Despite the need for trained Saudi health care workers, all is not as it should be.
An increasing number of young Saudi health sector workers -— nurses, pharmacists, radiographers, dental assistants and laboratory technicians — who have graduated from local privately-run health care teaching institutions say they cannot find a job.
Moreover, many attribute their difficulties to the quality of the courses they studied and to the fact that they were trained in Arabic whereas English is needed for work in hospitals.
There are 119 institutions in the Kingdom training almost 29,000 students in some 21 different specializations. Of these, 77 are for men only.
Such is the situation that the Saudi Commission for Health Specialists (SCHS), the licensing authority for health institutions, has stopped registering new ones. It says there is no need for any more at present. However, there are many fields not open to women to study, such as dealing with emergencies, medical equipment technicians, psychological treatment and medical insurance.
Trainee nurses account for the largest number of students — 8,430 of them at 92 institutions, 3,591 of them women. Pharmacy comes second with 6,623 students, 1,420 of them women. Other popular subjects include radiography and laboratory work — however, in these the number of male students is far greater than that of females. In radiography, for example, there are 1,592 male students compared to just 260 females. Moreover, in several fields, there is a worrying dearth of interest; some training courses attract less than 10 students.
There is concern among students that some courses are far from adequate. Training covers only “the basics” according to Hassna Al-Gharni a 29-year-old radiographer who graduated from the Health College of Jeddah but who has now been working for 10 years. Neither she nor her colleagues received any in-house training after starting work in hospitals, she says. “They only trained us on new machines — and we had to ask for that,” she adds.
A serious problem she highlights for those who have studied at private health institutions is the language barrier. Unlike the state-sector where training has long been in English, private sector training has been in Arabic, making it difficult for nurses and other health care specialists who graduate from such places. In hospitals they have to use English. They find it difficult, she says, if they were not trained in it. The private sector is now making the change from Arabic but a worrying number of those who graduated in the past find they are either not wanted or given lower paid jobs. If they want to make the grade they have to study English at their own expense.
Another graduate of the Health College of Jeddah, 26-year-old Razaz Fatawi, who has worked as radiographer for the past five years, agrees. She now provides in-house training at the hospital where she works. She says her workload is doubled when dealing with graduates from private institutions because she has to teach them not only scientific terms in English but “basically everything” (as she put it).
In her view, graduates from the state-sector Health College are better trained and have greater work experience than those from private institutions. But even university graduates are not all that well trained, she says.
Another concern, highlighted by 24-year-old Mona Al-Gharni, relates to the fact that, after three and a half years’ study, graduates from state college and private institutions are supposed to be able to obtain a bachelor’s degree provided they take an extra six-month course. Jeddah’s King Abdul Aziz University had provided such a program but after an initial period it was discontinued. The result is that without it, graduates are now recruited to lower positions and with lower salaries, Mona claims.
As to why so few school leavers opt to study radiography, Razaz claims it is because of the limited job opportunities at hospitals compared to nursing; the number of openings for X-ray lab technicians rarely exceeds 20 a year. Physical therapy, she says, is another specialization that fails to attract many school leavers because so few jobs are available in the various hospitals.
A particularly serious problem facing Health College students is that they have to work for the Ministry of Health for the first two years after graduation. But because the ministry cannot find jobs for all graduates it means that some are effectively denied a job at all.
A considerable amount has been written of late in the local press about these various problems surrounding health care training which, until recently, came under the supervision of the vocational sector but subsequently moved to the remit of the SCHS. A strong critic has been Dr. Muhammad Al-Khazim in Al-Riyadh who has accused the commission of failing to adequately supervise and evaluate the fee-paying institutions.
He points to the low numbers of students graduating from them. Of 10,111 students, only just over half (5,533) passed the SCHS evaluation test. In fact, partly as a result, the SCHS has decided to set up a committee to evaluate these institutions. Another change is that students who have graduated from high school with art certificates and who want to transfer to the health care industry and enroll in one of these institutions can no longer do so (except for administrative posts). Previously they could provided they completed a re-training course, but a quarter of them failed the examination.
The issue of private institutions has also long worried many students because not all are accredited. According to Dr. Mohammad Al-Furaihi, the commission’s general-secretary, there is increased public awareness of the issue. He warns against enrolling in unregistered institutions and advises students and parents to check the commission’s website to find out which are registered and which not. The problem, he says, is that some institutions “rush to accept students as soon as they receive the primary license” despite this being illegal. An offending institution discovered to be doing so would be removed from the accredited list or have its accreditation frozen, he says.
As for those institutions already registered, he rebuts the criticism and says that the training they provide is based on reputable professional programs and that the courses include work experience at certified hospitals. They also cover communication skills and work ethics. Students, he insists, undergo yearly examinations and are evaluated regularly.
Nor should language be seen as an obstacle for students. He says that three years ago the SCHS instructed private institutions to start using English. However, there were problems because of students’ difficulties with it. Some, he says, “remained weak”. To resolve this, the SCHS had devised a scheme whereby students cannot move beyond the preparatory year unless they pass an English exam. It is set by leading American assessment company Prometric.
