Health Cabinet Secretary Aden Duale’s Monday announcement that medical interns would earn Sh206,000 monthly has given way to a more complex reality—the salaries will range from Sh180,000 to Sh206,000 depending on where one is posted.
While the promise initially sparked celebrations among the 1,147 newly posted medical officer interns, appointment letters reveal a basic salary of just Sh46,120, with the remainder made up of various location-dependent allowances that not all interns will receive.
“They will earn everything. That’s why I came here to ensure there will be no more industrial health workers’ disputes in Kenya, for the success of universal health coverage,” Mr Duale declared on Monday.
The Sh206,000 figure, provided for in the 2017 collective bargaining agreement, serves as a benchmark, but the actual take-home pay for these new doctors is heavily influenced by their posting.
Hardship allowance
Kenya Medical Practitioners and Dentists Union Deputy Secretary-General Dennis Miskellah said: “This figure is not a flat rate. Based on the location where you are working, you will be paid appropriately. It follows the civil servants’ pay grade, which includes the basic salary and other allowances.”
The allowance structure includes hardship allowance, location-specific housing allowance, universal commuter allowance, emergency call allowance and overtime payments. Some interns may also receive non-practice allowances if not engaged in clinical activities.
Despite the record number of postings, some graduates have been left behind. Fifteen dentists from Moi University missed the posting cycle because the institution lacked reagents for conducting examinations, while 130 pharmacy students were excluded for delaying their Pharmacy and Poisons Board entry exams.
“It is unfair to punish these students by making them wait until next year,” Dr Miskellah said, adding that the union is in discussions with the Health ministry to accommodate those affected.
The delay concerns extend beyond immediate postings. Dr Valentine Ndunda, a Medical officer intern and chairperson of the Internship Liaison Committee, highlighted the broader employment challenges facing medical graduates.
“Getting the letter has come with mixed feelings. This year we haven’t struggled as much, we went to the streets twice, compared to last year when interns were on the streets for eight months. We are happy that dignity has been returned,” she said.
Her cohort has been at home for about a year after graduation, having spent nearly seven years in medical school due to pandemic-related delays.
“It is sad that we no longer get deployment letters after internship. We put the blame on devolution. Some county governments do not want to employ doctors, saying they are expensive,” she explained.
Workplace stress
The employment bottleneck has prompted calls for the establishment of a health service commission to address post-internship deployment issues systematically.
Recognizing the mental health challenges facing medical interns, Dr Ndunda's committee has developed support programs to address workplace stress and potential burnout.
“We know there used to be toxic working environments, but in our generation, we cannot be bullied. We have been empowered enough to speak up when we have such issues,” she said.
The successful posting represents a significant step toward resolving Kenya’s healthcare workforce challenges, though questions remain about long-term employment prospects for medical graduates and the sustainability of county-level health services.
Dr Ndunda urged the Health ministry to maintain goodwill in addressing these systemic issues for the sake of the country's healthcare provision, while the union emphasized the need for timely future postings to prevent knowledge decay among graduates.
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