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More than 100 medical graduates of the University of the West Indies’ St Augustine and Mona Campuses have refused to sign internship contracts offered to them by the Ministry of Health, saying the new conditions are unreasonable and unfair. The T&T Guardian spoke to some students, who chose to remain anonymous. “When we started medical school we were told the internship is one year. Someone called the ministry and they told us we have two options: Either we become a locum, or sign a two-year contract, and that this was based on directives from the minister,” one of them explained.”
Another student said about 11 graduates had accepted the offer and signed the contracts. However, the majority of students refused to sign. Saying graduates only became aware of the changes on Monday, another student added: “Even up to our oath-taking ceremony two weeks ago, we understood that it’s one year, and now we have suddenly been told that it’s two years and that we are not starting on July 1.” Students were told, unofficially, that the new measures were being put in place to develop more competent young doctors. The students said their post-graduate training would also be negatively affected and they were yet to receive official word from anyone on the issue.
Dean at loss, backs students
Prof Samuel Ramsewak, Dean of the Faculty of Medical Sciences, has come out in defence of his students. Saying he was yet to receive any official correspondence about the change, Ramsewak said: “As far as I am aware, the internship period for a graduate is one year. I have not been notified officially about any other changes.”
Confirming that internships each year begin on July 1, he added: “I find it odd that we have reached this stage and no formal notification has been issued.” Ramsewak said dialogue was needed on the issue before any changes were made. Ramsewak said measures had to be put in place before a two-year internship could work.
Minister: More changes coming
Health Minister Dr Fuad Khan confirmed yesterday that his ministry has moved to change the internship period from one year to two. Citing a string of mishaps in the public health service, Khan said after investigations, management had come to the conclusion that young doctors, particularly interns, needed more training. “I know I am dropping it harshly and people would be upset but sometimes you have to take the bull by the horn because there are just too many problems. I could do nothing and walk away, but something has to be done,” Khan said. “As it is right now, one year is not enough. They need more training in areas like critical care, resuscitation, anesthesiology and ICU care,” he added.
He said internships would begin on August 1 and graduates would function temporarily as locums until then. Khan added that after year one, interns would receive a salary increase. He said he was also thinking about changing the regulations that allowed full registration after internship. He said: “In this country, after one year of rotations a doctor is free to go into private practice. In the UK and other developed countries this cannot happen. “I am thinking to stop full registration after one year and replace it with temporary registration for three or four years, so they wouldn’t be able to go into private practice.”
Khan said he would also be targeting consultants who worked part-time at public hospitals. “I am going to form a position for full-time consultants. They will be paid a higher salary but once they have signed on as full-time they would not be allowed to go into private practice and would be available for teaching also. “And we are going to start a system whereby house officers and interns would be allowed to grade the consultants and we would remove them if they don’t perform well, just as is the case in the UK and US and other developed countries.”
Saying he was open to dialogue on the issue, Ramsewak was hesitant to accept Khan’s explanation. He said: “I think it is wrong to say that mishaps are related to the quality of interns, unless there is evidence to support that. “As far as I know, our interns perform exceedingly well and the Ministry of Health has not written any official complaints. We need to see the evidence that justifies the changes and if we get the evidence we would adjust to suit.” But he said he agreed with Khan on hiring full-time consultants.
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