How to become a Doctor (Medicine)

Six years of study (MBChB), then a compulsory internship (about two years) and a community service year before you can practise independently – so it’s closer to nine years from matric to full registration. After that, most doctors specialise (surgery, paediatrics, psychiatry and more) through further years of registrar training, while some stay in general practice (a GP needs no further registrar training beyond community service).

Where this degree can take you

• Specialist Physician
• Surgeon
• General Practitioner
• Public Health Doctor

After community service, you apply for a registrar post at an academic hospital (these are competitive and limited in number). Registrar training combines full-time clinical work with a Master of Medicine (MMed) dissertation and the relevant Colleges of Medicine of South Africa (CMSA) specialist exam - you need both before the HPCSA will register you as a specialist. Most specialties take 4 years; surgical specialties typically take 5, and neurosurgery 6. Several specialties listed below are themselves "subspecialties" reached by first qualifying in a base specialty (e.g. Internal Medicine, Paediatrics or General Surgery) and then training further.

Medicine (physician) specialties

• Internal Medicine (Physician) – 4 years
  Diagnoses and manages complex adult disease without surgery. The base specialty for most of the subspecialties below.
• Cardiology – +2 years after Internal Medicine
  Heart and blood vessel disease.
• Nephrology – +2 years after Internal Medicine
  Kidney disease and dialysis.
• Gastroenterology – +2 years after Internal Medicine
  Digestive system disease, including endoscopy.
• Endocrinology – +2 years after Internal Medicine
  Hormonal conditions such as diabetes and thyroid disease.
• Pulmonology – +2 years after Internal Medicine
  Lung disease, including TB.
• Rheumatology – +2 years after Internal Medicine
  Autoimmune and joint disease.
• Infectious Diseases – +2 years after Internal Medicine
  Complex infections, including HIV and drug-resistant TB - especially significant in South Africa.
• Medical Oncology – +2 years after Internal Medicine
  Cancer treatment with chemotherapy and other drug therapy - distinct from Radiation Oncology below.
• Clinical Haematology – +2 years after Internal Medicine
  Blood disorders and blood cancers.
• Geriatric Medicine – +2 years after Internal Medicine
  Medicine for older adults.
• Neurology – 4-5 years
  Diseases of the brain, spinal cord and nerves - diagnosis and non-surgical treatment.
• Clinical Pharmacology – 4 years
  How medicines work and interact, and rational, safe prescribing.
• Medical Genetics – 4 years
  Diagnosis and counselling for inherited conditions.

Surgical specialties

• General Surgery – 5 years
  Abdominal and general operations. The base specialty for several surgical subspecialties below.
• Paediatric Surgery – +2 years after General Surgery
  Surgery in children and infants.
• Surgical Oncology – +2 years after General Surgery
  Cancer surgery.
• Trauma Surgery – +1-2 years after General Surgery
  Acute surgical care after major injury.
• Vascular Surgery – +2 years after General Surgery
  Surgery on arteries and veins.
• Urology – 4-5 years (usually after 2 years of General Surgery)
  Surgery of the urinary tract and male reproductive system.
• Orthopaedic Surgery – 5 years
  Bones, joints and the musculoskeletal system.
• Neurosurgery – 6 years
  Surgery of the brain, spine and nervous system - the longest registrar programme.
• Cardiothoracic Surgery – 5-6 years
  Heart and chest surgery.
• Plastic & Reconstructive Surgery – 5-6 years
  Reconstructive surgery after injury, cancer or burns, and cosmetic surgery.
• Otorhinolaryngology (ENT) – 4-5 years
  Ear, nose and throat surgery and medicine.
• Ophthalmology – 4 years
  Eye disease and eye surgery.

Women's & children's health

• Obstetrics & Gynaecology – 4 years
  Pregnancy, childbirth and women’s reproductive health.
• Paediatrics & Child Health – 4 years
  Medical care for infants, children and adolescents. The base specialty for the paediatric subspecialties below.
• Neonatology – +2 years after Paediatrics
  Intensive care for newborns, especially premature babies.
• Paediatric Cardiology – +2 years after Paediatrics
  Heart conditions in children.

Diagnostics, pathology & imaging

• Diagnostic Radiology – 4 years
  Reads and interprets X-rays, CT, MRI and ultrasound to diagnose disease.
• Radiation Oncology – 4 years
  Cancer treatment using radiotherapy - distinct from Medical Oncology above.
• Nuclear Medicine – 4 years
  Diagnosis and treatment using radioactive tracers.
• Anatomical Pathology – 4 years
  Diagnoses disease from tissue and biopsy samples, mostly lab-based.
• Chemical Pathology – 4 years
  Diagnoses disease from blood and body-fluid chemistry.
• Microbiology – 4 years
  Identifies infections and guides antibiotic treatment from lab samples.
• Forensic Pathology – 4 years
  Medico-legal autopsies to determine cause of death, working with SAPS and the courts.

Anaesthesia & emergency care

• Anaesthesiology – 4 years
  Keeps patients safely unconscious or pain-free during surgery, and runs peri-operative and pain care. The base specialty for Critical Care below.
• Critical Care Medicine – +2 years after Anaesthesiology (or Internal Medicine)
  ICU care for the most critically ill patients.
• Emergency Medicine – 4 years
  Emergency department medicine - the first South African medical specialty to formally recognise this as its own field in Africa.

Community & population health

• Family Medicine – 4 years
  Broad-based specialist care for whole families and communities, especially in district and rural hospitals - distinct from working as an unspecialised GP.
• Public Health Medicine – 4 years
  Population-level health - disease surveillance, health policy and health-system planning.
• Occupational Medicine – 4 years
  Workplace health, injury prevention and compensation claims - important in South Africa’s mining sector.

Mind & behaviour

• Psychiatry – 4 years
  Diagnoses and treats mental illness. Distinct from clinical psychology, which is a separate, non-medical postgraduate qualification.

Skin

• Dermatology – 4 years
  Skin, hair and nail disease.