Gov’t proposes pre-internship exams, delays medical graduation

Kampala, Uganda | URN | The government is set to roll out a new policy that will introduce a pre-internship examination and require medical students, along with other health trainees, to complete their mandatory internship before graduation.

The policy, dubbed the National Education and Training for Health Policy, aims to reform the current training system, improve the quality of health education, and strengthen the transition from classroom learning to professional practice.

State Minister for Education, Dr Joyce Moriku Kaducu, said the policy, developed through inter-ministerial collaboration, will also establish a National Internship Management Framework to address long-standing gaps in the internship process.

Dr Kaducu explained that the framework will introduce a pre-internship examination for trainees before placement, and provide clear guidelines on the selection, deployment, supervision, and accreditation of internship sites.

The pre-internship examination is intended to ensure that all trainees, regardless of where they studied, meet the required competencies before entering clinical practice.

Dr Rony Bahatungire, Commissioner for Clinical Services at the Ministry of Health, said the policy will also prohibit training institutions and universities from graduating students before they complete their internship.   He clarified that while the total duration of medical training will remain unchanged, the reform will only affect the timing of internship and graduation.

Previously, medical students would graduate about six months into their internship year. Under the new arrangement, graduation will only take place after the full internship period has been completed. Dr Bahatungire emphasized that the core objective of the reform is to improve quality.

“The only principal change is that a well-refined and clinically competent medical trainee will be released into the health system,” he said.

However, the proposal to delay graduation until after internship has emerged as one of the most contentious aspects of the policy, drawing strong resistance from doctors and interns. Opposition has persisted since the draft policy was first introduced, with many in the medical fraternity describing it as flawed and lacking broad acceptance.

Dr Jacob Mwandha, President of Medical Interns, criticized the proposal, arguing that not all medical graduates proceed to clinical practice or internship. He noted that some pursue careers in public health or research, making mandatory internship before graduation unnecessary for all.

Mwandha also suggested that delaying graduation could be an attempt by government to classify intern doctors as students, thereby eliminating their allowances.

He further questioned the policy’s consistency, noting that while the Ministry argues universities are producing underprepared graduates, it still intends to rely on the same institutions to supervise internships.

Uganda Medical Association Secretary General, Dr Alon Nahabwe, also opposed the proposal, warning that integrating internship into undergraduate training is misguided and could disrupt both medical education and professional licensing.

Dr Nahabwe cautioned that the policy could worsen existing delays in internship placements and increase the financial burden on parents, given the already high cost of medical training.   He emphasized that internship is a form of national service, not an academic year, and noted that intern doctors already carry significant clinical responsibilities.

Reclassifying them as students, he said, could create uncertainty around licensing, as interns currently operate under provisional licenses that allow them to treat patients.

He added that if the government’s concern is quality, there are more effective alternatives. These include tightening entry requirements into medical schools enforcing minimum training standards, and introducing a national qualifying examination for all graduates.

Dr Nahabwe further suggested improving internship conditions by addressing the shortage of specialists, expanding accredited internship sites, increasing allowances, and providing decent accommodation for interns.

Beyond the internship debate, the policy also seeks to address broader challenges in the health training system, including outdated curricula, non-uniform admission procedures, and inconsistent examination standards.

The Government says the new framework will create a harmonised system capable of producing a competent health workforce, both in quality and quantity, to meet labour market demands.

According to Dr Safinah Kisu Musene, Commissioner for Health Education and Training, the National Education and Training for Health Policy, 2025, together with its implementation guidelines, will be officially unveiled on Thursday, April 30, 2026, at the Source of the Nile Hotel in Jinja.

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