Postgraduate Medical Education at Uwi: From Fantasy to Reality
Prof Mohan M.S. Ragbeer
Synopsis "Postgraduate Medical Education at Uwi: From Fantasy to Reality "
By the mid-1960s a steady drain of Caribbean doctors to Canada, USA and the UK, was subsidising these already well-endowed health systems, and depriving the struggling Caribbean economies of millions of rare dollars annually. This uncompensated loss denied the region of half or more of the annual output of doctors from the University of the West Indies (UWI). This book, "PGME at the UWI, Stemming the Brain Drain from the Caribbean", deals with the challenges poor nations face when they seek to develop educational programs of high standard, free of external vested interests and control. It describes the actions taken at that crucial time in UWI history, soon after its independence from London University, when it was expanding, facing financial and social difficulties, with internal want and unrest, and external pressures threatening its integrity. This was a time of global conflict, the Cold War and student protests, spreading in and from the USA. The author, immersed in this problem from the mid-sixties, and the need for other reforms, became the first full-time Dean of the Medical Faculty in 1971, and worked with medical colleagues, and a few from other faculties, and with external agencies, whose names are given, to combat the forces threatening the UWI’s existence as a regional body, and destroy its potential to unite the 14 units of the Commonwealth Caribbean that funded it, and gave its scholars a place and a voice. Given the bare minimum in resources, he and others—many named in the book—initiated a series of reforms and innovations in medical education, programs and policies to produce a range of specialists, family doctors and other manpower, and start a novel division of Community Medicine, of which details are provided, tailored to Caribbean needs. By these incentives to graduates, they hoped to stem the “brain drain.” Jamaica’s PM Manley urged him to turn “fantasy to reality”, and other Caribbean leaders agreed. The plan was bold and costly, but they persisted, over the skepticism, gratuitous criticisms and ridicule of some influential foreign observers, and later “threats” by US entrepreneurs, who were luring each island for use as bases for US medical education for profit. Ten years later, one skeptical journalist who had labelled him a dreamer, summarised his work as “high quality on a low budget.” Today, the UWI Health Sciences Faculty thrives on three campuses, produces enough doctors, generalists and specialists, for Caribbean needs and some for export even! The output continues: from aides and assistants to nurse practitioners, administrators and educators, family and specialist doctors, dentists, veterinarians, and a range of technicians and basic scientists, through Masters and Doctorate programs, who now provide medical services for the Commonwealth Caribbean. Community Medicine was not pursued, but the concept, described in the text, remains valid and survives as a document that had received preliminary approval by the Ontario Ministry of Health, but shelved. The book includes tables of data, photographs, and an Appendix with copies of original documents and published papers.
