Just what SA’s unemployed doctors ordered — innovative platform finds them work to boost experience

17 Dec 2024

The Surgical Assistant platform is changing the lives of South African doctors struggling to find work.

The past few years have been tough on South Africa’s health workers, including young, newly qualified doctors entering the system.

State budget cuts have led to a decline in paid posts in the public sector at a time when the number of students moving through medical schools has increased. Even in private healthcare the competition for opportunities is increasingly fierce.

One of the unexpected innovations to emerge from this crisis is Surgical Assistant, a platform that allows private-sector surgeons in need of assistants in operating theatres to connect with doctors seeking paid work and experience.

Read more: Newly qualified SA doctors shut out of jobs owing to budget constraints — union

Le Roux Viljoen, cofounder of the business, is a Cape Town-based medical officer seeking to specialise in orthopaedics. He describes the platform as one way South African doctors are dealing with the lack of posts and creating initiatives to help themselves and others.

“We want people and specifically surgeons to know about Surgical Assistant, because if you make use of the platform, you are actually helping a fellow doctor, a peer who is being failed by the healthcare system,” Viljoen said.

How it started

The idea for the Surgical Assistant platform emerged from Viljoen’s own struggle to specialise. In South Africa, medical practitioners pursuing specialisation need to complete four years of training in a registrar programme at a state academic hospital.

After completing his community service requirement in 2018 and working as a doctor on cruise ships for three years to pay off his student debts, Viljoen returned to the country with the goal of pursuing orthopaedics.

Read more: ‘Waiting lists to work for free’ – the struggle to specialise for young doctors in SA

However, the limited number of medical officer and registrar posts at state health facilities, combined with the backlog of young doctors seeking to specialise, made this all but impossible.

Viljoen ended up taking on unpaid work at a public hospital in Cape Town to gain orthopaedic experience. To earn an income he worked night shifts at a private health centre and sought jobs as a surgical assistant.

“The penny dropped one Saturday afternoon at about 5pm when a surgeon in Somerset West said, ‘Listen, I need your help for a hip replacement... Can you come?’ And I said, ‘The Springboks are kicking off in 10 minutes. I’m not going to come, but I’ll send my mate’. That’s when I had the idea of starting Surgical Assistant,” Viljoen said.

“The platform started off with me and with finding the right assistant for a surgeon. It has now become a pathway for people of different backgrounds and different areas of interest to work towards their specialisation. We’ve got a very soft spot for people working for free in the state sector.”

Good growth

Since Surgical Assistant was founded in October 2018 it has built up a database of more than 2,000 potential assistants across the country – mostly young general practitioners or medical officers who are looking for paid work, says cofounder AD Schoeman. Some are struggling with unemployment, while others have taken on unpaid shifts at public health facilities to gain the experience they need to specialise.

When registering with the platform, the doctors provide records of their experience, as well as an indication of the types of surgeries in which they would like to assist. The Surgical Assistant team then helps them to register with the various private hospital groups.

“We also provide cover and liability insurance for the young doctors because that’s another cost that they can’t cover themselves,” Schoeman said.

There are more than 100 surgeons on the platform with their own specifications for an ideal assistant. When one of them contacts the company, the team uses WhatsApp to check the availability of appropriate candidates in its pool of young doctors.

Schoeman says the platform is assisting with about 200 surgeries per month. A 15% finder’s commission is applied in each case where an assistant is placed.

Diliza Madinga, a Johannesburg-based doctor who completed his community service in 2018, started using Surgical Assistant at the end of 2023, after months of struggling to find work. He now connects to a job through the platform at least once a week.

“It literally saved me financially. I was going to be in ruin if it wasn’t for the Surgical Assistant platform. I couldn’t get a conventional job [in healthcare], even wanting one… Something as simple as working in a private casualty – usually they always have shifts open and there weren’t even shifts there,” he said. “It came in at the perfect time and it solved a massive problem.”

Madinga notes that assisting with different types of surgeries and working with many different surgeons also allows him to expand his résumé and get access to more work opportunities.

“Recently, I assisted a surgeon who’s a professor in arthroplasty, so joint replacements and such. I realised it was a rare experience, because even people who are specialising in orthopaedics really need to do those types of procedures.

“Just being able to say that I’ve worked with him, I have been able to book [a job with] another orthopaedic surgeon,” he said.

Creating a healthier ecosystem

Surgical Assistant has grown rapidly. There is a spike in new registrations each December as young doctors complete community service and start seeking other work, says Schoeman.

“We’re now in a position where our business is growing and we are expanding, purely on the basis of people being unemployed and desperate. Doctors are saying, ‘I’m available to do whatever you need me to do, so that I can at least keep my pot boiling at night and my kids fed’,” he said.

Read more: I’m an unemployed doctor, like many medical peers, despite SA’s health skills shortage

Schoeman says that to create a healthier ecosystem there needs to be movement of doctors from Surgical Assistant into permanent, paid positions in the broader healthcare environment.

“At the moment, what we’re seeing is a massive flow of doctors coming in, unemployed, but no one leaving our system. We’ve created a solution, one which could be scaled up and be brilliant for everyone involved, but you want a constant flow into the bigger system,” he said.

“That would be a sign of success; that would mean there is something for the doctors to work towards.” DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.

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How it started

Good growth

Creating a healthier ecosystem