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Guide
Registrar posts are scarce and the competition is brutal — but the scoring criteria are more visible than most applicants realise. Here's what real adverts and departments reward, and a 24-month plan to build a CV that matches it.
Last updated Advert references, closing dates, salary notches and exam fees change every cycle — always work from the current advert and the current CMSA and DPSA documents, not the examples quoted here.
We summarise publicly documented facts in our own words and cite the source, so always confirm the current details with the primary source before you rely on them. See our methodology.
Our how-to-specialise guide explains what registrar training is. This page is about the part nobody explains: how the scarce posts actually get awarded — what adverts score, how departments decide, and what to do with your medical-officer years so that your application competes.
A registrar post is a joint appointment: you’re employed by the provincial health department while the university’s medical school trains you, against training numbers (“N numbers”, or S numbers for sub-specialties) that the HPCSA grants to the faculty. Training runs 48 months for a specialty and 24 months for a sub-specialty — and it’s a contract post with a hard end: KZN’s programme states that at the end of the 48 months registrars are expected to leave the training post whether or not they have completed their examinations. The clock matters from day one.
Be clear-eyed about the bottleneck. Reporting through late 2024 and 2025 put the number of unemployed post-community-service doctors between roughly 1,500 and 1,800, with the March 2025 budget funding posts for only about 800 of them (Bhekisisa). Daily Maverick’s reporting describes registrar post numbers that haven’t meaningfully grown in over a decade while graduate numbers rose sharply — with waiting lists in the Western Cape even to work unpaid. And a warning about that route: unpaid supernumerary time does not count toward registrar training. None of this is a reason not to try; it’s the reason to treat your application as a campaign, not a form.
Formal eligibility everywhere: MBChB, completed internship and community service, HPCSA registration as an independent practitioner with a current annual practising certificate, and a valid Z83 application for public-service posts. The unwritten floor sits above that: many programmes require 12 or more months of post-community-service medical-officer experience, ideally in the discipline — Eastern Cape’s annual recruitment has asked for two years of post-CS clinical experience in the province, and some university programmes (UCT’s emergency medicine, for example) additionally require in-date resuscitation certifications (ACLS/ATLS/APLS-or-PALS).
The clearest public evidence is the advert wording itself. Eastern Cape’s annual recruitment has spelt out its weighting: completion of the CMSA diploma and Part 1 (primary) examinations relevant to the discipline is “an added advantage”; “reasonable proficiency in speaking local language(s) and evidence of a long term commitment to the” province “will add weight”; and priority goes to medical officers already employed by the department in prioritised specialties — with exceptions possible for excellent CMSA performance, rare specialties, or where no qualifying local applicant exists, on the head of department’s motivation. Inside departments, the process is collective: Wits Anaesthesiology, a programme with roughly 107 funded registrar posts, describes an inclusive selection with representation from all units, consensus decisions, and transformation and equity considered in appointments — a standard consideration in public-service appointments. The pattern across the evidence: exam progress, discipline-specific MO time, internal candidacy, and a credible commitment to the place you’re applying.
If you're a medical officer aiming at the next-but-one intake, this is the build order that matches what adverts score.
Get MO time in the discipline you want — it’s both the strongest CV line and the honest test of whether you want four years of it. Book the resuscitation courses your target programmes expect (ATLS/ACLS/APLS as relevant). Unsure of the discipline? Our specialty quiz and registrar-readiness quiz are built for exactly this.
The Part 1/primary is the single strongest “added advantage” on the evidence. Per CMSA’s published instructions (check the current version): exams run twice a year with online-only applications and hard closing dates — no late entries — and require a head-of-department-signed training certificate. Plan the sitting around the current CMSA instructions.
Where one exists — DA, DCH, Dip PEC, Dip Obst and others — the CMSA diploma is the second half of the advert’s “added advantage” pair, and it makes your MO work in the discipline examinable, not just claimable.
Complete an audit or small research project in the discipline and present it — a poster or departmental presentation is enough to make the point. Line up referees who sit inside the system — in a consensus-based selection, informal reputation within the department carries real weight.
Z83, CV, certified copies, and a motivation letter that mirrors the advert’s own criteria line by line. Follow the advert’s certification requirements exactly, and rebuild the pack fresh each cycle — in adverts like Eastern Cape’s, previous applications don’t carry over.
Build order derived from the selection criteria in Eastern Cape DoH’s annual registrar recruitment adverts and programme requirements published by KZN DoH and university divisions. The referee and audit/research steps are general application practice rather than advert criteria. Every cycle’s advert is the final word — mirror the one you’re answering.
Most applicants don’t, in the current market — so have the next move planned before results. The strongest position to wait in is a funded MO post in your discipline: it keeps you visible to the department that will shortlist next year, builds exactly the experience adverts score, and pays you while the CMSA milestones accumulate. Watch for the exception clauses some adverts carry — Eastern Cape’s has allowed outside or non-prioritised applicants where CMSA performance is excellent, the specialty is rare, or no qualifying local applicant exists, on the head of department’s motivation. That doesn’t create extra posts, but it means the internal-priority rule isn’t absolute. And before accepting unpaid supernumerary work, re-read the honest maths above: it can buy exposure and references, but not training time. Whatever happens, reapply — with a CV that visibly grew since last time.
Three things to know from day one. Pay: registrar posts have been advertised around the R1.0m-per-annum mark on the OSD scale with compulsory commuted overtime (DPSA vacancy circulars, 2025) — scales adjust every April, so read the notch in your own advert, and see our salary guide for how the package breaks down. MMed: since 2011 the HPCSA requires a completed MMed research component for specialist registration, and you register as a university postgraduate student at your own cost. Start the research protocol in year one: a 2025 SAMJ survey found only about half of registrars complete both the research and the CMSA exams within the stipulated training time. Exit: the CMSA Fellowship plus the MMed lead to specialist registration with the HPCSA — and work-back obligations exist — Eastern Cape, for instance, has contracted specialists it funded to train out of province to work back a period equivalent to the training — so read the contract before you sign it.
Sources: KZN Department of Health: Registrar Programme · Eastern Cape Department of Health: vacancies & annual registrar recruitment · Colleges of Medicine of South Africa (CMSA) · DPSA Public Service Vacancy Circular · Health Professions Council of South Africa (HPCSA) · Accessed 2–4 July 2026. Always confirm the current details with the primary source.