Tau­reef Mo­hammed

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.