By Rob L. Wagner
29 January 2016
Jeddah – Female pre-med and nursing students at the King Saud bin Abdulaziz University for Health Sciences spend classroom time listening to professors’ lectures while surreptitiously going over their notes for the next class.
They are the new breed of health care students: conscientious, ambitious and allergic to wasting time. Female pre-med and nursing students of 2016 are a sharp contrast to women a decade ago who shunned nursing, which was deemed shameful because of the proximity to male patients.
Today, Saudi women with a broader worldview are turning to the medical field in increasing numbers to take advantage of good salaries and a chance at independence.
The Saudi Ministry of the National Guard and the Education Ministry have embarked on an ambitious programme to establish a Western model of high academic medical training standards to boost the numbers of Saudis graduating with bachelor’s degrees in nursing and medicine.
It’s not an easy task. Only 812 Saudi nurses graduated from private and government universities in 2014. Saudi Arabia requires at least 7,000 nurses each year to fill the needs of government and private hospitals, according to the consultancy firm McKinsey and Company. An estimated 82% of the doctors and 74% of the nurses are foreigners, McKinsey said. There are 16 physicians and 36 nurses per 10,000 people in Saudi Arabia, far lower than 30 doctors and 58 nurses per 10,000 in neighbouring Bahrain.
Dr Taqwa Omar, dean of the Saudi National Guard’s College of Nursing, said Saudi Arabia has 26 government nursing colleges and 21 private institutions. However, student admissions are limited because colleges lack the faculty to teach. Only three of the 47 colleges have teaching hospitals.
“We are struggling to recruit faculty,” Omar said.
Health care officials must contend with these challenges against the backdrop of the recently announced government fiscal austerity programme and the intention to privatise hospitals to reduce government expenditures on health.
Expat doctors and nurses are filling the kingdom’s health care ranks at a time when there is a significant demand for more hospital beds due to a sharp increase in cases of heart disease and diabetes stemming from an obesity rate twice the average of other countries.
“The problem in Saudi Arabia is that they have been training nurses for some time but they are not filling the needs,” said Helen Ziegler of Helen Ziegler and Associates, a Toronto recruiting company that sends medical professionals to foreign countries.
Ziegler said recruitment agencies can’t meet the demand for Western-trained nurses and doctors in Saudi Arabia. “Hospitals want very specific people and want people to work in (the emergency room),” Ziegler said. “We send about 120 nurses from North America to Saudi Arabia every year.
“The salary is good at about $60,000 a year. It’s tax-free and some hospitals offer up to seven calendar weeks off each year. Many people go over there for five, six, seven years.”
To reverse the trend of hiring foreign nurses, Saudi government universities have pushed for higher academic standards that require fluency in English and at least a bachelor’s of arts or science degree instead of a simple diploma.
The National Guard has established a two-year pre-professional programme that introduces English and basic science courses to nursing students before they go on to nursing and medicine curriculum. The programme is especially vital for Saudi students educated in public schools where rote learning is the method of teaching and English-speaking skills may be mediocre.
“We try to change the learning process and we want them now to be more critical thinkers,” Omar said.
There is less societal pressure on Saudi women to take nursing jobs. An estimated 60% of Saudi university graduates are women and have the potential to earn significant salaries. But higher academic standards and competition with expats have added considerably more professional pressure.
One Jeddah university professor who teaches in the medical field said nursing interns tend to fall into two categories: One who wants a career but remains unsure how her job fits socially; they worry that a potential husband would balk at marriage if she works 12-hour night shifts. The other is enthusiastic and wants to pursue further education to specialise in one area or engage in research. Those nurses often struggle working under foreign supervisors who are not always helpful in training.
“Some expat nurses feel the Saudis may take their job away from them,” the professor said.
Omar said she is confident that Saudi Arabia will fill 75% of the medical positions with Saudis. “We can accomplish a reversal in the Saudi versus expat ratio,” Omar said. “It’s coming, but we just need time.”