What is driving the glut of medicine graduates in Somalia?
According to a 2020 Country Graduate Survey by the Iftiin Foundation, a development and education-focused Somalia-based NGO, the number of education and arts graduates in the country is far too low. In the meantime, there are a large number of medical graduates, when considering overall student numbers.
Of the 17,548 students who graduated in 2020, 6,700 were from medical-related faculties, said the Iftiin Foundation, while only 397 and 202 were from education and arts faculties, respectively. The survey, released last August (2021), drew statistics from 26 faculties in 56 universities in 11 Somali cities, including Mogadishu, Galkayo, Kismayo, Merca and Jowhar.
The imbalance is deep-seated. In 2018, 4,422 students graduated from Somali medicine-related faculties, whereas only 410 graduated with education degrees and 75 with arts degrees (in this case, focusing on languages).
In 2019, 5,880 graduates had medicine-related degrees, whereas 292 had education and 48 arts degrees (also focusing on languages).
“This survey is a true reflection of our students’ interests. But, also, it’s a wake-up call to us [educationalists] to start reorienting our students, so we strike a balance in the labour market,” said Ahmed-Nor Mohamed Abdi, a public policy and research lecturer based in Somalia’s capital, Mogadishu, who lectures at a range of senior universities in the capital.
Given a majority of Somalia’s students want to pursue medicine and health-related courses, he noted: “When you ask them why, the response is mostly because they were pushed by their parents, who regard it as a religiously blessed career, and that it has high prospects of getting a job,” he told University World News.
“If we are not careful, we will end up not having graduates in other fields, which will be detrimental to our labour ecosystem,” he added.
What is driving the increase?
Despite this imbalance, Mohamed Mohamud, the deputy rector of academics at a Mogadishu-based private institution SIMAD University added that the proportion of students taking up medicine and health sciences at his university was increasing.
He said this has been triggered by the real demand for qualified doctors and nurses in Somalia, fuelled by past reports that the country’s health sector remained weak and needs more skilled health workers. According to World Bank data in 2014, for example, there were just 2.3 medical doctors per 100,000 people in Somalia.
“Education here is not free; everyone funds themselves and, therefore, people prefer to graduate from faculties that give them jobs immediately – and this is the medical field,” Mohamud told University World News, adding that students are also inspired by the popular conception that doctors command respect and are highly paid compared to those in other disciplines.
Moreover, there are some strong cultural prejudices against technical work, such as plumbing and textile or clothing manufacturing.
Indeed, he said: “Culturally, in some regions, technicians are not welcome,” adding that the situation is compounded by “a lack of clarity on the importance of vocational education and the role of graduates”.
He added: “For instance, some see jobs like [working as] painters, plumbers, mechanics or even in some agricultural fields as dirty and to be shunned.”
Furthermore, Somalia lacks well-equipped vocational schools and colleges, with those few that do function being donor-reliant, which makes them less sustainable than those with government support or a solid student fee base.
“There are no dedicated local investors in TVET [technical and vocational education and training] schools, like other tertiary institutions. Therefore, people cannot see more future opportunities in such schools,” he said.
Social sciences affected
Iftiin Foundation coordinator Abdiweli Mohamed, commenting on the 2021 report, said there has not only been a shift of focus from teaching and vocational careers to medicine, but there is less interest among students in social sciences, geology, marine, and maritime studies, as well as in agriculture. The World Bank says food production accounts for 75% of Somalia’s GDP.
For instance, he said, the report documents that just 388, 50, 40 and 33 students graduated in agriculture, social sciences, geology, marine or maritime studies respectively in 2020.
“This means that we are also neglecting critical faculties that are key to our economic growth, such as study in geology and maritime issues that can help us exploit our natural resources,” he told University World News.
He said that the survey was designed to highlight such graduate labour trends, informing institutions of higher learning and policymakers about which disciplines needed more emphasis regarding student recruitment.
If this rush to medicine is not reversed, said Mohamud, the trend will hurt the entire Somalia education sector in the long term, thus harming Somalia’s economic development.
What strengthens this demand is the fact that there is an increasing demand for doctors and nurses in Somalia, for instance to serve the 200-bed Erdogan Hospital (named after Turkish President Recep Tayyip Erdogan), the 700-bed Banadir Maternity and Children’s Hospital, the Martini and Madina hospitals, and five other private hospitals, all in Mogadishu.
There is also more demand for medical professionals in other cities, and even remote villages. However, said Mohamud, given the rate of training, “with time, we will have a surplus” (and, hence, unemployed medical doctors), and there is a risk of over-extended training, resulting in “unskilled or half-baked medical student graduates,” said Mohamud.
“We must consider two things: first, to make sure that medical graduates are qualified and well-trained [so] they can contribute to the healthcare needs of the country. Secondly, to encourage graduates to go and work in remote areas where healthcare facilities are less available to save lives,” he said.
But this cannot be done at the disservice of other courses, he said, noting that a lack of local technicians undertaking jobs such as work in the masonry and construction industry, will slow economic growth and deny Somali nationals job opportunities, as investors will rely on foreign staff to bridge labour market gaps.
The lack of teaching graduates here is a major problem: “Our universities depend on primary and secondary education. If we don’t have well-prepared pupils and students from that level because there are no teachers, then, definitely, the higher education sector will suffer, including the medical disciplines,” he added.
A dearth of teaching hospitals in the country means that practical instruction has significant weaknesses, he said.
SIMAD University has a teaching hospital and associated laboratories and its medical faculty has introduced entry exams to ensure that all enrolled students have the aptitude and required educational background.
To standardise quality and meet international standards, he said, all medical students must sit intermediate exams assessed by external professors in their third year.
“Instead of accepting a colossal number of medical students and keeping them around, our approach is to produce few but well-trained, qualified and skilled graduates,” he said.