All above board with Windsor med students

FOR YEARS we have known about medical students from abroad being taught at the nation’s public hospitals. They came from as far as India, Pakistan, Philippines, United States and Canada. There have never been objections in the past to what has developed into a long-standing practice of foreign doctors doing internship at our hospitals. But when money is paid directly to doctors to teach students at a Government-run hospital, the Ministry of Health finds this odd.

This week, the Ministry made no bones about exposing a programme run by a team of senior doctors at San Fernando General Hospital (SFGH), who had been tutoring medical students from an offshore medical school. The students who grabbed an offer to complete their final two years (clinical training) at SFGH, hail from the tiny Caribbean island of St Kitts, enrolled there at Windsor University School of Medical Sciences. The US dollars the students have been paying the doctors for tuition was the least crucial finding of a confidential report compiled by Principal Medical Officer (Institutions), Dr Rampersad Parasram. It was the sub-standard “quality” of these medical students. Non-approval from the ministry, the report stated, forced the Ministry to stop the programme. Sunday Newsday spoke with Dr Stephen Ramroop who, as clinical co-ordinator of the programme at SFGH on behalf of Windsor, contends that the public have been fed misconceptions about the teaching programme. Ramroop, who is Head of the hospital’s Accident and Emergency Department, said: “Offshore medical schools have been in the Caribbean for many years. This offshore medical university is based in St Kitts.” The University, he added, has its base in the United States with campuses in other smaller Caribbean Islands.

A probe of the Windsor Web Page on the Internet, revealed that the school has its orgin in India. The school’s president is Srinivas Gaddam MD; Guldeep Singh Gill MD is listed as the university’s Dean of Academic Medicine. The university lists Trinidadian Ramroop as a member of its Education Committee. Most, if not all of Windsor’s students, come from India or are of Indian orgin. Asked about his role in the programme, Ramroop said: “Yes, I was asked by the university to co-ordinate the programme. Officials came to Trinidad, held discussions with the Ministry (Health) during the latter part of 2000. They were referred to the Medical Chief of Staff Dr Austin Trinidade, San Fernando General Hospital.” But the question crying for answers is whether permission was granted. Ramroop agreed. He recalled Trinidade tabling a document at one of the montly meetings of clinical Heads of Department. It dealt with Windsor’s application to have the students train at SFGH. Ramroop said: “It was agreed that there can be no conflict between UWI and non-UWI lecturers or consultants in as far as teaching medical students.” Ramroop, as orthopaedic consultant, sat in at the meeting and according to him, “it was agreed that UWI cannot dictate to other consultants in the service whether it could teach anybody”.

Consultant doctors in various specialties teach medical students at Mt Hope Hospital. These consultants are paid by UWI, to which the students are enrolled. Did Ramroop sought to effect a similar system at SFGH? He explained: “We decided that all who were interested in teaching can teach. Those who were not, they can continue to teach only UWI students. It was then decided that appropriate authorisation should be obtained and that we should clarify it with the medical board as well as with the Ministry of Health.” Ramroop added that at each of the meetings Trinidade held at which the Windsor matter was discussed, there was an Regional Health Authority representative. “It was his (RHA representative) responsibility to take the authorisation process to the CEO of the RHA and back to the ministry to get appropriate authorisation.” Sunday Newsday asked  —was permission granted or not? Ramroop said: “The university came, met with the CEO who passed it on to the Chief of Staff (Trinidade) who did what he had to do. He (Trinidade) got the consensus of all the clinical heads. The clinical heads decided that Dr Ramroop will head a committee to make recommendation about the programme and report back to the clinical heads.” Checks at the Windsor Web Page revealed that students pay as much as US$16,000 per year for four years of study. The Windsor programme advertises a four-year programme, with the first two years of pre-clinical at Windsor. Students have an option, the advertisment states, to complete their two years of clinical training at any hospital of their choice. SFGH is listed, with a photograph, as one such hospital.