By Lukoye Atwoli
Sunday Nation 01 June 2014
Recent demonstrations by medical students at one of our local universities exposed just the tip of the iceberg as far as problems in the training of medical personnel are concerned. The students were complaining about lack of facilities and staff to teach critical courses in their curriculum. This shouldn’t surprise anybody knowledgeable about medical education in this country.
Many universities treat medical education as a cash cow rather than as an avenue for increasing the number of critical personnel in the health sector. Several times in the past, medical students have been admitted to “medical schools” only to find themselves idling on campus without teachers or material to learn.
The Medical Practitioners and Dentists’ Board, being responsible for regulating medical training in the country, has tough questions to answer in this regard unless they can demonstrate the problematic institutions are duplicitous in their dealings with the Board.
The Board is certainly aware of the shortage of doctors in this country, and any move to rectify this situation is definitely laudable. Unfortunately this shortage also affects availability of experts to train medical students in the various areas of medicine. Especially in the basic sciences that form the bedrock of medical training, there is an acute shortage of lecturers even in the more established medical schools.
This being the case, it is surprising that there is no sustained policy to focus on training of experts in these fields in order to ensure all medical schools are sufficiently served. The result is that in some cases the same individual is involved in teaching medical students at several universities, obviously to the detriment of quality teaching and all but obliterating any opportunities for research. With the proliferation of medical schools in all corners of this country this situation is sure to worsen.
Further complicating the issue is the involvement of universities in the training of certain paramedical cadres without clear career progression. For a long time in this country, the Kenya Medical Training College has been training a highly qualified cadre of paramedical personnel known as clinical officers.
These officers have helped ensure Kenyans in the most remote parts of the country have access to a clinician who can diagnose and manage common medical conditions. Beginning training at diploma level, they were able to further their training at higher diploma level specialising in one field of medical practice. Those that were so inclined could later join medical school and train to become doctors.
Some of our universities jumped into the fray and initiated the training of this cadre as they prepared medical curricula for future training of doctors. After a while, some bright chaps at these universities came up with the idea that they ought to train the same cadre at degree level, without a thought as to how they would fit in the highly regimented medical fraternity.
Many of the students enrolled in the courses believing they were being trained to become doctors. Unfortunately many of their dreams are ending in frustration when they find that many institutions do not know how to deploy them when they apply for jobs.
It is time we held candid discussions about the direction of medical training in this country because, after all, the arguments and tantrums, the lives and livelihoods of Kenyans are at stake.
Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. firstname.lastname@example.org