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Rapid Responses: Rapid Responses published:
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Tropical Medicine experience
- Mohan Kumar V Sathyamoorthy (25 February 2005)
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Specialist Registrar training should recognise experience gained when working in low income countries
- Roland D Gosling (19 April 2005)
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Mohan Kumar V Sathyamoorthy, SHO Wycombe Hospital HP11 2TT
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I agree with the author that as British subjects travel throughout world and as Britain is becoming a truly multicultural society, it becomes imperative for the Royal colleges/PMETB etc., to recognise equivalent International Medical Experience not only limited to US/Canada/New Zealand/Australia but including from the rest of world, atleast from WHO recognised institutions. It is also essential for the above reasons to reeducate people who are already in the system on Tropical Medicine, as I myself have seen an example of delayed management of a patient with TB. Though GMC's good medical practise does advise doctors to know their limitations, but when coming to Tropical Medical Medicine people without sufficient exposure without realising their constraints still delay/mismanage patients with TB. Competing interests: None declared |
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Roland D Gosling, Clinical Research Fellow Kilimanjaro IPTi, AMBRELA, PO Box 5004, Tanga, Tanzania
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Editor- As a specialist registrar having an Out Of Program Experience (OOPE) in a low-income country I feel at will to express my opinions on Learning from Low income countries. Apart from seeing a wealth of pathologies that are uncommon in the developed world, health care workers are exposed to many other experiences that are of a huge value to a hospital consultant in the UK and the NHS as a whole including rationing of resources, managing teams of people with different abilities and many intercultural issues. The barrier to this time spent doing highly valuable work being counted in training appears to be that of supervision. The colleges want a recognised person or institution to be responsible. Anyone who has worked in a low-income country will recognise the circular argument: the reason why we are asked to come and work here is because there is no one to do the job and therefore no one to be supervisor. If I am lucky I will be able to find a name of someone physically distant but perhaps in the same country to be a “supervisor” and my college, by chance, maybe happy and count some of my time out here. However the task is long and arduous and difficult to do in countries with poor and unreliable communications. Personally speaking, the biggest problem that I face is the restriction of time that I am permitted to stay out of program. My work is likely to be longer than that permitted by my OOPE. If however it was accepted that my training was continuing out here in a low-income country then this problem may cease to exist. The UK has a long tradition of doctors working in low-income countries and many of my older colleagues who have experienced working in this environment actively encourage doctors to go and see. The situation seems to have changed with Kalman, the whole system is focussed on training in the UK without substantial flexibility. The experiences gained by health care workers working in low-income countries will and have been a benefit of the NHS and it is now time for the colleges to recognise this and put into practice a practical way to count time whilst working in low- income countries. Competing interests: SPR Microbiology working in Tanzania |
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