By Ben Musanje
What began as a discussion on Uganda’s transition to a paperless Judiciary quickly transformed into a powerful indictment of a controversial health policy that professionals say threatens the future of medical training and healthcare delivery.
The Uganda Law Society (ULS), which had convened the engagement primarily to discuss the Judiciary’s planned migration to a fully paperless court system by July 2026, instead found itself hosting an increasingly united front of doctors, pharmacists, nurses, midwives and students opposed to sweeping changes in the country’s internship training framework.
At the centre of the storm is a government policy that integrates internship into formal university education, requiring medical, pharmacy, nursing and dental students to complete supervised clinical training before graduation rather than after obtaining their degrees.
Government officials have presented the reforms as a modernization effort aimed at closing the gap between academic training and professional practice. Under the new arrangement, universities will submit names of eligible final-year students to professional councils for provisional licensing, allowing them to undertake supervised internship placements before graduation. Full professional licenses will only be issued after successful completion of the internship year.
But health professionals who addressed the ULS forum argued that the policy threatens to dismantle long-established professional standards while creating new barriers for thousands of aspiring healthcare workers.
Leading the criticism was Dr. Frank Asiimwe, President of the Uganda Medical Association (UMA), who described the policy as “draconian,” “shambolic” and ultimately “dead on arrival.”
Speaking passionately before lawyers, healthcare professionals and students, Dr. Asiimwe argued that the policy is built on a fundamentally flawed understanding of what a medical intern is.
“An intern is not a student,” he said.
According to Dr. Asiimwe, medical graduates entering internship have already completed all academic requirements for their degrees and successfully passed years of examinations and clinical assessments. Internship, he said, is not an extension of classroom education but a mandatory period of supervised professional practice designed to ensure safe healthcare delivery.
Drawing from his own experience as an intern nearly 30 years ago and as a supervisor of interns since 1998, he said the profession cannot afford to blur the distinction between students and qualified graduates.
“The first year of practice must be supervised because we deal with human lives,” he said.
The debate has sparked growing anxiety among students who are preparing to enter the healthcare workforce.
Precious Gracious Ocen, President of the Uganda Pharmaceutical Student’s Association and a finalist pursuing a Bachelor of Pharmacy at Makerere University, issued one of the strongest warnings of the day.
“Unless this policy is reviewed and looked into, we want to promise that we’re not showing up for internship come August,” she declared.
Her remarks reflected a growing sense of frustration among students who fear that the policy could delay their professional progression while increasing the financial burden of entering practice.
Although the restructuring of internship has generated significant concern, the deeper source of anger lies in what many health professionals see as the erosion of support systems that have traditionally enabled interns to complete their training.
Professional leaders argue that internship is one of the most demanding stages of healthcare training, requiring graduates to work long hours in hospitals while taking on significant responsibilities under supervision.
Dr. Stephen Lutoti, President of the Pharmaceutical Society of Uganda, warned that the policy fails to appreciate the realities faced by interns.
“Interns work almost around the clock in different departments and units,” he said.
He explained that trainees require support for accommodation, meals, transportation and other welfare needs while serving in hospitals.
“This allowance is not a salary. It is support that enables them to continue providing essential healthcare services,” Dr. Lutoti said. “Removing it would be a very dangerous proposition.”
He also questioned whether the country’s health facilities possess the capacity required to implement the new framework.
According to Dr. Lutoti, many hospitals currently operate at less than 40 percent of approved staffing levels and lack sufficient specialists, consultants and supervisors needed to support competency-based training.
“We do not have enough educators, supervisors, specialists or consultants in many facilities, particularly district hospitals,” he said.
The concerns were echoed by Dr. Patrick Odongo, Vice President of the Association of Graduate Nurses and Midwives of Uganda, who criticized both the substance of the policy and the process through which it was developed.
“Policies of this nature are supposed to be developed through broad consultation and engagement with all relevant stakeholders,” Dr. Odongo said.
He argued that many of the professionals expected to implement the policy were either inadequately consulted or entirely excluded from its development.
For Dr. Odongo, the consequences could extend far beyond administrative reforms.
He warned that the policy risks creating inequality within the healthcare profession by making internship increasingly inaccessible to graduates from less privileged backgrounds.
“We risk creating a situation where students complete university training but are unable to progress to full professional status because they cannot afford the costs associated with internship placement,” he said.
Such a scenario, he argued, would create a profession divided by economic status rather than merit.
Health sector leaders repeatedly stressed that internship is not an optional stage of training but a mandatory legal requirement that prepares graduates for independent practice.
Without it, they argued, healthcare professionals cannot safely assume full responsibility for patient care.
Dr. Asiimwe likened the healthcare profession to a pyramid, with interns forming its foundation.
“We are weakening the base,” he warned. “The intern is the one who makes the first diagnosis, identifies problems and ensures patients enter the healthcare system correctly.”
According to him, weakening internship training ultimately threatens the quality of healthcare available to ordinary Ugandans.
The Uganda Law Society’s involvement added a legal dimension to the debate.
Although the organization’s primary focus was judicial reform, its platform provided health professionals with an opportunity to challenge what they believe is a policy that lacks adequate stakeholder ownership and raises important legal questions about professional regulation and training standards.
The convergence of legal and health sector voices created a powerful message: reforms affecting critical professions should not be developed in isolation from those expected to implement them.
As pressure continues to build, doctors, pharmacists, nurses, midwives and students are now calling for the policy to be withdrawn and subjected to fresh consultations.
For them, the debate is no longer simply about internship structures.
It is about preserving professional standards, protecting future healthcare workers and ensuring that Uganda’s health system continues to produce competent, motivated and adequately supported professionals. (For comments on this story, get back to us on 0705579994 [WhatsApp line], 0779411734 & 041 4674611 or email us at mulengeranews@gmail.com).
