Socialist training in Medicine

Jul 07, 2009 Letters

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Dear Editor,
Anyone familiar with Virgil’s Aeneid would be aware of Laocoon’s cry, “ Timeo Danaos et dona ferentes” which properly translated means, “ I fear the Greeks even when they offer gifts”
The Cuban government has made available to Guyana a number of scholarships. I am only qualified to speak on scholarships in the field of Medicine but what I have to say may well apply to other areas.
The government continues to delude the populace and proudly announces the return of individuals with Cuban qualifications.

In the field of Medicine, Guyanese trained in socialist countries faced several obstacles. The best students were not chosen. The students had to cope with a foreign country, a foreign culture and a foreign language.
It was therefore not surprising that at the end of the day the products are sub-standard. Socialist medicine is not geared for independent practice – there has to be a protracted period of supervision. What we have here is a system inherited from the British and it is a system of independent practice. Without retraining it is therefore not surprising that the products of these socialist systems have been unable to provide the service in a country geared towards independent practice.
In order to accommodate the infusion of individuals returning from Cuba the Minister of Health and the Medical Council selected under the Ramsammy formula made regulations which gave recognition to a number of entities to provide internship training.
The new regulations now include the Diamond Centre, the Leonora Cottage Hospital, Suddie Hospital, Mahaicony Cottage Hospital, West Demerara Hospital, New Amsterdam Hospital and Linden Hospital etc – a plethora of sub-standard institutions.
The purpose of internship is to enable individuals who have had a mere introduction to Medicine to be apprenticed to gurus in the field so that at the end of internship they should be able to practise the basic principles of Physic and Surgery independently.

There are no individuals who would qualify for recognition at the centres named above so we have a situation where the unqualified are training the unqualified.
We will at the end of the day have numbers without quality and the majority of Guyanese are being put at risk. Another troublesome aspect is that these unaccomplished individuals behave as if a piece of paper makes them the reincarnation of Hippocrates.
Their arrogance knows no bounds. They know not what they do not know. It is the tragedy of mediocrity.
Under British rule the Georgetown Hospital had a reasonable complement of specialists and was regarded as being suitable for the internship of British trained doctors. On account of this the regional Medical School – UWI recognised the Georgetown Hospital as being suitable for internship training.
Today neither the General Medical Council of Great Britain nor the regional Medical School UWI recognise the Georgetown Hospital as being suitable for internship. If this hospital is no longer suitable for recognition how on earth the extended list referred to above ever qualify.

The quality of hospitals is dependent on the quality of doctors who traverse its corridors and not the amount of steel, concrete and wood used to build these institutions.
Prior to my assumption of Chairmanship of the Medical Council we were misled that the Cuban “Primero” or Grade One qualification signified specialty in a discipline.
The reality is that it is the “Segundo” qualification and not the “Primero”, which enables one to gain recognition. Not a single Guyanese has achieved that qualification and this explains why Cuban “specialists” do not measure up to specialists trained in North America or the United Kingdom. Our unsuspecting public believes the holders are specialists when all they have is an entrance qualification for further training.
The government although aware of the diminishing number of accomplished specialists has taken no steps to send for training bright individuals to be trained as specialists.

The death of Dr M. Y. Bacchus, FRCOG, the realisation by Mr. Wallace Lee, FRCS that he is too old to do major surgery, the virtual retirement of Dr. Narine Sooknanan FRCOG, and retirement of Dr. Enid Denbow FRCP means that the only Guyanese specialists who are now operative and who would receive recognition by the GMC and UWI are Mr. Rampersaud Sarjoo, FRCS, Mr. Roger Viapree, (FRCS both of whom practice in the field of ENT), Mr. Honnet Searwar, FRCS, Mr. Deendial Sharma, FRCS (Ireland), Dr Ramsundar Doobay, MRCP, and Dr Walter Ramsahoye, FRCP, FACP, FAAN. All these individuals are over the age of 60. Mr. Sheik Amir FRCS is under 60 but he passed the FRCS when the British introduced a new system which made that exam easier but insisted on Higher Training in recognised institutions. He did not secure the DM (UWI).
This is not to denigrate Cuba which has offered scholarships. It is regrettable that the President has not managed to secure scholarships from the UK, Canada or USA.
If Cuba is as good as the Minister claims, why do we not close the UG Medical School and use the funds to provide facilities such as dialysis, renal transplants, oncology and cardiac interventions.
A Prado costs the government $11 million duty–free, so money is available! One cannot splurge on Prados, have Pradoville and Eccles with an oligarchy moving from rags to riches and use a begging bowl to underpin economic policy!

Our leaders display no confidence in the system which they espouse as they all, including the Minister of Health find themselves in North America when they are unwell. Propaganda has taken the place of a strive for excellence.
Neither the British nor the Americans recognise the DM programme offered by UWI and I am not excited about the quality of the Indian nationals, who have been allowed to parade here as specialists without professional qualifications. I utterly reject the late Dr M.Y. Bacchus’ view that the third world should expect nothing better than third rate standards.
Until many corrective steps are taken there will be more medical centres, more hospitals, more doctors, more “specialists” but concomitantly higher mortalities and morbidities!
Walter Ramsahoye

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