The Tribune

By RASHAD ROLLE

Tribune Staff Reporter

rrolle@tribunemedia.net

THE concern some junior doctors feel about an impending programme they fear will push them out of the public healthcare system is fuelled by experiences with the University of the West Indies' post-grad programmes where matriculation rates are low.

Dr Young Sing was three and a half years into the surgery programme there when he became frustrated and dropped out in 2017.

Despite the setback, he said he will soon enter one of Europe's most prestigious and competitive fellowship programmes for plastic surgeons after just months in the United Kingdom.

Upon completion, he will specialise in breast, hands, skin cancer, microsurgery and breast reconstruction and be capable of practising anywhere in the world, he said.

UWI, the traditional route by which regional doctors gain expertise that leads to independent practice certifications, has such flaws that people find their professional development obstructed, he added.

"For any junior doctor to finish their MBBS and to gain entrance to their postgraduate programme clearly demonstrates their aptitude for work and their intelligence," he told The Tribune.

"Perhaps the high failure rate of students in UWI's post-grad Doctor of Medicine (MD) programme is not the failure of the students, but one of the system, or the ones who control it. If a programme that has such a high failure rate of its candidates when it has included only the cream of the crop of the nation's students of every Caribbean nation then logically this cannot be due to the candidates' sudden deterioration of intelligence as the DM programme seems to infer. I would urge the university to totally relook at the subjectivity surrounding the examination process and the teaching process that does not adequately equip their candidates for their exams."

Dr Sing, a native of Trinidad & Tobago, dropped out of UWI Bahamas not long after failing a key written and oral exam in 2016.

"They gave me no feedback on why I failed," he claimed. "What was I weak in? How could I improve? They never said.

"If they don't like you, they will fail you, no matter how well you do," said Dr Sing, who began working at Princess Margaret Hospital in 2013 while enrolled in UWI's DM programme.

"You cannot get through UWI's post-grad medical programmes if you are not a golden boy or one of the highly favoured. You have a small pool of older guys who let their personal feelings halt younger people from moving up. The process for determining if one passes exams is subjective and doesn't reflect your intelligence level. It's all about the people in power protecting their own business interests."

Health Minister Dr Duane Sands revealed this week that more than 200 senior house officers are "trapped" in the public healthcare system after failing to obtain certifications that would allow them to practice independently.

Dr Sing, however, said the statistics don't tell the whole story. He said either local doctors obtain requisite licences in countries outside the region, in which case many of them never return to the Caribbean, or they go through UWI's system where many fail and get stuck at the SHO level.

"UWI's standards are so high that one of its supposed failures, like me, came to Europe and now has institutions bidding for me to enroll with them," he said sarcastically.

His success in the UK compared with UWI is not because of fluctuating work ethic, he added.

"At UWI, I worked approximately 120 to 140 hour work weeks on average. I was paid for only 40 hours. I was in DM classes an hour before work started and that consisted of me giving presentations and being barraged by continuous questioning that required preparation. Somehow I needed to find the time to read about four chapters of solid research as well as create PowerPoint slide presentations without leniency for working day and night. I have scars on my face where I have blacked out and fell from sheer exhaustion after working five days and four nights without a break or time to shower or eat. I was not given any public holidays or applied vacations. Their explanation was, 'you aren't Bahamian, you don't get any vacation if Bahamians need it, or you are in a trainee programme, you aren't allowed to have vacations.' By contrast, in the UK, I work strictly 40 hours and I leave. I have weekends and public holidays off. I fly every other weekend to a different country as evidence by my Instagram. Yet I am far more successful here where I work less but I wasn't successful where I had slaved and gave blood, sweat and tears to a job and a university programme that said nothing was good enough for them."

Before he came to The Bahamas in 2013, Dr Sing says he passed his Membership of the Royal Colleges of Surgeons of Great Britain and Ireland (MRCS) exam to obtain a postgraduate diploma for surgeons.

He didn't see the certification as a viable option until he became fed up with UWI's programme.

"No one in the Caribbean actually tells you how to get to the UK to practice medicine," he said. "They tell you it's not feasible, that you won't get a visa, that it's closed off to us as juniors. They tell you the MRCS is useless."

"I took a chance and now I am a senior specialist registrar, (which is above an SHO). If I knew then what I know now, I wouldn't have gone to The Bahamas. Bahamas wasted three years of my life. Had I come straight to the UK I would've been the youngest consultant in the Caribbean by now."

Dr Sing will enter the fellowship programme at the St Andrew's Centre for Plastic Surgery and Burns in July.

Meanwhile, beginning this month, some junior Bahamian doctors will be selected to participate in a residency programme within a medical department at PMH. Those not chosen will be mandated to participate in a foundation programme designed to push them into private practice. Doctors who fail the programme or its final exam will be forced out of the profession.

Dr Sing and local doctors fear the foundation programme will mirror the characteristics of UWI's programmes they despise, featuring low lecturer feedback and alleged bias.

They also fear people who could succeed elsewhere in the world will be out of a job in The Bahamas as a result of planned changes.