Medical and health sciences students across South Africa are confronting a persistent financial crisis as the National Student Financial Aid Scheme (NSFAS) continues to structure allowances around a 10-month academic year, despite clinical programmes requiring year-round commitment.
Ambrose Lekalakala, National Convenor of the South African Medical Students Union (SAMSU), highlighted the structural mismatch: while medical, nursing, physiotherapy, and allied health programmes operate on a 12-month academic and clinical training model, NSFAS funding—including accommodation and meal allowances—covers only February through November. This leaves students without essential support during January and December, precisely when clinical placements and training intensify.
“Students arrive as early as the third of January with nowhere to sleep and nothing to eat,” Lekalakala stated. “They are vulnerable, taken advantage of, and their rights to education, health, safety, and basic dignity are compromised.”
More than 9,000 students are currently pursuing medical degrees in South Africa, with over 60% reliant on NSFAS funding. The scheme covers tuition, accommodation, and living allowances but remains bound by policy frameworks designed for standard university calendars. Lekalakala noted that medical students spend most of their time in hospitals—often far from university campuses—forcing them to purchase meals at costly hospital cafeterias without corresponding allowance adjustments.
SAMSU first formally raised the issue with NSFAS in 2024, when the entity was under administration. According to Lekalakala, NSFAS responded that it could not resolve the matter independently, as it implements policies set by the Department of Higher Education and Training. The union subsequently engaged the Department, where both the former minister and current Minister Buti Manamela acknowledged the concern. Officials cited budget constraints and indicated the need to consult the Minister of Finance, but SAMSU reports no substantive progress since.
“We don’t know where the problem is,” Lekalakala said. “They must be honest enough to come to us and say: we are facing these challenges. Let us find an amicable solution. It does not make sense for a country to want to produce life-saving professionals while compromising the health and dignity of the very students training to fill those roles.”
The funding gap also affects “missing middle” students—those pursuing medicine as a second degree. NSFAS policy restricts funding to first undergraduate qualifications, leaving many capable students from rural backgrounds without support after completing initial degrees in related sciences. Lekalakala explained that these applicants often misunderstand the MBChB application process and only discover funding limitations after gaining admission.
SAMSU has also called on the Department of Health to reinstate historical bursary support for health sciences students, noting that provincial health departments previously recognised the unique demands of clinical training.
Beyond financial strain, Lekalakala emphasised the psychological toll. “Students are emotionally and mentally compromised,” he said, though he declined to share specific confidential cases. He stressed that despite these pressures, medical students remain committed to their vocation, supported by university staff, lecturers, and hospital-based clinicians.
SAMSU continues to advocate for policy interventions that align funding structures with the realities of clinical education. Lekalakala concluded: “The only way for us to save lives is to study properly—and that requires being properly supported.”
