Medical interns at UWI are asking to be transferred to Jamaica or Barbados to avoid having to do a new two-year internship instead of the one-year programme they were expecting to start next month. Since Health Minister Dr Fuad Khan’s 11th-hour decision, announced last week, to extend the medical internship programme to two years, they have written to Prof Samuel Ramsewak, dean of the Faculty of Medical Sciences, University of the West Indies, asking to be moved to other campuses. In a letter sent last Friday, hours after Khan's announcement that the new system would take effect on August 1, the T&T Medical Students Association (TTMSA) expressed concern that the programme would not achieve the desired results, whereas if they transferred to the other UWI campuses at Mona, Jamaica or Cave Hill, Barbados, they could complete their internship in the original timeframe and would not fall under the new system.
They are also worried that the new regulations and consequent one-year delay would prevent many of them from accessing specialist medical training programmes. In the letter on behalf of the interns, president of the TTMSA, Erron Ramdass, accused the Ministry of Health of failing to consult with major stakeholders. He wrote: "The medical students were not privy to any knowledge of this decision until a week ago. This new structure is being proposed to begin as early as August 4, 2014. “We believe, however, that inadequate considerations/consultations have been done concerning the change and so if implemented, it is unlikely to achieve the goals desired." The letter said the interns believed the regulations governing their internship and receipt of full registration as doctors should be standardised across all UWI campuses and so they should not be subjected to an extended internship period.
Ramdass added: “As a result, a large number of the student population from years one through five have expressed interest in transferring to another campus outside of Trinidad where the regulations of the internship period are being adhered to according to the policies set by UWI.” On their behalf, he therefore asked about the possibility of their being transferred. Ramsewak could not be reached for comment yesterday, as he was out of the country and was expected back next week.
New Two-Year Plan
The new Medical Foundation House Officer Programme is proposing a two-year course which will focus on training in areas, such as emergency and resuscitative procedures, administrative duties and critical care. Highlighting various aspects of the new programme during last Friday's launch at the Radisson Hotel, Port-of-Spain, Khan stood firm that it would be implemented.
However, he invited the interns, medical organisations and professionals to submit a position paper containing ideas, suggestions and recommendations as he stressed that nothing had been cast in stone and that changes could be made to adapt the new programme.
Khan: Still backing new plan
Responding to the concerns expressed by the TTMSA, Khan said he was prepared to dialogue with anyone or any organisation concerning improvements in the medical sector.
However, he is confident about the new programme, which will focus on patient safety and personal development. Khan added: "This is a democratic country and students are free to seek opportunities abroad if they so desire. “However, I am confident that the training being offered to medical interns locally is on par with what is offered in first world countries. I know the interns here will have a better foundation." Khan's claim yesterday that the new programme would enhance the skills and training of new doctors was endorsed by the acting Chief Medical Officer, Dr Colin Furlonge, who reminded all medical professionals they were servants to the public. "Everything we are doing is geared towards creating a better doctor and by so doing, we can restore public confidence and trust in the health system," Furlonge said.
UK doctor in support
Meanwhile, UK-based professional Dr Nilash Ramnarine expressed support for the new programme as he said a similar initiative in the UK in 2005 also prompted negative responses from all quarters when it was introduced. Emphasising the changes in the medical system following its implementation, Ramnarine suggested T&T foundation doctors should be required to complete training in several areas, such as advanced cardiac life support, advanced trauma life support and advanced paediatric life support during the two-year internship. He listed another advantage, in that a four-to-six month training period for interns in accident and emergency (A&E) would ensure "that all doctors gain front-door experience and that A&E is well staffed." He added: "A well staffed A&E has implications for the proper function of the entire hospital. ”There are many more advantages that I saw and experienced first-hand. My strong feeling is we need not to repeat the mistakes of implementation made in the UK but with the aid of hindsight ensure that such a programme hits the ground running."