“It is difficult to imagine that from the Minister of Health, the Permanent Secretary in the Ministry of Health and the Chief Medical Officer, none can say what the expected future needs of Trinidad and Tobago’s medical profession will be in the next five years.”
The following Letter to the Editor, submitted to Wired868 by an anonymous, unemployed doctor, addresses the issue of too-many-doctors and too few employment opportunities:
It was irritating to have read the comments in the article entitled “Shattered Dreams” printed on the 22 July 2018 in the Guardian newspaper and the corresponding input by both the University of the West Indies (UWI) and the Ministry of Health on the same page.
Reading the responses of institutions involved was like nothing short of watching an embarrassing blame game amongst primary school children caught in mischief by their teacher.
For the average person, the current plight of the unemployed doctors is mind-boggling. The numbers, staggering!
Six hundred-plus doctors are unemployed. Did the Ministries of Health and Education not know they would have to hire these persons after using taxpayer’s money to fund their education?
Even with the proposed opening of two new hospitals—the Couva Children’s Hospital and the Arima Hospital—is it that the capacity of those two hospitals will be able to employ 600 junior doctors plus the 200-odd current interns who will finish their internship next year and also be looking for meaningful employment?
And this still does not account for the 200-plus Trinibagonians in each of the five year-groups currently enrolled in the various medical faculties of the UWI.
It is difficult to imagine that from the Minister of Health, the Permanent Secretary in the Ministry of Health and the Chief Medical Officer, none can say what the expected future needs of Trinidad and Tobago’s medical profession will be in the next five years.
The Ministry of Education will say that they cannot tell persons which career to pursue when they are awarding scholarships. I ask, how difficult is it to pick up the phone and ask your colleagues what are our needs in the next three to five years and award a finite number of scholarships in those fields to match expected needs? Is needs-assessment beyond the thinking capacity of those tasked to lead?
We now find ourselves in a situation where a significant number of our best and brightest shall leave these shores with the possibility that many may never return. We will then look on at these same folks as they shine brightly, enriching the medical fraternity of other nations and wonder where it all went wrong.
The University of the West Indies’ official line, “The UWI is not responsible for the placement of doctors,” shows that the UWI is not interested in anything other than money—and who could blame them?
They are a business and the aim of a business is to make money. The Faculty of Medical Sciences is the cash cow of the UWI with money often being taken to fund other faculties and university initiatives. Why wouldn’t they want as many students as possible when they are all backed by the surety of payment via the Government Assistance for Tuition Expenses (GATE) or scholarships.
What the university does not seem to care about is the quality of education given to students. Granted, the lecturers attached to the Faculty of Medical Sciences (FMS) at the UWI do work tirelessly to impart what they can, but there is only so much that can be done when you have to lecture to a class of 200+ students, or your ward rounds in clinical years have 10+ students as well as the medical team around a patient’s bedside.
How can this be a conducive learning environment? Now imagine how the patient feels.
While it may have been in the past that there was a shortage of junior doctors and initiatives such as “dollar for dollar” and its successor, the GATE programme, have now successfully dealt with that problem, the Ministry of Health has been unequivocally short-sighted. So where do we go from here?
Junior doctors are no longer needed in such numbers, so why not focus on specialist training?
There is very little incentive offered for the junior doctor to specialise. Of the few post graduate training programmes offered by the UWI, many are mired by a lack of progression though the programmes, with residents often forced to take more than the allocated time to complete specialist training.
Those who choose other routes of specialisation, risk being left in the cold with little to no guidance as to what their options are.
Surely, there must be some way for our government to engage other governments to have our people trained in specialties where we fall short, and accompany those arrangements with binding agreements for employment upon return.
This must however, be coupled with providing your now skilled doctors with the tools necessary to do their jobs to the best of their ability—which is, in itself, an entirely different discussion.