say erroneous because registrars many times go way beyond their scope of studies, greatly surpass their course specifications, work beyond normal school hours and face inhumane treatment. As a union representing doctors, this special group of people needs to be compensated for the services they offer to the public. Here below are some of the reasons why ALL registrars must be paid: i) These are the doctors who run the training institutions of KNH and MTRH. The hospitals have employed just a few consultants and no primary doctors. ii) The registrars are subjected to extremely long working hours sometimes exceeding 100hours per week! iii) The work done is actual and not simulated; thus registrars engage in patient care, perform procedure which are charged, and directly generate income. Its only at the point of sharing the revenue generated when it is quickly remembered that registrars are not employees of these institutions iv) Masters in medicine programme is fulltime unlike other programme. The doctors in post graduate training must have a source of income and this can be in the work they do in serving the training institutions clientele and indeed the Nation v) Like other doctors, registrars are greatly exposed to all risks associated with practice of medicine. This ranges from exposure to infection, chemical injuries, radiations and occupational injuries vi) It is very hard to demarcate the line between studies and work. Likewise, ALL registrars exceed their course requirement in the first few months of their study but are compelled to remain in school for periods extending to 5years doing forced, unpaid labor.

vii) It is strangely in the field of medicine where one can die from a preventable illness simply because the provider cannot afford. How can one provide services, professional services to the public yet s/he cannot afford these services? viii) All registrars spend more that 80% of time at their work stations- wards, OPD (casualty), wards, theatres, special clinics. A very small percentage of time is spent on reading. ix) A quick comparison shows that it is not only enough to adequately pay registrars, they MUST indeed by exempt from paying tuition fees. The logic is any person one offers services, they pay the moneys to the government. Therefore charging fees to a person proving a revenue generating activity is outright exploitation. Residents, just like other Kenyans are subjected to the realities of hard economic times. Just like all other citizens, we grapple with rent, utility bills, transport to and from work as most are not housed, meals, school fees, families to support (you still remain a mother/father/husband/wife even after joining the masters program), medical bills to name a few. It is our submission that, as long as registrars remain in the business of offering medical services in actual terms, these services must be paid for. Therefore all registrars training in the country must be paid for these services. The terms of payment must also include other statutory allowance and subject to all the applicable labor laws.