The keynote presenters included Prof Johan Fagan who gave the overview of the CMSA, highlighting CMSA as the specialist voice at government health care and a custodian of specialised medicine and dentistry. Prof presented the Journal of CMSA and that CSMA HAS established a panel of senior authors who are prepared to mentor poorly written articles that need to be published. He concluded by that CMSA has health Policy Committee, which was established in 2024, including introduction of admission ceremonies celebrations, and this as a excellent milestone for the organisation. 

Prof Martin Schenellnuss discussed evolving impact of sport, exercise lifestyle medicine on chronic diseases. He represented the newest college and in the 70 years the sports, exercises and lifestyle medicine has been a college for five years, contributing to about 7% of activities of the College of Medicine of South Africa. He focused on three core areas, exercise as a preventative and therapeutic tool for NCD’s,rehabilitation of patients with chronic diseases using lifestyle intervention, Musculoskeletal exercise related injuries with non-surgical management, lastly on the medical condition prevention and treatment that are precipitated by exercise, He reminded the audience that SA has 51% of all death due to NCDs and that the prevalence of NCDs in SA is very high. He also presented the health benefits of endurance exercise therapy, and the impact of sports, exercise, lifestyle medicine on chronic medicine that this speciality helps to provide medical expertise to reduce the burden of NCDs.  

Prof Vindane Chibablai explored mitigating the impact of antimicrobial resistance on specialist medicine. She discussed how AMR actually complicates care across several specialist disciplines. Explored how AMR will impact global health across for the next 25 years. And discussed some current AMR data from South Africa, examining potential solutions to curb the impact of AMR. Ended by asking to reflect on the evolving role of specialists in AMR mitigation. Emphasised the need to be able to monitor and evaluate resistance trains on antimicrobial use. One of the interventions is that every province has an antimicrobial stewardship committee and at this stage, every hospital, at least every large hospital, should be having an antimicrobial stewardship programme in place. They are antimicrobial stewardship prescription charts, which are specific for antimicrobials that are not the same as a normal prescription chart, which goes through all of the. Quality indicators for antimicrobial prescribing. 

Prof Riaz Seedat discussed advancing access to specialist medicine in the Free State. there's medical knowledge is actually increasing exponentially here actually in 2000 already it was estimated that medical knowledge is doubling every 70 days. Technology and IA innovations are important in the advancement of specialist. A factor that's driving the development of greater specialisation and sub specialization is advancements in technology and. Although technology is often seen as very new, technology is often seen as very expensive. It plays an important role in developing, disabling more efficient and cost-effective care with improved outcomes. He looked at the situation of medical specialists in South Africa when compared to global standards, there is a shortage of the depending on what source you use for the number of specialists, there's somewhere between 10,000 and 15,000 specialists in all disciplines. Which is actually very few for turtle population of 61 and the distribution of these specialists is mainly in the urban provinces of counting in Western Cape and there's far fewer in the rural provinces like the Free state. Half of specialists are in the public sector. Most specialists in South Africa are in the private sector. The registrar numbers in the Free State have remained static over the past two decades, but better off than some of the other provinces. Existing the profession through retirement and immigration and to we must remember, we've got a large elderly population of specialists that are going to be retiring in all disciplines, it’s important to attract and retain young specialists. no pathway for them to continue to stay on. Despite the desire by many of these newly qualified specialists to continue to further develop their skills and great experience and the considerable expenditure of the Department of Health, they are forced to leave to private sector. 

The MEC for health FC, Mr Monyatso Mahlatsi gave a keynote address and congratulatory message to CMSA. He acknowledged the unwavering commitment of all stakeholders in the healthcare community. The dedication of CMSA in improving health outcomes in FS province and have paved the way for the advancements of specialist training. He stated the achievement of DOH in FS, that the recent launch of various digital health services stands as a testament of their commitment to innovation and improving patient care, and not only responding to emerging balance of disease, but are also proactively strengthening our health system to meet. 

Panel discussion concluded to discuss the challenges in specialist medicine in Free State. The lack of retention of specialists that go to private sector due to the difference in salaries. Huge amounts of money of about 4.3% of GDP is spent on health care by government, you there is a need to realign to improve the quality of care in the public sector and decrease the cost in private. Recommendation to introduce a two-year Community service after specialisation that should be forced to work back, and this has been introduced in the NHLS quite effectively. DOH has started the process to accredit Regional Hospitals as academic and training centres so that specialists can be deployed there, this is because of large vast distances that the patients need to travel for specialists.   

In conclusion, there is a need to optimise what we have, the specialists that we do have empower them to do what they do best, and that would include things like equipment, data that we already have, Then the next point is to retain. Registrars retained them to specialists. the acknowledgement that solutions and intervention equal money. The need for collaboration with private for funding sources.