Fact Finding Committee and Medical Education

The FFC is reaction rather than, as ought to have been the case, pro-action.

In other words, it is primarily a gross policy failure in the matter of medical education that has led to the present situation

The leader of the Opposition Paul Berenger has criticized the setting up of a Fact Finding Committee (FFC) by the Tertiary Education Commission, that is, the government, to look into the allegations made by two prospective Indian students of the DY Patil Medical College about what appears to have been mainly lapses in procedures. Berenger, perhaps with some justification, referred to the FFC which was set up to investigate another allegation concerning the MITD, following which there was apparently no concrete outcome.

With his experience in government, Berenger is well placed to know what quite often happens to reports that are commissioned by governments of all hues for various purposes. The public at least knows that very soon they are forgotten, put aside and even any action taken eventually happens so far down the line that by then interest in the matter becomes diluted. Point is: FFCs are one of several mechanisms that governments have at their disposal in the country’s governance, and it is the seriousness and sincerity of purpose of the government of the day that really determine what good follows to the country after a report is submitted.

That, as anyone with simple commonsense will know, depends on the quality of the report, which in turn depends on the quality of the people who make up the FFC or whatever other mechanism is chosen. As the chair of the FFC is usually a legal person, and the members are drawn from the relevant technical field along with administrative support, it follows that the technical expertise is crucial in advising the otherwise lay FFC.

The criticism of Berenger would have been more valid if he had focused on that aspect, starting from the premise that medical education and medical service are two different kettles of fish altogether. What was relevant in this case is whether TEC has taken care to have Judge Seetulsingh being supported by the right technical expertise, that is expertise in medical education. This means many things, namely experience in teaching or training medical undergraduates/graduates/post-graduates; the organization and conduct of examinations; the setting and correction of examination papers; evaluation and assessment of results of examinations; quality control in medical education; engagement with academia; familiarity with and experience in the interfacing of service delivery and provision of medical education; involvement in clinical training.

These are among some of the main areas which the expert on the FFC panel must have actual experience in. If this level and depth of expertise is not available to the FFC, then whatever report comes out is bound to have weaknesses.

More fundamentally of course is that the FFC is reaction rather than, as ought to have been the case, pro-action. In other words, it is primarily a gross policy failure in the matter of medical education that has led to the present situation which is, nevertheless, being overblown. That there is a degree of overkill has already been underlined, and this ill serves the interests of the hapless students whose parent have made huge sacrifices to support their post-graduate medical studies.

In an article on the subject two weeks ago, we had alluded to a World Bank report of 1997 which had recommended that the time was ripe for Mauritius to set up an autonomous College of Medical and Health Sciences to be based at Pamplemousses which had both the infrastructural (hardware) and the education programmes in medicine, nursing and the allied professions (software) to kickstart such a project. As this opportunity was missed a new one which was presented by the University of Mauritius, reviving the concept with more detailed considerations, unfortunately suffered the same fate, and thus the splash that has boomeranged on the national scene today.

We embarked on a so-called ‘knowledge hub’ in medical education without adequately preparing ourselves for it. After the National Health Service in the UK was set up by Aneurin Bevan in 1947, it took several years of discussions and consultations among the stakeholders – the universities, the General Medical Council, the professional bodies including the Royal Colleges, the service oriented public hospitals and so on – before the latter could, for one, be accredited for medical education purposes and, two, for the academic and service staff to strike a modus operandi of collaboration and cooperation.

Here we decided to run before we could even waddle on the medical education scene. None of the larger questions were addressed – simply because there was no proper entity to do so. Or rather, the two main legitimate and legally empowered structures that could have played that role were simply ignored – the University of Mauritius and the Mauritius Institute of Health.

How many medical colleges do we need, can we sustain in Mauritius? 1, 2, 3, 4, 5, 6…? Who will decide that? Lay people or medicos with no notion of what medical education entails or is all about? Politicians out of a whim, bent on leaving a mark — even if it is a scar on the face of the nation – or having an agenda to pursue?

There are already a couple of hundreds of freshly graduated doctors awaiting to do their internship. Last December another 60 or so were added to the pool, and there must be hundreds more studying abroad who will be coming to swell the numbers in a foreseeable future. There has never been an official advisory to counsel prospective medical students about the situation and what to expect – or rather not to expect – as regards future possibilities or opportunities of employment.

Clearly, there’s a lot of fresh thinking that is needed in the matter of medical education. We will never have any clarity on the way forward unless this is done.

 


* Published in print edition on 15 March 2014

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