Rural Allowance: Yes
Doctors Quarters:
- Yes, cannot speak to the quality. Not always space
Academics:
- Department dependant, generally little
Supervision:
- Department dependant. Some usually available. In a lot of departments, call alone (Medicine, Paeds, Anaesthesia, Ortho), though do have a consultant to call for backup. Surgery you have a senior medical officer with you in case you need to operate. Obstetrics I assume the same?
Clinical Exposure:
- Reasonable, department dependant. A lot of cutting in Uro, not as much in general surgery, decent in Ortho
Departments worked in:
- I was in Uro, did Gen Surg Calls
- Departments offered: Surgery, Medicine, OBGYN, Paeds, Orthos, Anaesthesia, Urology, Ophthal, ED
Social Scene:
- Minimal, despite lots of Comm serves
Additional Comments:
The following is a copy and paste from my review posted on one of the Facebook groups
Medical Community Service Review of Mafikeng/Mahikeng Provincial Hospital (MPH), 2025
Firstly, I’d like to apologise for the delay in writing this. I know that many people have been assigned to MPH for 2026, but I wanted to wait till I completed my year before writing. I did my year in Urology, with General Surgery calls.
Secondly, this is not an internship review of MPH, though much of the following will still be applicable. Internship at MPH is generally not ideal, with supervision being an issue at times. I would recommend elsewhere
Hospital
MPH (which is different from Bophelong psychiatric hospital, though many of the locals refer to it as Bophelong, and they share a plot, but a new BPH is being built) is a 400 to 500 bed regional hospital, with some tertiary services. There are consultants in every department, a 24 hour CT scanner, a 4-theatre complex with a 24 hour theatre, an onsite blood bank (they’re excellent!), an onsite lab (also very good), dialysis services during the day, and an ICU/HCA. We receive referrals from 4 or 5 district hospitals, while we refer to Rustenburg or Klerksdorp, our tertiary centres. Being a rural regional facility is difficult. We are expected to handle complex cases with limited resources, but it’s good exposure. (and yes there is rural allowance)
Departments
Departments available to comm serves, with approximate numbers of comm serves in brackets, include Medicine(5-6), Surgery(5-6), Paeds(5-6), Obs and Gynae(5-6), Casualty(3-4), Ortho(4-5), Anaesthesia(5-6), Urology(2-3), and Ophthal(2). There is quite a large comm serve group of about 40, which is nice, though honestly not much of a community (yet?). This year there was very few interns after complaints in the past of the quality of teaching (maybe 8 interns for the whole 1st year). There may be more interns next year. The hospital is accredited for a DipObs, DipPEC, DCH, Dip Int Med, DA, and a Dip HIV (at least if you are in Medicine). It is NOT accredited for a DipOphthal.
There is no Psych, that’s a separate facility at BPH, and so getting Psych time is very difficult if you’ve been given MPH. There are consultants in every department, and there’s a lot of autonomy with comm serves functioning as MOs. Within two or three months, you call alone in Anaesthesia, Paeds, and Medicine (and maybe others). Teaching is variable depending on department and seniors. Post call is not a thing in most departments, so your shifts can stretch to 32 hours as you may work the whole day after (department depending). There is generally nowhere to sleep so you end up in your car, which is tricky in the summer. If you work over 80 hours, you can claim extra overtime up to a max of 112 hours a month.
Surgery-wise, it was a challenge as theatre afterhours was often taken by Obs and Gynae, so it was a struggle to get emergency cases done. There was always a senior MO on, so you’d never cut alone. Not a lot of violence (thankfully but then less trauma operating), but good exposure to emergency gen surg cases in casualty - appendicitis, bowel obstruction, TBIs, occasional stab or GSW that you’d try and take to theatre. Cutting in Gen Surg wasn’t ideal as 6 Comm serves and 1 Junior MO all fight for a chance to cut (no one besides the consultants do laparoscopy and they only ever do a lap choly every few weeks, so all procedures open), lots of amputations and debridements. Surgery is a very busy department. G-scope was also broken for 10 months. Casualty can be problematic, especially the senior casualty MOs who, in this passed year, have missed pneumothoraces, tibial plateau fractures, called a Right LL Pneumonia a cholangitis, called an acute limb ischaemia a DVT - twice, and don’t do gases for some reason, even for burns patients (we have two gas machines). At least they do Ct Brains for TBIs before putting in the surgery box.
Urology was my day job and the operating opportunities were excellent there. No post call was very difficult though, especially given a busy Uro clinic. But by the end of the year, you’re comfortable with most things, can do a torsion, hydrocoele, circumcision, basic cystoscopy. I’ve been getting better (though not quite independent) at TURPs, Orchidopexy for undescended Testis (we do Paediatric Urology too), Optical Urethrotomy (DVIU). Small department so you do a lot, with an inspiring HOD.
Allocations
We were allocated randomly when we arrived by the clinical manager, but were allowed to swap amongst ourselves. The clinical manager has now changed, so not sure how allocations will take place. Most departments are willing to split time if you speak to the HODs, but Orthos specifically (and possibly Ophthal) would be unlikely to be willing to let their Comm serves go after 6 months. It’s department dependent.
Town
Mafikeng is 3.5 hours from Joburg, and just over 3 hours from Pretoria. It’s the provincial capital, there are more potholes than road, lots of mosquitos and very hot, and 1 of the 6 traffic lights on the main road actually works - there’s more traffic than you think. People are generally very sweet. There’s a large rural population in and around Mafikeng, and most people speak only Tshwana, so you often (as in almost always) have to get a translator if you aren’t familiar with the language. Some of the older Male Uro patients spoke Afrikaans as well.
It’s my strong recommendation that you view any places to stay yourself before signing a lease, as some accommodation can be down poor quality roads, in more rural areas, which is an issue when there’s rain or at night. There is a DQ, interns get preference, I am not sure the quality. The International School is a popular option, and it’s quite safe with a pool and tennis courts, there are Squash courts too but you have to pay. It’s an expensive option though. I stayed at a small guesthouse and was happy with the place. Power and water cuts do happen, area dependent.
There isn’t a lot to do in Mafikeng. There’s a small independent cinema, lots of fast food places (very few are halaal - Pedros, 2 Nandos, and 2 McDonalds), 2 mosques (Danville is closest to the hospital - Jummah Khutbah at 1pm, same as the main mosque). The nearest paddle is 45 minutes away in Lichtenburg. Botswana is like 30 minutes away, Gabarone is 2 hours from Mafikeng, but none of us really went. There is a Casino (Mmabatho Sun), can’t speak to it’s quality. They used to have an excellent Golf course that is now closed unfortunately.
Closing
Mafikeng is an interesting place. It’s quite a large centre that most people haven’t heard about. There are a lot of issues with resources, and it can be especially busy, particularly with poorly functioning district hospitals and clinics referring to you. I don’t think you can find as big a place with as much support that still counts as rural and gives you rural allowance, while allowing you to stay in a spec the whole year. There is always a senior, whether senior MO or consultant, you can call on for advice. To be a bit cliché, it is what you make it.
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