Anna-Lisa Paul and Bobie-Lee Dixon
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New training system for medical interns stays—Fuad
Health Minister Dr Fuad Khan was adamant yesterday that the sweeping changes in training for University of the West Indies (UWI) medical graduates will be implemented, hours after he first announced them on Thursday. Medical interns are now required to do a one-year internship programme, but the new Medical Foundation House Officer Programme is proposing a two-year course which will focus on training in emergency and resuscitative procedures, administrative duties and critical care.
Addressing a packed room at the Radisson Hotel, Wrightson Road, Port-of-Spain yesterday, Khan revealed that as part of the change, interns will now be asked to grade their consultants, as efforts are made to ensure greater accountability by those responsible for training future doctors.
Khan said this decision was taken following complaints that there “was a lot of phone training and not enough presence training” taking place at hospitals across the country. He warned consultants that this “falling down in teaching” would no longer be tolerated.
Faced with concerns that these very consultants would be the ones tasked to implement the programme, Khan said measures were still being adapted to suit the local landscape and nothing had been cast in stone. He said a plan had been submitted to a Cabinet subcommittee for clinical trainers, counsellors and consultants to be given adequate compensation, as they will be required to work full-time, with no private practice.
He urged all present to discuss suggestions and recommendations, even as moves continue to introduce the programme on August 1. He also invited interns and other medical professionals and organisations to submit a position paper containing ideas and suggestions on how their professional development can be improved. The deadline for submission was seven days.
Admitting that recommendations presented in the Cottle Report had prompted this action by government, Khan acknowledged that some of the proposed changes would create a stir among the medical fraternity.
“The Cottle Report indicated there was a bit of a deficiency of resuscitation measures by the junior doctors. When we looked at it and all the other problems occurring, there was a common trend,” he said. “The common trend was, there was a need for more critical care training. A lot of the junior doctors do the basic modules but they don't rotate through the intensive and critical care training.”
He added that the idea for a longer and even temporary registration of doctors was born out of the need to keep people in the system longer to ensure they learnt more. Saying intensive-care training would now be made compulsory, Khan explained, “Now we are going to look at it in a different manner. What I might do is maintain the one-year internship but also have the temporary registration in place so you can do the modules in that course.”
That temporary registration can last for between two to three years, but the length is yet to be decided. Asked how he intended to ensure this new programme satisfied its mandate, Khan said, “It will be. The quality department will bring in the T&T Medical Association and the Council of the Medical Board to develop a plan of action based on what we see in the assessment forms.” The assessment forms will be completed by interns and consultants, and will focus on two areas, patient safety and personal development.
“What we are looking at is how do we change the system to make people responsible for being a little more efficient in their actions,” Khan said. He said he was not worried the new programme would negatively affect interns who might be tempted to continue their studies abroad, as this was an innovative programme.
CMO: let’s fix the system
Acting Chief Medical Officer Dr Colin Furlonge presented an overview of the proposed programme as he called for everyone to join hands to fix the medical sector. He said it was important to understand the system and each other.
Saying the new programme was developed after numerous complaints from the public about an absence of care and compassion, as well as the dismissive attitudes of doctors, Furlonge said the aim of the new programme was to “create a better doctor” who was mindful of patient safety and clinical governance.
He also said offshore medical schools were fast becoming the new craze as the intake of medical students continued to increase yearly. There is a proposal by the Indian government to set up one in Tamana, which would be similar to a distance learning centre.
The Cottle Report
A team of investigators led by retired Justice Mustapha Ibrahim was appointed by Attorney General Anand Ramlogan on March 17 to probe the death of infant Simeon Cottle. His mother, Quelly Ann Cottle, underwent a C-section on Carnival Saturday, March 1, at the Mt Hope Women's Hospital, during which Simeon died from a laceration to the head.