Medical for Quality Healthcare in Zambia (MQHZ) has proposed the introduction of paid, contract-based internships for Junior Resident Medical Officers, a new approach aimed at reforming the employment of medical doctors and reducing long-term pressure on the government wage bill.
The proposal seeks to address longstanding challenges in the employment of doctors, workforce planning, and sustainability within the public health system.
According to the organization, the approach will directly respond to concerns around unpaid or poorly structured internships, which have left many medical graduates underemployed or working on a voluntary basis.
MQHZ Director General Dr. Quince Mwabu explained to Money News that under the proposed model, all junior doctors undergoing internship would be employed on fixed two-year contracts covering the full duration of their internship training.
“During this period, doctors would receive a monthly salary and operate under clearly defined terms of service, recognizing the essential clinical services they provide while maintaining the primary purpose of internship as supervised training,” Dr. Mwabu explained.
Dr. Mwabu stressed that the model is designed to prepare doctors for professional success both within and outside the public sector, enabling them to thrive with or without government employment or support.
“By earning a salary during internship and completing structured clinical training, doctors are better equipped to pursue diverse career pathways including government employment where positions exist, private medical practice, specialization, healthcare entrepreneurship,” he said.
He added that the establishment of predictable, time-bound internship contracts would create continuous and guaranteed entry points for newly graduated doctors each year, eliminating prolonged post-graduation waiting periods and preventing the accumulation of unemployed medical graduates seeking internship placement.
According to Dr. Mwabu, the move would ensure that graduates remain productive, financially supported, and professionally prepared rather than idle while awaiting opportunities.
“The proposal also aims to reduce long-term pressure on the government wage bill by limiting public payroll commitments to the training period only. This allows the government to recruit doctors strategically based on national health needs and available resources, while encouraging private sector participation and innovation in healthcare delivery,” Dr. Mwabu sressed.
He emphasized that the proposed reform would not affect doctors who are already on permanent government employment.
“Instead, it seeks to expand internship opportunities, promote fairness in doctor training, and support the development of a sustainable and self-reliant healthcare workforce in Zambia,” Dr. Mwabu added.
He implored the Government, through the Ministry of Health, regulatory authorities, professional bodies, and other stakeholders, to engage in constructive dialogue on the proposal.
“Collaborative reform is essential to modernizing medical training, protecting healthcare workers, and improving health outcomes for all Zambians,” he noted.
