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Pick your placement: community service applications

Dr Lynelle Govender provides some top tips on what you need to consider when it comes to deciding where to spend your community service years

Amongst your colleagues you will find that internship can be a varied experience. Some will hate it, and yet others thrive. About halfway through your second year of internship you all face the same new and particular daunting challenge: applying for community service.

In the midst of trying to cope with the madness of internship you are faced with the reality that very soon you will be a community service officer. The security blanket of senior advice will not always be available to you and it is time to decide where you would like to be placed: a single application form with five choices sent to a faceless stranger will decide your fate.

The government will send you a time schedule along with your application form – read this schedule very carefully. According to the 2013 schedule, the forms were sent to all provinces by 30 May 2013. The final deadline for completed forms to arrive at the Department of Health (DoH) was 12 July 2013.

Simply put: you have approximately one month to decide where you would like to work. Use your time wisely and efficiently

Communicate clearly with your Human Resources department; they will usually request your forms to be handed in earlier than the stated deadline so that they can be posted well in advance to the DoH.

Simply put: you have approximately one month to decide where you would like to work. Use your time wisely and efficiently. You should begin thinking about your community service (com serv) placement from the beginning of your second year of internship. This will give you adequate time to do research in order to make an informed decision.

It cannot be overemphasised how important research is. Once you have decided which hospitals you prefer, endeavour to find out more information about the facility. Ask in-depth questions regarding the following:

  • Housing – Find out if accommodation is provided for the community service officers and if the housing is of a suitable standard. If housing is not provided, make sure you find out if your rent will be subsidised.
  • Overtime hours – Different facilities have different structures of overtime, which may affect both your lifestyle and your salary. Ask the difficult questions and be aware what you are getting into.
  • Salary – Not all community service officers earn exactly the same. Some receive rural allowance and yet others are given relocation allowance. Find out if you are eligible to receive these benefits and what sort of paperwork will be involved. Moving to a new province can be a costly business and you should prepare yourself financially.
  • Work experience – Craving theatre time or seeking more time to build rapport with patients? Do some digging to find out what awaits you next year.
  • Senior support – Senior support can be anywhere between a cavalry of consultants while in other facilities you may be the most senior doctor on site. Acquire these key facts before plunging in to the proverbial deep end.
  • Local surroundings – You may be surprised how much you enjoy distant towns in far-flung provinces. Enquire about the environment and what amenities are available, ie, banks, shops, entertainment.

Make a simple phone call, or use your greatest ally: social media. Use online groups and forums to gain the information you need.

Hospitals, just like people, have reputations: whispers of horror stories or glorified anecdotes of the hey-days when com servs could sleep on call. Reputations, however, are not always reliable and you should keep in mind that many dilapidated hospitals have been renovated and refurbished and several once-popular facilities have slipped into a state of decay. Speak to a doctor presently working at the facility in order to gain more accurate information.

That said, you would do well to remember that a current doctor’s opinion is largely influenced by numbers. A formerly famous hospital that receives fewer com serv doctors may be a disaster, and conversely, a notoriously busy or lonely facility that receives a full complement of staff may be a pleasure to work at.

Both the Department of Health and the Department of Defense (South African Military Health Service) offer posts across all nine provinces.

You would do well to remember that a current doctor’s opinion is largely influenced by numbers

Once the application forms are released it will become a talking point amongst your intern friends and colleagues. Do not let others sway you. Think carefully and calmly about what you wish to experience from your com serv year. Some interns will wish to be in a specific town, others want to experience the freedom of rural practice, while yet others will want an academic setting with a potential opportunity to rotate through a chosen specialty. Everyone wants different things and your task will be simply to decide what you want.

“I’ve been second-rounded,” or worse, “third-rounded” – now what? Grammatically, it is up for debate as to whether these terms actually exist. However, the professors of English will have to forgive us our blatant misuse of the language.

The expressions “second-rounded” and “third-rounded” strikes immediate fear into the heart of an intern: the horrifying prospect of not being allocated to any of your first five choices is a nightmare. If the worst happens remember to keep a cool head. Weigh your available options carefully and you may find that being secondrounded is not the disaster that it initially seemed to be.

Most com servs agree that your experience of community service depends not only on where you are allocated but with whom. There is indeed strength in numbers. A distant rural hospital can be a great experience if you gather a few friends and apply to go there together. This is a particular good strategy to hold on to if several of your friends have been “second-rounded”.

Approach the year with a positive attitude and a good experience is sure to follow

Collectively you can turn a theoretically lonesome and dreadful experience into a fun and enjoyable year. Community service can be a year of immense personal and professional growth. Regardless of where you are allocated, approach the year with a positive attitude and a good experience is sure to follow.

Dr Lynelle Govender is a Community Service Medical Officer at Area Military Health Unit (Nelspruit), Mpumalanga

Rural-vs-urbanRural v Urban

Going rural has many benefits which include, but are not limited to, the famed rural allowance. Rural clinics can offer you:

  • The opportunity to practise medicine and make decisions independently
  • Beautiful surroundings
  • The opportunity to explore parts of the country you would have otherwise ignored
  • Laid back atmosphere
  • Rural or deep rural allowance
  • Theatre time.

You can be limited, however, in the following:

  • Little or no senior support
  • Difficult to refer patients with referral hospitals often far away
  • Few special investigations available at your disposal
  • Small town living can result in boredom and loneliness
  • Few amenities available.

Being in a large centre in a big city always sounds promising and it certainly can be. Benefits include:

  • Senior staff that can assist you with difficult cases
  • Convenient location
  • Special investigations easily available, even after hours
  • Easier to refer patients
  • You may be allowed to rotate through a specialty of your choice at a large hospital
  • You may pursue diplomas in these above-stated specialties.

However, the metropolitan life has its disadvantages as well:

  • Busy, stressful environment
  • No rural allowance
  • Relying on seniors to manage difficult cases with less self-confidence built
  • Less theatre time.