Med school mess! - UWI admits challenges facing doctors in training but says these are being addressed
The administration of the Faculty of Medical Sciences at the University of the West Indies (UWI), Mona campus, has admitted that all is not well at the facility, but argues that steps are being taken to remedy the situation.
The acknowledgement came last week during a Sunday Gleaner probe of complaints from medical students about overcrowding and lecturers' absenteeism, which they alleged have significantly compromised the quality of their education.
The issues affecting the faculty have also caught the attention of the Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM-HP), which is the legally constituted body established to accredit medical, dental, veterinary, nursing and other health profession programmes leading to professional degrees required for practice in CARICOM member states.
In June of last year, CAAM-HP instructed the UWI's three campuses to show that steps are being taken to address issues identified in site visit reports of 2012 and 2016 as failure to do so "would result in a redetermination of accreditation status" of the medical programmes.
Last week, the director of medical education at the Faculty of Medical Sciences, Mona campus, Professor Michael Branday, told our news team that steps have been taken to address the CAAM-HP concern about the student-per-lecturer ratio.
"One of the responses was to decrease the numbers enrolled, which we actually started from last year," said Branday.
"So the students that are currently in, are in some of the larger classes, but in another two years, the numbers will have fallen again to a more manageable number. I think our accreditation has been extended to 2019 because we have taken a decision to address the problem, which includes appointing additional associate lecturers, among other things," added Branday.
He said class sizes have consistently been over 300, but since last year, a cap has been imposed at the three campuses, with Mona's cap being 280 new students per annum. For 2017, the faculty is said to have taken in 266 students while approximately 287 were admitted last year.
The Sunday Gleaner obtained a lecturer absenteeism and schedule alterations timetable for the Bachelor of Medicine and Bachelor of Surgery Class of 2018, which showed that between February 3 and March 18, 2015, at least 15 lectures were rescheduled for the second semester of year two. Some of these classes were pushed back by almost a month.
During our news team's visit to the faculty last week, several medical students, at different stages in their studies, stated that the problem of lecturers missing classes, some without prior notice, has persisted.
"The institution's recruitment of students far exceeds its capacity to effectively prepare medical students, far exceeds its ability to create an appropriate teaching environment and deliver high-quality output," one disgruntled student argued.
"As a result, the quality of the medical education is compromised and has become substandard.
"Often, lectures are delivered several weeks or a month after the originally scheduled date. Often, the rescheduled lecture occurs after a clinic or other learning event for which the lecture material was essential, which puts students at a tremendous disadvantage," added the student who asked not to be named.
Another student alleged that "For some of the classes, if time runs out and they don't get to teach it, they don't put it on the exam. But we still need to be taught it if we are going into the practice. Plus, students would have sacrificed to come to the class."
While dean in the Faculty of Medical Sciences at Mona, Dr Tomlin Paul, conceded that there might be occasions where a lecture was not delivered, he dismissed the notion that it would compromise the standard of education for the doctors in training.
"They may miss a lecture, but I can't think of any course that we have run where we have got to a point where due to absenteeism or anything like that, we have sacrificed the students in terms of a significant objective of learning," said Paul, who became dean of the faculty in August.
"Since taking over as dean, I have commissioned a continuous quality improvement initiative (CQI). We are going to put in that CQI initiative in conjunction with the heads of departments, as quality management has to run parallel with managing finance, staff and everything, as it is at the core of what we are doing," said Paul.
The trainee doctors also complained of challenges with getting efficient clinical training because of the number of students to a patient during ward visits.
But Professor Trevor McCartney, deputy dean for clinical affairs at the Faculty of Medical Sciences, Mona campus, while acknowledging that the number of students to a patient has indeed been an issue, said efforts have been made to address this.
"It is an ongoing process since 2007 where we have utilised all the type As and Bs hospitals," said McCartney. "We have done a lot of clinical labs where students in small groups of no more than five are taught by preceptors on particular patients," added McCartney.