Dr. OCB

Born again. | Medic. | Rotaractor. | President @RAC_SorotiUni. | 2nd Guild Speaker @Soroti University. | Financial markets. | Jer 29:11. | Top 40 under 40.

[Dr. OCB @CBryahn]

Built something I wished to help with clinical workflow.
[WardMateAI]👇
https://t.co/EIufuKfhG5

[SUMSA .Soroti University Medical Students Assn. @s_umsa]

A health system cannot thrive by neglecting those who carry much of its daily workload. Protecting interns' welfare is protecting the future of healthcare in Uganda. @GovUganda @Parliament_Ug @OfficialFUMSA @TheUMAofficial @RubabindaJr @MinofHealthUG @AgoraCFR @KagaheJamadah

[Medical Pre-interns 2026/2027 @MedPreInternsUg]

"Most of them are not housed, and live in rented unsafe locations distant from the training hospitals; they are not provided with meals and have to buy and cook their own food, yet they work 24/7 with no time to cook"
The President in his 2021 letter regarding Medical Interns

[Andy Kristian Agaba @andykristian]

@KarisMedical in Nalya shaping up. It will be Gumite.

[David Sejusa, DM. @sejudav]

We need to applaud our leaders when they get it right. So Thank you Your Grace! Btw, WHY CAN'T GOVERNMENT PAY ITS INTERN DOCTORS? I have been trying to understand it clearly: Why can't Government find money to pay a few thousand intern doctors? WHAT IS THE LOGIC? Because it is not the money as the Archbishop correctly points out. If you have Shs 200bn to spend on cars for People, many, who even FAILED THE ARTS you are refusing to pay for now, how can you FAIL TO FIND just Shs 28bn for 2000 INTERN DOCTORS?

WHAT IS THE LOGIC? Refusing to pay ARTS TEACHERS and you Pay SCIENCE TEACHERS MORE, produce the SCIENTISTS AT THE UNIVERSITY, then refuse to pay THESE SCIENTISTS, BUT INSTEAD PAY THE ARTISTS, even HIGH SCHOOL DROPOUTS(MPs) with Shs200bn FREE CARS? BTW, WHY DO WE GIVE FREE CARS TO MPs WHO EARN SHS 50 MILLION PER MONTH? WE WHO STRUGGLED WITH BLOOD AND SWEAT, AND THOUSANDS DIED TO BRING ABOUT THAT PARLIAMENT; THEY DON'T BUY CARS FOR US; AND WE DON'T DEMAND! We buy our own Cars. And those who can't, THEY USE TAXIS! So what is it with these POLITICAL FREELOADERS?

Here is my take: Either the People in charge are SUBVERSIVE; ie, silent enemies of the State, or they are extremely ignorant and incompetent! So, which is which? The GOVERNMENT has placed SCIENCE STUDY at the centre of the EDUCATION SYSTEM. I hear the President drumming it up daily. They even increased Salaries of Science teachers tenfold, and abandoned Arts teachers, etc. And in this endeavour, many young people are taking Science subjects: Medicine; Engineering; Food Science; AI, Environmental Science, etc.

Take THESE INTERNS/Doctors. The biggest field, perhaps second to ARITIFICIAL INTELLIGENCE(AI) today is BIOTECHNOLOGY AND PHARMACOLOGY. There is so much going on in these areas which deal with the application of BIOLOGICAL SYSTEMS AND ORGANISMS to make and use things like VACCINES, GENE THERAPY,etc, which are central in the quest for DISEASE ERADICATION. The Bridging of the gap between LABORATORY RESEARCH and PATIENT CARE is now the bedrock of GLOBAL HEALTH CARE SYSTEMS. So why would government not support people who are key in such fields; i ask again, WHAT IS THE LOGIC?

[Dr. OCB @CBryahn]

@al_clifton The commentary 😑

[Dr. OCB @CBryahn]

@M_Jenist USMNT player dribbles ball off pitch across the line
Commentator: if the pitch was increased by one inch, would've been good 😂

[Dr. OCB @CBryahn]

@CreativeBrainy Took like 3 minutes on it btw 😂😂😂

[Dr. OCB @CBryahn]

Hope we get a community note
@CommunityNotes

[Alan Kasujja @kasujja]

Al Jazeera needs a better digital editor.

These clickbait headlines are uncharacteristic…

The same article says-

“….The outbreak has also spread to Uganda, where authorities announced…..two deaths….”

Does the is warrant such a dramatic headline?

@cate_soi - Looks like your people are desperate to make this about Ug!

[Dr. OCB @CBryahn]

@Esau_Matsiko @AnitahAmong @MathiasMpuuga If anyone's selling a car they recently bought, there has to be a major issue with it!

[Dr. OCB @CBryahn]

Interns contribute equally to service delivery regardless of sponsorship origin.
#revisetheentirehealthpolicy
@MinofHealthUG
@CHRISBARYOMUNS1
@TheUMAofficial

[Dr. OCB @CBryahn]

Conditioning the award of a university degree on post-degree activities (internship) contradicts the academic certification frameworks governed by Acts of NCHE and Universities.
A degree is an academic award, making it contingent on post-award employment activities distorts this

[Dr. OCB @CBryahn]

Medical interns perform essential public health services. Article 40 of the Constitution of Uganda protects just and fair remuneration for work done. Compelling private interns to work without any welfare support while government interns are compensated violates this right.

[Dr. OCB @CBryahn]

@DrSerunjogiEmma Here's what I've been working on.
Basically tools I've enjoyed using myself through my final year of medical school and preinternship
https://t.co/EIufuKfhG5

[Dr. OCB @CBryahn]

@DrSerunjogiEmma Iam in awe of your passion for building tools given your medical background. I look upto you.
Might still discovering myself, but I know for sure I could have abit of zeal.
I've attempted to build, am the only user of my tools currently.
Incase you don't mind, I'd appreci...

[Dr. OCB @CBryahn]

@DrSerunjogiEmma ... appreciate a coffee sometime for some mentorship.

[Dr. Sserunjogi Emma @DrSerunjogiEmma]

Bobi Wine once said:

"Atamanyi bw'aba ngamanyi nti tamanyi, oyo abera muyizi mumuyigirize."

So, I will assume that you do not know, and that you know you do not know. So let me teach you.

Who is a Medical Intern?

Medical interns are fully qualified health professionals who have completed university and been awarded degrees. They include:

Medical Doctors
Nurses
Midwives
Pharmacists
Dental Surgeons

After graduation, they have two possible paths:

1. Non-Clinical Path

A graduate may choose not to practice medicine directly. They can:

Join research
Pursue a Master's degree in a non-clinical field
Work in public health
Join administration, policy, academia, or other non-clinical careers and be working.

2. Clinical Path

A graduate who wishes to treat patients in hospitals must first complete one year of supervised internship.

Uganda follows a British-style training model where a graduate works under supervision for one year before being granted full independent practice.

The purpose of internship was originally simple:

Learn under supervision
Gain practical experience
Transition safely into independent practice

The Problem:

Over the years, Uganda has faced a severe shortage of healthcare workers.

Many hospitals operate with:

Too few doctors
Too few nurses and midwives
Too few pharmacists
Limited budgets for hiring staff

Hiring a fully employed health worker is expensive. Government must pay salaries, benefits, study leave, pensions, housing allowances, and other costs.

As the shortage grew, government needed a cheaper solution.

The Solution Government Chose:

Instead of hiring enough healthcare workers, Uganda increasingly relied on medical interns to fill staffing gaps.

The were turned into a source of extremely cheap labour and went from being supervised to gain experience but doing real employable work.

For many years, interns received only about UGX 750,000 per month, with no food, housing, or other benefits. This arrangement saved government billions of shillings that would otherwise have been spent hiring fully employed health workers.

What Internship Became:

On paper, internship was supposed to be supervised training.

In reality, it gradually became service delivery.

Medical interns routinely:

1. Work Extremely Long Hours

Many intern doctors perform 36-hour shifts at least twice a week.

2. Provide Cheap Labour

Hospitals depend heavily on interns to keep services running, some hospitals can go days without seniors but interns doing the job (They're not being supervised but are providing a service, which the government is supposed to hire someone to do it)

3. Work With Minimal Supervision

Any medical intern will tell you that supervision is often limited. In many rotations, supervision happens mainly during the first few weeks. After that, interns largely report to seniors while independently handling patients and making decisions.

Personally, during internship, I performed over 100 Caesarean Sections without a senior doctor physically present.

That is not what most people imagine when they hear the phrase "supervised training."

The Impact:

This system achieved several things:

- Hospitals continued functioning despite staff shortages.
- Patient complaints reduced because healthcare workers were available.
- Government avoided hiring large numbers of senior staff and thus budget saved.
- Health budgets remained lower than they otherwise would have been.

The result:

Government saves an estimated:
UGX 12–15 billion per month
UGX 145–180 billion per year

compared to the cost of hiring enough fully employed health workers to replace the work currently performed by interns (This isn't gap of being supervised to learn, it is a real healthcare staffing gap being filled by medical interns).

Meanwhile, government spends approximately:

UGX 4.55 billion per month
UGX 54.6 billion per year

on intern allowances.

How the Fight Started:

Over time, interns increasingly felt that they were no longer being treated as trainees. They were functioning as employees while being paid trainee allowances.

Interns raised these concerns to President Museveni.

In 2021, the President agreed that intern allowances should be increased to approximately UGX 2.5 million per month.
The increase was implemented because government recognized that interns were providing critical services to the healthcare system and dumpenning the deficit.

What Happened Next:

One year later, discussions emerged about reducing the cost of internship even further.

The argument was simple:
Government wanted the services interns provided but did not want the financial burden that came with paying them.

As a result, ministry of health, which is supposed to fight the well-being of its people decided to raise a proposal to revise medical training and extend the duration of medical school from five years to six years, just because they want to take exploitation to another level and have it completely free.

The practical effect would be that the same work currently done by paid interns would instead be done by students during an additional year of training, labelling medical interns as students failed and thus, they decided to add a full year to medical practive just to have free labor.

Why Many Consider This Unfair

This change affects more than future interns.

It affects every medical student, including those who may never want to practice clinically.

Someone who wants to:

- Work in research
- Join public health
- Enter administration
- Pursue non-clinical careers

would still be forced to spend an extra year in medical school because government wants clinical services without paying internship allowances.

Many see this not as an educational reform, but as a financial decision designed to reduce government expenditure while overworking its citizens.

The Real Issue:

This debate is often framed as:

"Why should interns be paid to learn?"

That is the wrong question.

The real question is:

"Should interns be paid for the substantial work they perform beyond the original purpose of supervised training?"

If internship truly consisted of observation, teaching, mentorship, and closely supervised practice, the discussion would be very different.

But that is not the reality experienced by many interns.

A Simple Analogy

Imagine joining a company as a cleaner.

Because you are a cleaner, your employer begins assigning you additional responsibilities.

You become:

The gatekeeper
The gardener
The cook
The electrician
The driver

Eventually, several other employees are removed because you are performing their duties.

On paper, you remain a cleaner.

In reality, you are doing the work of an entire department.

That is how many medical interns feel.

Officially, they are trainees.

In practice, they always function as a critical workforce keeping hospitals running.

And unlike the cleaner in this example, the intern cannot simply refuse, because completing internship is mandatory for obtaining a license to practice.

"Stop using Medical Interns"

[Dr. OCB @CBryahn]

@rkalyes1 @newvisionwire But where is UMDPC in all this?

[Musundi Joshua Junior(MBChB IV) @MusundiJoshua]

📌Interns can never be students.
📌Interns deliver 90% of health services.
📌The patients will suffer the consequences.
@MinofHealthUG rethink..Itz a draconian policy.

Mzee @KagutaMuseveni, we surely believe in your abilities,your not senile,.look critically into this please.

[Dr. OCB @CBryahn]

The @MinofHealthUG is even failing to interpret their own drafted policy.
The rush, irregularities and secretivness around this clearly shows why this policy MUST be rejected in its current form.