Odyssey Editions, 2013,
ASIN: B00CEFF88S; 34 pages.
Review by Kevin Baldeosingh
There is no plan, neonatologist Dr Petronella Manning-Alleyne said yesterday, in response to Health Minister Dr Fuad Khan’s proposal to introduce a two-year internship programme for medical graduates in less than a month.
In a telephone interview, Manning-Alleyne called the proposed programme a “knee-jerk response.”
Responding to Khan’s claim that the programme was based on recommendations arising out of the Cottle Report, Manning-Alleyne denied this was possible, saying: “To use the Cottle Report as the premise to introduce this programme is erroneous. It is a knee-jerk response.
“There hasn’t been enough time elapsed between the report and now for a move like this to have clearly been thought out and for the logistics to be put in place.”
Instead, Manning-Alleyne said, Khan was hiding behind the Cottle Report to implement the new programme.
The new Medical Foundation House Officer Programme will introduce a two-year course in place of the regular one-year programme, which will focus on training in areas such as emergency and resuscitative procedures, administrative duties and critical care.
Manning-Alleyne was one of the team of investigators led by retired Justice Mustapha Ibrahim who were appointed by Attorney General Anand Ramlogan on March 17 to probe the death of infant Simeon Cottle.
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.
The report was submitted on June 6, after which Ramlogan promised it would be sent to the Director of Public Prosecutions and the acting Police Commissioner for investigations, to determine if disciplinary action should be taken against Dr Javed Chinnia, who did the surgery.
Referring to the report yesterday, Manning-Alleyne said the junior doctor should not be blamed.
She said while several deficiencies were highlighted in the report, it was important that blame be assigned to the right parties, since “junior doctors don’t function on their own but under the guidance of senior doctors.”
On neonatal care, Manning-Alleyne stressed: “The paediatrician is not the competent authority.”
Pointing to the lack of neonatologists in the country—she is the only one qualified in the field in T&T—Manning-Alleyne said the findings of the report spanned neonatal care and obstetrics.
She said while it was never recommended that junior doctors improve their skills in the area of resuscitative care, it was important that “the man instructing the junior doctor would be the one” called on to improve his professional skills and training.
Questioning the process, Manning-Alleyne said: “We are now asking senior doctors to train the junior doctors when they themselves need to be trained.”
The new programme promises consultants and trainers generous compensation packages, as they will not be allowed to carry on a private practice if they are contracted to the ministry.
Manning-Alleyne said in order for the new programme to take effect, several things had to be done, including selection of teachers, development of training programmes, choice of subject content and provision of accommodations for both staff and interns.
Warning that the field of medicine was no joke and there was an urgent need for neonatologists, Manning-Alleyne said: “The amount of money they are going to spend paying the wrong people to do the job, they can hire the right people for that money.”
She recommended hiring a team of neonatologists to guide paediatricians, with a view to developing a standard of care in this area.
Medical group: Good move, but more talks needed
Meanwhile, the Medical Professionals Association of T&T (MPATT) Reformers, while applauding government’s initiative to tackle issues related to the training and registration of doctors, expressed concern with the way the changes were being made.
In a release, the group referred to the lack of senior supervision and to deficiencies in certain core skills areas.
“Despite the good intent of the ministry, the MPATT Reformers have some concerns with the manner in which these changes are being implemented. We are very concerned that vested stakeholders such as the T&T Medical Association (T&TMA), Medical Board (MBTT), University of the West Indies (UWI) and Medical Professionals Association (MPATT) were not sufficiently consulted. It is to be noted that Medical Sciences Faculty of all campuses of the UWI in the Caribbean recommend a one-year internship period for its graduates as its standard for registration with the respective medical boards.
“Taking this into consideration, we do not agree that the ministry should take a unilateral decision like this without consulting UWI and MBTT.”
The release continued: “We also have objections that new graduates were not given adequate notice of the changes and are feeling coerced into accepting the changes. We also feel that measures such as reasonable workload, reasonable hours-of-work, vacation/other leave, reasonable salaries and adequate supervision/training should all go hand-in-hand.”
MPATT Reformers called for dialogue from all stakeholders to decide the way forward in this matter.
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