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Friday 23 March 2018

Khan seeks extension of internship periods for medics

Health Minister Dr Fuad Khan has called on stakeholders in the medical profession to present the Health Ministry with a position paper on the extension of the period of internship for medical interns, to enable further training in patient care and personal development.

He called on medical practitioners’ associations and interns yesterday to come up with their position papers “within the next seven days.”

Dr Khan then, was speaking at a Sensitisation Meeting for the Medical Foundation House Officer Programme, held at the Raddison Hotel, Port-of-Spain.

At the meeting he proposed extending the current internship period from one year to two years. There was some amount of opposition, as well as support, for a change in the internship programme.

Khan also called on the stakeholders to present their position on whether or not, the temporary registration of medical interns to practice, should be extended.

He also announced that based on request to sort out administrative demands, the start of internship for the current batch of graduates from the University of the West Indies Medical School, will begin on August 1, instead of July 1 as has been the case previously.

“The internship will start August 1. Whether (the internship) will be for one year or two years,” he said, “we will determine that later on, with all the stakeholders.”

The proposed extension of the internship, he said, was based on numerous complaints of patients’ care and management in the hospitals. Those seen in the media, he said, were just a few. The Cottle Report, he said speaks to resuscitation management. The Cottle Report is based on investigations on the death of baby Simeon Cottle who died after he sustained a cut on his head, while his mother was undergoing a Caesarian section.

He also noted the case of a 16-year-old-boy who went into a hospital in a good condition with a tracheosomy, but is now brain dead due to poor resuscitation methods, and lack of simple care management.

The case he referred to was, that former Senator and social activist Verna St Rose-Greaves’ grandson, Randy Reyes, who was shot by stray bullets on March 14. Reyes was admitted for a tracheostomy procedure, and was in a vegetative state at the Port-of-Spain General Hospital.

“When we looked at it, and all the problems occurring,” he said, “the common thread was a need for more critical care, and intensive care training. A lot of the junior doctors do the basic modules, but they do not go through the critical care and intensive care training at the internship level.”

Khan said that apart from providing for the interns, a proposal has been put forward to remunerate doctors who will be full-time consultants.

These consultants, he said will not be in private practice, but will be clinical trainers, and the clinical counsellors of the interns.

In a brief presentation, Acting Chief Medical Officer, Dr Colin Furlonge noted that since 1968 periods of internships have gone at different intervals for periods ranging from two years to 18 months to one year.

The proposal to move the current period from one year to two, he said, was because of numerous complaints to the ministry about absence of care and compassion from medical and health care providers. Complaints, he said also included time spent with patients, dismissive attitudes, the absence of communications skills, and lack of attentive listening.

The increase in the internship period, he said was also needed because of the increase of offshore medical schools, which were now providing graduates to standards which the ministry was “not sure about, but who will be part of the system.”

The increase of intake at medical schools in which a trainer now has to deal with large classes, and being unable to communicate with a student on a one-and-one basis, he said, was also another matter of concern.

The two-year system of internship proposed is based on an English model which will provide for three-month periods each in general surgery, medicine, obstetrics and gynaecology, and paediatrics, and not six-week periods as now obtains.

The second year will include four rotations in anaesthetics, intensive care, accident and emergency and sub-speciality in either surgery or medicine.


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