Dr Duane Sands, Minister of Health. Photo: Shawn Hanna/Tribune staff
By RASHAD ROLLE
Tribune Staff Reporter
AS some junior doctors express concern for their future, Health Minister Dr Duane Sands admitted yesterday officials must do a better job at developing young doctors.
His statement followed a Tribune article that highlighted the experience of a doctor who said he dropped out of the University of the West Indies’ (UWI) post-graduate programme only to succeed as a doctor in the United Kingdom.
Dr Young Sing blamed poor feedback from lecturers and alleged bias for the low matriculation rates of UWI’s Doctor of Medicine programmes.
Dr Sing’s views reflect those of many junior doctors in the public healthcare system.
“For whatever reason young physicians are not able to progress through the institutions as well as we would like and certainly what it means is we ought to make whatever adjustments are necessary to assist and to mentor and to develop these young physicians,” Dr Sands said.
“Relying on historical anecdotes might make people warm and fuzzy but it does’t change the current reality. As we start to look at what types of things that ought to happen I think we need to revise our programmes, make a decision on how many people we will be taking going forward, make sure we are providing proper feedback, coaching and evaluations and where people are not performing they need to be alerted to that fact early. We have to design a system where we hold not only students accountable but ourselves, the teachers. Like everything in this country there is a need for radical reform.”
Dr Sands was speaking about doctors operating under the guidance of consultants in the public healthcare system.
As for UWI specifically, he said: “While the majority of Bahamian medical students train through the UWI programme and a majority of residents train through a programme at UWI, we do not dictate to UWI what they should do. We need to make our facilities responsive to the needs of our students even as we advocate for changes at the university level. What that also means is that the University of the Bahamas will now need to look at its own medical school.
Dr Sands continued: “Just as we’ve moved away from a reliance on Scottish, British and Canadian medical schools, it is probably time to wean ourselves and cut the umbilical cord from UWI, not saying that it should happen this year or next year but in our national development the idea that we should accomplish self sufficiency and can accomplish self sufficiency makes a lot of sense. We may choose to partner with another institution and there are some proposals on the table to do that. UWI, it must be said, has singlehandedly produced the vast majority of practitioners in this country but it is not the only institution. There has been an historic tension, a UWI non-UWI rivalry if you would. The easiest narrative is to suggest that because I am not a UWI graduate I don’t understand it. I don’t know that argument holds a whole lot of water. What is most important is that we acknowledge the need to develop our human resources to its maximum potential.”
UWI is considered the traditional route through which regional doctors have obtained expertise leading to their independent practice certifications; however, criticisms come against the backdrop of impending changes within the public healthcare system.
Some junior doctors will be chosen for a residency programme within a medical department this month. Those who do not make the cut will be mandated to participate in a “foundation programme” gearing them toward private practice. Those who fail the programme or its final exam could be pushed out of the profession. Junior doctors fear the worst characteristics of UWI’s programmes will define the foundation programme as well.
The planned changes are a response to provisions of the Medical Council Act 2014, which mandate that doctors receive specialized training or participate in supervised rotational programmes to qualify for independent practice licenses.