Tuesday, October 14, 2008

Doctors-in-waiting ... Cuban medical graduates continue to wait on registration

Doctors-in-waiting ... Cuban medical graduates continue to wait on
registration - Part II

Tuesday October 14 2008

he doctors a bit of a tap on the wrist, Dr. Benjamin also expressed his
displeasure at not only the treatment of these doctors, but also their
own self-inflicted injustice. Noting that in the past, some have
practised in his office as assistants to gain experience and keep their
skills alive, he noted that not all were as ambitious in their pursuit
of gaining experience.

"There are so many of us in the medical fraternity who would open our
doors to these doctors if they really wanted to get the experience ...
my door is always open."

In the same breath, however, he also added that it was a shame that the
medical fraternity wasn't rallying behind these doctors, offering as
much support as they could.

Rest of th Article

Beginning of the Article

The suggestion of having the doctors registered once they would have
found a position under the supervision of an already established or
prominent medical practitioner was presented to Dr. Sealy-Thomas during
our interview. Pondering it a bit, she explained that it would be noted
and possibly considered by the board, once the application was
accompanied by a signed document from the established doctor, making
recommendation and promising supervision.

Today, there are 13 Antiguan doctors waiting to be registered, having
been told that the years they spent in Cuba do not make them eligible
for registration. As there is little communication between the boards,
the number of doctors expected next year and in the upcoming years is

So while more and more of our young doctors (some having begun studies
as soon as they graduated from secondary school) continue to pursue
studies at the AUA Medical School and eventually become registered with
little or no hassle, our Antiguan doctors who studied in Cuba continue
to wait.

While many of the accountants, economists, physiotherapists and even
dentists who graduate from Cuba continue to make waves in their careers,
having already been employed in prominent establishments, our
Cuban-trained doctors continue to wait. Interestingly enough, while one
sibling who graduated this year was given a great job in his discipline,
his older sibling, having graduated the year before as a doctor,
continues to wait.

While we continue to tell our children that they can be anything they
want to be, even doctors, given the opportunities to pursue such
studies, we tell our graduate doctors they have to wait to practise. We
tell them that they are our future, tease them with opportunities of
attaining medical careers, then slap them in the face and tell them they
are inadequate.

While they watch many of their peers live and excel in their careers,
our Antiguan Cuban doctors, the ones we happily sent to Cuba to return
as doctors, continue to wait.

Cuban medical graduates continue to wait on registration

Part II

by ZIA

The proposals

This is not to say that the government and more so the Ministry of
Health have not attempted to pacify this situation. Toward the end of
2007, proposals were devised for the young doctors.

The first option was to return to Cuba for another three years or more
to read for their general comprehensive medicine and gain experience.
Having already completed rotations in their study, which are made part
of their programme, the Antiguan doctors were not keen on returning to
Cuba, wary that further problems may be fabricated upon their second
return. Additionally, they would be offered US$20 a month by the Cuban
government for their tenure in Cuba. They were told they'd be
responsible for finding their own means of air transportation to and
from Cuba. Notably, for many students who study abroad, whether through
scholarship or their own means, it is not uncommon for them to provide
their own air fare and even accommodations.

But given the hindsight of their original scholarship, it's
understandable that these doctors would need assistance to "now" be
deemed eligible for registration.

Their second option was the Guyana option. Through coalition with the
Guyanese government, an offer was created where the doctors would get
the opportunity to spend a year in Guyana where they'd complete
rotations at the General Hospital in Georgetown. Not a bad offer
considering that they'd be given institutional registration in Guyana,
and US$500 a month by the Guyanese government (which is the average rate
for a doctor in Guyana) in addition to another US$500 by the Antigua and
Barbuda government – a stipend that was eventually given after months of
negotiations. Accommodations were also sought for our young doctors.

But tally the room and board they'd have to pay in addition to the
transportation to and from the hospital and that US$1,000 begins to look
very dismal for their survival. Some options of accommodation amounted
to as much as US$300 a month per person, which excluded utilities that
could run them an average of not more than US$300 a month.

To inspect and review this option, two of the doctors accompanied
Minister of Health John Maginley, Dr. Zachariah and Dr. Philmore
Benjamin to Guyana. To date, although there were six signatures affixed
to the proposal, only two have pursued this proposal and are currently
in Guyana.

Those who remain shared their concerns that have yet to be abated by any
members of the Medical Board or the Ministry of Health. For one, they
were not about to sign a contract that concluded in an ambiguous state
of their registration upon return.

Being very considerate, Dr. Sealy-Thomas submitted a draft of the letter
that would be given to each doctor. While all the terms and conditions
appeared reasonable and coincided with past discussions, the final
paragraph sparked great debate. The draft read as follows:

Dear Dr. _______,

Members of the Medical Registration Board have reviewed your application
for registration as a medical practitioner in Antigua and Barbuda. It is
the Board's view that you require further supervision in a hospital setting.

We are aware that the government of Antigua and Barbuda has accepted the
government of Guyana's offer for such further supervision at the
Georgetown Public Hospital in Guyana for one year.

The Board approves of this programme and has agreed that upon completion
of the year at the Georgetown Public Hospital, you will be registered
according to the relevant legislation.


For these injured doctors, their main concern, knowing that the current
legislation is being reviewed, was that they'd return to Antigua after
their year's internship and find that they would yet again be ineligible
under possible changes to the Medical Registration Act.

Dr. Ephraim expressed that all they wanted was a clearly written
document guaranteeing them registration upon successful completion of
their internship in Guyana.

Sharing his views of the Guyanese programme, Dr. Philmore Benjamin
admitted that while the programme may have been a good idea, it was also
designed for the Guyanese medical system and not Antigua's.

He further expressed his disappointment with the Board and Cabinet in
their prolonged response to these doctors. Noting that the Guyanese
government already recognises them as doctors, and would register them
as such, albeit under the institutional provision, they'd still be
registered nonetheless. "If Guyana can recognise them as doctors, I
don't see why Antigua has a problem now."

In response, Dr. Sealy-Thomas offered that the year in Guyana would give
the doctors a chance to put into practice what they had learned, keeping
their knowledge fresh in their minds, as well as giving them the
opportunity to learn more.

"For the two that will return next year, they'll be registered ... while
the others could have gone that route but chose not to."

The third option, more of a shadow option, was to have a Cuban professor
come to Antigua and design an internship programme at the Holberton
Hospital. As of July, such a person was here discussing the
possibilities of a programme with doctors at the hospital; it was
unclear even then as to when such discussions would be completed and if
anything would be resolved at all.

And so they wait

So, our Cuban graduated doctors continue to wait.

With their documents, hours of rotations and no registration, our
doctors remain in waiting as Cabinet and the Medical Registration Board
continue to linger on the issue. Just a few weeks ago, the issue was
raised in Cabinet with more promises of the issue to be resolved, the
end result of which would be the registration of the doctors. To date,
no one has been notified as to the finality of the decision. Dr.
Sealy-Thomas was clear, however, in asserting that Cabinet could
recommend registration, but the final decision was ultimately up to the
Medical Registration Board.

Speaking at the graduation ceremony, Prime Minister Baldwin Spencer only
served to echo sentiments expressed in past meetings with the doctors.
Noting that they were indeed being done an injustice, smiles were again
shared as he made promises of resolving the situation. Adding to the
mantle, Minister of Youth Winston Williams added his outrage at their
injustice and offered his support. Minister of Education Bertrand Joseph
upped the ante at the podium guaranteeing all Cuban graduates that once
their disciplines could be used in his ministry, there would be jobs
waiting for them.

Needless to say, one or two doctors of the nine have gone into the
teaching of biology students in the secondary schools. One has joined
the 2006 registered doctor at the Medical School as a lecturer, two have
migrated (one with encouragement and best wishes from Dr. Sealy-Thomas)
and one or two have taken up assistant positions in prominent private
practices. Others have resorted to medial occupations in the meantime.

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