Medical genetics in South Africa.

Medical practice in South Africa is firmly grounded in the British tradition. The country's first medical faculty was established at the South African College (soon to become the University of Cape Town) in 1917 and, although the second followed in Johannesburg three years later, another 23 years. were to elapse before another came into being. Today there are seven medical schools (eight if one includes the small, recently established one at Umtata in Transkei, one of the 'independent' homeland states), which, between them, produce some 900 doctors each year. Before 1918 South Africans went to British medical schools to train, although preclinical courses were offered at the South African College from 1911. Many of the country's medical academics have pursued specialist training in the United Kingdom, with smaller numbers'proceeding to the USA or Holland for postgraduate studies. There are approximately 20 000 registered doctors in South Africa (95% are white and 85% are male) and the doctor:population ratio was 1:1344 in 1985 (up from 1:2157 in 1960), which compares with 1:650 in the UK, 1:520 in the USA, and 1:10 500 in Kenya. (For these and the following statistics relating to medical practice in South Africa I am indebted to Kirsch and Benatar.') In the major urban areas of South Africa the ratio is 1:875 but in the 'homelands' (rural areas inhabited almost exclusively by black people) it is much less favourable. In Transkei it is 1:19 000 and in Qwa Qwa, another of South Africa's national states, it is 1: 1 16 000. In the 1940s the ratio ofgeneral practitioners to specialists was 7:1, but the figure has gradually fallen until it is now 3:1. In western Europe the ratio is 1:1. Successful completion of a six year course and a one year internship makes the candidate eligible for