and people have gotten National awards for things they have done famous examples being the separation of Siamese twins and reimplantation of a severed hand.
The only challenge to this is you have a smaller cohort than those who only used to teach undergraduate course now managing undergraduates( more than 5 times the initial numbers), post-graduates, and subspecialists. This begs the question: what is the quality of teaching? For the post-graduates and sub-specialists the situation is not as dire but even their intake numbers is far beyond recommended standards but being mature adults they are able to look for information and opportunities for practical experience. The undergraduates on the other hand I don’ t know and now we are being faced with serious breaches and vices like exam cheating.
For me the high intake and reduced numbers of lecturers is the“ Bad!”
The“ Ugly!” is what we are going to witness downstream, when we produce half-baked doctors who do not know the basics of medicine. This will obviously have an impact on the healthcare system and we all know a healthy nation Is a wealthy nation. It is also very ugly when one takes their life as they are not able to cope with the pressures that they are facing.
Another challenge facing the education sector is the introduction of courses that make absolutely no sense. We have a cadre of staff known as clinical officers. Now universities have began an undergraduate course in clinical medicine. There already exists a course called master of Medicine and Surgery MBBS, but the clinical officers do not want to spend 6 years in school. There will soon be a masters in this course, if it is not already there.
Our doctors are very good and I’ m proud that a lot of great work has come out of our institution and people have gotten National awards for things they have done famous examples being the separation of Siamese twins and reimplantation of a severed hand.
What this course serves only God knows.
Rather than looking at the needs of the wider population, which I believe the course at the Medical training Colleges tried to address at inception we look at the needs of a few individuals. What has happened is that the nurses and clinical officers doing the university courses want to be managers and have limited clinical experience.
The cadre of clinical officers only exist in East Africa, the closest equivalent I can think of are paramedics who do ambulance services in the west. We should look at the healthcare system and see have we reached the time to change to ambulatory medicine? What is the valueadd to the healthcare system by having a clinical officer become an undergraduate in clinical medicine?
Unfortunately for me I have taken my shot!! I am wearing a very big helmet and lots of armor as I wait for return fire. The aim is not to criticize but to offer solutions and one can only offer solutions to problems they are cognisant of.
For interns if feasible, and I believe it is, maintain the CBA and pay them what is right. The state has started collecting for SHIf / SHA much more money they can put a percentage of this into training and welfare of healthcare personnel. This will alleviate a lot of pain and suffering as internship is not a joke. But on the other end can we stop being barbies and telling us about 40 hour work weeks as this is not the way doctors work and why in public setting we earn extraneous allowances.
For Universities, an audit and bench marking with other great medical universities should be done. It is known the ratio of teachers to students for various courses. While it might not be feasible to stick to the exact ratios it must be capped that we should not exceed by more than double the expected international standard. We must invest in proper training of personnel and not just healthcare but as this is my field I am advocating for proper training of my tribe.
I know this may not be very popular but as a result of the above it means we will have to cap the intake of medical students but the flip side is increase the number of lecturers and through this improve the quality of education the students are receiving.
Development of courses should be critically looked at and people should not work in silos. Other than being revenue generating courses, why should we spend time and money to create an individual who is only able to find work in their country as these skills are not transferable.
We have a relatively new administration whose slogan is“ kusema na kutenda!” Can we resuscitate our public universities as majority of users of these services are the very people who voted you in: the youth. The future of our youth is pegged on them getting the right tools to help them become productive members of society.
Dr. Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi. You can commune with her on this or related matters via email at: Drmaureenowiti @ gmail. com.