Ultimate Guide to Practicing Medicine in South Africa

Updated June 28, 2022

South Africa is home to the majestic Drakensberg Mountains, the Big Five (lions, rhinos, elephants, water buffalos, and leopards), finger-licking Bunny Chow, and has borne the earthy tones of the Soweto Gospel Choir and the anti-apartheid revolutionary Nelson Mandela. Here is a guide to practicing medicine in South Africa.

Medical License/Registration

Volunteer and training licenses are available to those wanting to temporarily practice in South Africa and are fairly easy to obtain. Full medical registration is for those making a more permanent move to South Africa. It is a very challenging, lengthy, and opaque process typically taking 12 months to complete as many government departments don’t communicate well (or at all).

The three key components for a full medical license are:

1. Registration with the National Department of Health Foreign Workforce Management Programme
   
2. Credential verification through Electronic Portfolio of International Credentials (EPIC)
3. Registration with the Health Professions Council of South Africa.

In general, South African government agencies require copies of official documents to be “certified”. This is common practice in South Africa where police and/or attorneys can review documents and “certify” that a copy is the same as the original document. In addition, I recommend that prior to submitting any forms you ensure that the forms and the submission addresses are up-to-date. 

Registration with the National Department of Health Foreign Workforce Management Programme (FWMP)

The FWMP regulates the recruitment and employment of foreign doctors. After applying and completing a “Z83” form, the FWMP will provide an endorsement to apply for a job, and later a work visa.  This process typically takes 2-3 months though it can take over 6 months. This can be done in parallel with the EPIC credential verification application as below.

Credential Verification with EPIC/ECFMG

Your medical credentials will be independently verified by the Educational Commission for Foreign Medical Graduates (ECFMG) which provides an Electronic Portfolio of International Credentials (EPIC). They will send a report of your medical credentials to the Health Professions Council of South Africa (HPCSA). This process typically takes about 3 months with an associated fee.

Registration with the Health Professions Council of South Africa (HPCSA)

You will then apply for registration with the HPCSA. You need to have attended a medical school approved by the World Directory of Medical Schools and the Medical Board will assess your medical training to determine if you qualify for the non-exam track or if you need to take South African Medical exams. Typically, American-trained physicians are exempt from taking additional examinations. 

Initially, you will apply for a general license as a general practitioner and then you can register as a specialist. Internal medicine (IM), family medicine (FM), and pediatrics (Peds) are considered specialties in South Africa. However, because IM, FM and Peds residencies are 4 years in South Africa compared to 3 years in the United States, many American doctors have been denied a “specialist” registration in their fields (this is hit or miss). If you have completed a fellowship, this will often allow you to meet the training duration requirements for IM, FM, or Peds registration, though the duration of training may not be enough for the sub-specialist registration (!).

It takes 3-6 months to obtain a general practice license, and an additional 3-6 months for a specialist license. This process will be longer if you need to take additional exams.

South African Qualifications Authority (SAQA) verification 

SAQA is a South African agency that evaluates foreign credentials. They verify the credentials and  evaluate them based on their South African equivalent.  SAQA verification is not required for HPCSA registration (since HPCSA uses EPIC); however, the South African embassy will require this verification to obtain a Critical Skills Work Permit or other work visa as below. This application can be done concurrently with HPCSA registration, there is an associated fee, and it typically takes 2-4 months to obtain.

Finding a Job

Most jobs are found via word of mouth, by networking, and through colleagues.  Jobs in public sector hospitals located in major cities are very competitive. As a result, many foreign doctors work in rural hospitals. Rural hospitals are chronically understaffed, and the conditions are very challenging.

If you are committed to working in a large city like Johannesburg, Cape Town,  or Durban you will have to spend 6–12 months in South Africa to find a job. Most American and British physicians I know work as Academics or with Non-Government Organizations.  Many came to South Africa for personal reasons (married to a South African spouse or a partner with a job transfer to South Africa) and spent several months finding a job.

Finding a job can be done concurrently with HPCSA registration. 

Immigration

In order to obtain a work visa, you must have a job offer in hand, have a FWMP endorsement, HPCA registration, and SAQA credentialing. Doctors were recently removed from the “critical skills” visa list, so are no longer entitled to an automatic work permit (as of March 2022). This now makes it extremely difficult for someone to work in South Africa unless they are eligible for a work visa for some other reason (such as through marriage, etc), or they come on a research permit because they work for a foreign university, etc.  

Bottom Line

South Africa is an incredible country to live in and practicing medicine here can be extremely fulfilling. That said, the registration process is incredibly frustrating. I would only recommend it to those who have a strong personal reason for moving to South Africa. I would advise against trying to register to practice in South Africa for a short 1-2 year stay.

For more information on the workplace culture and salary check our Working as a Doctor in South Africa

Dr. Ribka Berhanu is an infectious disease physician and research scientist in the Global Health Department at the Boston University School of Public Health. She is based in Johannesburg, South Africa. She has over 10 years of clinical and research experience working in the field of tuberculosis research and clinical care in South Africa.