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Advisers to the South African health ministry are suggesting national service for new doctors in response to a brain drain. The ministry wants to ensure that they work off some of the state money spent on their education before leaving South Africa.

A third of medical students at the universities of Cape Town and the Wi****ersrand are reported to be planning to leave after graduating. Figures released by the Central Statistical Service showed that in the first ten months of 1994, 76 doctors left - including 16 specialists - and that emigration rose by nearly 50 per cent.

However, the number leaving is probably much higher as many do not emigrate officially.

The medical gap is being partly filled by large numbers of doctors immigrating from eastern Europe and other African states, especially Uganda, Ghana, Zimbabwe and Kenya.

Dan Noaylyana, editor of the South African Medical Journal, proposes less draconian solutions. "We must provide them with an incentive to stay through job satisfaction. This means ensuring an acceptable working environment, which includes adequate supplies of drugs and equipment, proper nursing care and an end to overcrowding in hospitals," he told The Star in Johannesburg.

Dr Noaylyana said it was essential to keep as much talent in the country as possible: "On the other hand, we need only those who are committed to the future."