In Uganda, East Africa, there are three public universities offering undergraduate training in Medicine, they include: Makerere University located in Kampala, Mbarara University of Science and Technology (in South Western Uganda) and Gulu University (most recent and located in Northern Uganda). Undergraduate training in Medicine is both by government and private sponsorship. A student of medicine in Uganda spends five years in a medical school learning General Medicine. The five years consist of preclinical years (1st and 2nd years) and clinical years (3rd to 5th years). In pre-clinical years students study subjects such as anatomy, histology, embryology, bio-chemistry, pharmacology, physiology Community Health and pathology. In clinical years they study surgery, internal medicine, obstetric and gynaecology, paediatrics, ENT ophthalmology, dermatology, psychiatry and anaesthesia. This training is adequate and equips the student doctor to handle patients after the training in any setting especially in rural areas with a high disease burden. After the medical school, the doctor is subjected to one year’s period of internship where he works under supervision in the two disciplines of his/her choice (e.g. surgery and paediatrics). After internship the doctor is free to work in any setting and plan for post graduate training. Post graduate training in Uganda is not free, the doctor has to meet the costs himself/herself, or look for someone to sponsor him/her. Most average Ugandan doctors are unable to sponsor themselves for post graduate training due to low earnings and therefore have to rely on sponsors who are not readily available to everyone. Given the above factors, the number of Ugandan doctors going for post graduate training on self sponsorship is still low (less then 50%). The duration of post graduate training depends on the speciality chosen; most courses last three years but orthopaedic surgery goes up to four years. A number of specialities are offered in Uganda, however, those whose needs are not met here travel abroad to places like United Kingdom (U.K), South Africa, etc. for their post graduate training. These doctors return home after training but a few who sponsor themselves may opt for greener pastures elsewhere.

My experience in a rural setting
Whereas most Ugandan doctors prefer working in an urban setting, some find themselves in rural places, like myself. I have worked in two rural hospitals since I completed my internship in 2004, they include: Lwala Hospital (Kaberamaido District) and St. Joseph’s Hospital (Kitgum District). I have also worked in an urban setting i.e. in Gulu Regional Referral Hospital (Gulu) under AVSI. In a rural hospital, the patient to doctor ratio is very high leading to work overload and stress. However, my being in these hospitals does not leave regrets in me because I have a good experience from them. I have got exposed to many patients with different disease conditions and I have been able to manage them or refer accordingly. I am happy because I can carry out most emergency and elective surgical and gynaecological/obstetric operations. My ability to make decisions regarding patient management has greatly improved. In St. Joseph’s Hospital, I work with Dr. Salandini Giorgio an experienced surgeon who continually adds on my knowledge and skills especially in orthopaedic surgery.