A quiet crisis is unfolding in Uganda’s health sector, and this time, it is not about disease outbreaks or drug stockouts. It is about the system’s youngest professionals — medical interns — who say they are being pushed to the limit by a government that has broken its promises, ignored its own laws, and turned a blind eye to their suffering.
For months, hundreds of interns deployed to hospitals across the country have been working without receiving the allowances guaranteed in their internship contracts. Some are surviving on loans, others on the goodwill of senior colleagues, while many are simply sinking into financial and emotional distress.
What began as delayed payments has now escalated into a full-blown standoff between the Ministry of Health and the Federation for Uganda Medical Interns (FUMI), the national body representing more than 2,300 interns across 74 internship centres.
At the centre of the dispute are two government documents that paint radically different pictures of who deserves to be paid — and who does not.
A Contract Signed, A Contract Broken
On November 17, 2025, FUMI wrote to the Attorney General, accusing the Ministry of Health of deliberately breaching its obligations after failing to pay allowances for nearly four months.
“Interns signed contracts at their respective sites entitling them to monthly allowances of one million shillings,” the letter states.
“The Ministry has refused to honour this obligation and withheld remittance of the funds for over 180 interns on government payroll.”
At the core of FUMI’s argument is a simple but powerful claim: medical interns are not students.
They are qualified health professionals who have completed their academic training and graduated. Their one-year internship is a legal requirement imposed by the state — not an extension of school — and it involves full-time, high-pressure clinical work.
Interns typically work 36–48 hour shifts, conducting emergency deliveries, reviewing patients, filling medical forms, assisting in surgeries, dispensing drugs, handling night calls, and sometimes managing entire wards when specialists are overstretched.
In any other profession, this level of labour would be classified as work — not training.
The Ministry’s New Policy That Sparked Outrage
But one month earlier, on October 1, 2025, the Ministry of Health issued a circular, signed by Dr. Charles Olaro on behalf of the Permanent Secretary, outlining new restrictions on which interns are eligible for allowances.
The Ministry said the changes were necessary because it had to deploy two cohorts at once — the backlog from 2024/2025 and the incoming 2025/2026 group.
Its solution? Cut the number of interns eligible for payment.
According to the circular, the following are now ineligible:
Medical interns already receiving a government salary
Refugee medical interns
Senior House Officers (SHOs) on government scholarships
The circular emphasised that this was a top management decision “in consultation with Key Ministries, Departments and Agencies.”
To the Ministry, this was a financial adjustment.
To interns, it was a constitutional violation, an act of discrimination — and a betrayal of professional trust.
“Totally Unconstitutional”: Interns Fire Back
FUMI argues that the Ministry’s interpretation of the Public Service Standing Orders is wrong, selective, and unlawful.
Citing Public Service Standing Orders Section E-a (1 & 2), FUMI says interns qualify for allowances because:
They handle extra exertion
They shoulder additional responsibilities
They incur out-of-pocket expenses
They perform work essential to government service delivery
“Any civil servant who performs extra work for the government is entitled to allowances,” the federation wrote.
“Interns work far beyond what is stipulated… often enduring 36–48 hours of nonstop service.”
The federation has now demanded that the Attorney General interpret Sections E-a 1 & 2 and E-a 9, which the Ministry has been using to justify its non-payment.
If the interpretation favours the interns, the Ministry’s circular may be declared invalid.
If it favours the Ministry, more than 180 interns — including Ugandans on payroll and refugee interns — may lose their only income for the entire year.
A System Built on Unpaid Labour?
Behind the legal fight lies a much deeper national issue: Uganda’s health sector relies heavily on interns to function.
Across regional referral hospitals, general hospitals and PNFP facilities:
Intern doctors run emergency wards
Intern nurses handle night coverage
Intern pharmacists dispense medication
Intern midwives conduct deliveries during high-traffic hours
Senior doctors privately admit that without interns, many hospitals would collapse.
And yet, these same interns — who form the backbone of frontline care — often go months without pay.
This is not the first time.
2021: Interns went on strike over delayed allowances.
2022: Deployment stalled for months due to lack of funds.
2023–2024: Intern numbers were capped; internship almost collapsed.
The pattern is the same: delays, underfunding, and miscommunication between ministries.
Human Faces Behind the Crisis
Interviews with interns paint a bleak picture:
“We borrow money to eat.”
One intern at a regional referral hospital said he has been surviving on loans from friends and boda-boda side jobs.
“I sleep at the hospital because transport is too expensive.”
An intern midwife said she spends days inside the facility because she cannot afford the daily commute.
“Patients don’t know we are unpaid — they just expect help.”
An intern pharmacist said the emotional toll is immense because they are forced to work professionally while living in uncertainty.
Legal Battle Looms
In its petition, FUMI gave a clear warning:
“Our legal team will proceed with litigation should this decision not be reversed.”
According to senior members of Uganda’s medical fraternity, this could become a landmark case.
If interns win, it could force the government to honour all intern contracts going forward — even during financial strain.
If interns lose, it may set a precedent allowing the government to categorise entire groups of medical trainees as “ineligible” during tough budget years.
Either outcome will profoundly shape the future of Uganda’s health workforce.
A Health Sector at the Crossroads
Uganda’s population is growing rapidly. Disease patterns are shifting. Hospitals are understaffed. Rural areas depend heavily on new graduates. And the country still faces periodic outbreaks that require all hands on deck.
Medical interns are not a luxury — they are essential.
Their dispute with the government is not simply about money; it is about dignity, legality, and the sustainability of healthcare delivery.
Unless the Attorney General steps in with a clear, binding interpretation, the crisis may deepen — and the health sector may pay the price.
For now, the country waits.
And interns continue working.
Unpaid.
