To Retire or Not to Retire Physicians at 55- that is the question!

For several years I have often pondered on the early retirement age of 55 years for government-employed physicians in Cameroon and the effects this has on the Cameroonian healthcare system. Although understandable and even logical from the viewpoint of a government that can only afford to employ and pay a limited number of physicians at any give time, it seems counter intuitive to cut-off physicians in their prime in a country facing a severe deficit in medical doctors.

Training a physician is a long process that doesn’t end with graduating from medical school but continues throughout the physician’s career as they gain in experience and perfect their skills. In Cameroon medical training in state owned medical schools is heavily subsidized by the government costing only approximately 100USD annually in fees for a total of 700USD for the seven years of training.  These figures stand in stark contrast to the staggering 200,000USD estimated cost to train a physician in many western countries and highlights just how much the Cameroonian government spends in training physicians for its work force.

To spend so much in training doctors to work in its healthcare system only to precipitously retire them when they are in their prime in terms of experience and what they can offer to the system is a great loss for the system and in my opinion not the best use of its resources. It is obvious that physicians retired from the government at 55 years do not go on to spend their retirement days lounging in the sun and gardening to fill their new found free time. Many of them still strong and having lots to offer, export their competencies to the private sector at home and abroad where they go on to practice for many years before truly retiring.

In a country which has no universal healthcare system and in which the minimum wage is only 36,270FCFA per month (about 65UD), most of the population cannot afford private healthcare and rely heavily on government healthcare facilities for their healthcare services. These government healthcare facilities are primarily staffed by government trained and employed physicians. The combined effects of early retirement and brain drain of trained physicians lead to a self sustaining vicious cycle where there are never enough doctors to support the health needs of the Cameroonian population.

How then do we break this cycle? Will raising the retirement age for Cameroonian doctors help? Is this a change that Cameroonian doctors want and will welcome? There are certainly no easy answers to these questions, which bring into play several challenging factors. While raising the retirement age for doctors in Cameroon from 55 years to say 65 years will certainly help to increase the numbers of physicians in the public sector, many physicians argue that this will simply extend the time during which they will have to work for a meager government salary. A proposition that is highly unattractive for obvious reasons.