Maldivian doctors refusing to work in the islands?
Today I heard some of my colleagues talk about the recent criticism and accusations made against Maldivian doctors that they refuse to work in the field in the islands. I believe it is only fair to put these accusations and criticism in proper perspective.
As per an agreement, signed by most Maldivian medical students at the time we receive scholarships for medical studies abroad, we are required to work an unspecified but reasonable length of time in the islands once we return after completing our training. Unfortunately in recent years, several Maldivian medical graduates were allowed exemption from this already agreed obligation while others were virtually forced to adhere to it. This had created a sense of inequality among the graduates and prompted some to refuse to carry out their obligations unless equality is restored.
There is no denying that our countrymen, women and children need our graduates to serve them in earnest. We are indeed duty bound on moral and ethical grounds to serve them. Many of the graduates have done that, in perhaps the harshest clinical settings they themselves have ever had to practice under. It is therefore deeply concerning and highly unfortunate that Maldivian doctors as a whole have been accused of being insensitive to the peoples needs.
I do understand and share the feelings of those who have served in the islands when they hear of their colleagues' refusal to do the same. It is even more disgusting when rules are bent and broken in favour of allowing certain members of the medical fraternity to be made exempt from such rules. If rules are to be applied, they have to be applied across the board. No exceptions and no exemptions. We must create such a situation of equality.
Indeed, if one would be so diligent to look into the matter, one would find instances where a number of the graduates were never asked to serve in the islands. Surprisingly some were held back from doing so even upon request. In this kind of situation, the accusations are misleading and demeaning.
The current practice of sending graduates fresh from medical colleges to work unsupervised, on their own, in a poor resource setting is also questionable. Most of these doctors, although full and complete graduates from medical schools, have little or no experience in handling cases entirely on their own, especially in high pressure and resource constrained settings as those found at most health centers in the country. It is perhaps better to allow them to be nurtured and groomed under proper supervision for a reasonable length of time at a tertiary hospital or regional hospital before being posted to practice medicine on their own.
It is, in my personal opinion, paramount that we revise and review the current practices of posting Maldivian doctors to the Health Centers and Regional Hospital, if we are to realistically tackle the medical staff shortage situation in the islands. The current system is flawed and outdated. The exceptions and exemptions of days gone by have made it an inequitable system that is frowned upon by Maldivian medical graduates.
I support and am in favour of posting Maldivian doctors to the islands to serve our people. For this to work, we must make the system fair for everyone. For the doctors posted in the islands to deliver reasonable quality of services they must be nurtured and groomed well prior to their postings. The places they are posted to must also be resourced-sufficiently to allow for the doctor to serve to his abilities.
As per an agreement, signed by most Maldivian medical students at the time we receive scholarships for medical studies abroad, we are required to work an unspecified but reasonable length of time in the islands once we return after completing our training. Unfortunately in recent years, several Maldivian medical graduates were allowed exemption from this already agreed obligation while others were virtually forced to adhere to it. This had created a sense of inequality among the graduates and prompted some to refuse to carry out their obligations unless equality is restored.
There is no denying that our countrymen, women and children need our graduates to serve them in earnest. We are indeed duty bound on moral and ethical grounds to serve them. Many of the graduates have done that, in perhaps the harshest clinical settings they themselves have ever had to practice under. It is therefore deeply concerning and highly unfortunate that Maldivian doctors as a whole have been accused of being insensitive to the peoples needs.
I do understand and share the feelings of those who have served in the islands when they hear of their colleagues' refusal to do the same. It is even more disgusting when rules are bent and broken in favour of allowing certain members of the medical fraternity to be made exempt from such rules. If rules are to be applied, they have to be applied across the board. No exceptions and no exemptions. We must create such a situation of equality.
Indeed, if one would be so diligent to look into the matter, one would find instances where a number of the graduates were never asked to serve in the islands. Surprisingly some were held back from doing so even upon request. In this kind of situation, the accusations are misleading and demeaning.
The current practice of sending graduates fresh from medical colleges to work unsupervised, on their own, in a poor resource setting is also questionable. Most of these doctors, although full and complete graduates from medical schools, have little or no experience in handling cases entirely on their own, especially in high pressure and resource constrained settings as those found at most health centers in the country. It is perhaps better to allow them to be nurtured and groomed under proper supervision for a reasonable length of time at a tertiary hospital or regional hospital before being posted to practice medicine on their own.
It is, in my personal opinion, paramount that we revise and review the current practices of posting Maldivian doctors to the Health Centers and Regional Hospital, if we are to realistically tackle the medical staff shortage situation in the islands. The current system is flawed and outdated. The exceptions and exemptions of days gone by have made it an inequitable system that is frowned upon by Maldivian medical graduates.
I support and am in favour of posting Maldivian doctors to the islands to serve our people. For this to work, we must make the system fair for everyone. For the doctors posted in the islands to deliver reasonable quality of services they must be nurtured and groomed well prior to their postings. The places they are posted to must also be resourced-sufficiently to allow for the doctor to serve to his abilities.
I hear that a good number of med students are currently abroad. Probably more than 200? IF they come and serve in the islands, for sure, the services are going to be better for us poor folks living in the islands. Each one of them can be sent to an island. Each island will have a new doc. BUT.. like u say .. b4 placing them in the islands, 1 year grooming is a good idea.
Lets say it takes 7 years to finish MBBS. That means by 2015 a doc should have been trained for each single island.
Bodaa haakaane kameh nei. Aharumen fageerunah hidhumai koh dheyn thi kudhin fonuvanee kiyavan.
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I agree that doctors should go the islands and severve as they are obligated to do. But we really need to ask y doctors are refusing or reluctant to go and serve?
last time i cheked there were lots of issues. hoping to hear those voices who had experiences...
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Can you elaborate on the reasons why these doctors are refusing to serve in islands, other than the administrative discrimination of letting some exempt, specially the ones related to the ruling class. Is that a valid reason for the rest to sideline the islands?
A lot of doctors I know serve happily in islands. Some even are serving longer than they were asked to. While others are refusing to even stay and help the islands a single day. Is this how the doctors are taught to serve? Doctor while staying in an air-conditioned room?
Sadly due to these refusals we loose the trust we have for doctors in general. We do not believe that doctors really intend to cure anyone, but rather we tend to think that they are just looking for capitalists benefits and want to be treated as people superior in status than the rest. Niyaf, you can write something addressed to these doctors, you are not among these doctors!
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I totally agree with what Niyaf has said.
When we were medical officers I never met a single doctor who was not willing to serve in the islands (it maybe different now).
When the system of posting doctors in islands collapsed some time back, we had meetings with the Ministry and forwarded a report highlighting the problems and possible solutions. This was never taken seriously.
As far as I know there were even some who requested to be posted in the islands but the ministry had refused to do so.
Inspite of all this a former health minister went on record in parliament stating that Maldivian doctors were refusing to serve in the islands. A very horrific attempt to cover-up their inadequancies!
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oi, most Maldivian doctors DON'T refuse to work in the islands. What they are asking the authorities to do is to be fair. Being fair should apply to everyone. The patients, the doctors....everyone. The only way to make the system work is to revamp the current system to make all doctors equal.
Even the doctors, the few of them, who apparently refuse to serve in the islands are asking the authorities to treat themselves and their colleagues fairly without discrimination.
Aishath Shaleela, there are several reasons. I am not attemting to make an exhaustive list here, let me high-light a few issues though: the level of clinical experience a junior doctor gets from working in the islands is very little compared to that which he will get by working in a tertiary center (important because for post graduate training opportunities a certain amount of experience is required), the facilities in the island health centers are bare minimal (not enough for the doctor to serve to the best of his abilities; even when he strive hard to do so), the duration of service in the islands is variable (6 months, 1 year.....not fixed), doctors are posted to the islands in an ill-organised way (you maybe asked to serve in the islands when several others who joined just before you were made exempt for undisclosed reasons), ..........these are just reasons specific to the field of medicine.....there are others that are universal to all fields (having to leave family and kids, living conditions, schooling for kids, .....etc).
But like you said; we are a profession that should be dedicated to serving the people. We must serve in the islands too. BUT the current situation needs to be improved!
I think many people unnecessarily glamorize a doctors professions. It is hard work. Thankless at times. Distressing too. We don't just sit in AC rooms. It is a glamor job for some, but for the dedicated people it is serious and hard work.
Ziyan has spoken from experience and points out few vital points.
It is so easy to criticise......but it serves us all better if we could get the system improved to make it work. We have to make it work. And we have to get the system off the sick-bed to make it work!
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So why don't you go on and make the system fair and just for all. Whats keeping you from doing that? Get rid of the barriers if needed.
After all it is the health of a nation and its people we are talking about here.
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Hi dj, I will try. It will help if others, who too believe the same, participate in the effort as well.
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Ya if all work together may be we can over come the obstacles from the administrative side.
Insha Allah
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Niyaf, I totally agree on your article. What you highlighted in your article are true, but sadly there are a FEW doctors who refuse to go to islands simply because their parents are influential people in the society and they know they can use that influence to refuse.
I propose that the Maldivian Medical Association (of which you are president, I think) to propose the following to the Medical Council. That regardless of their or their parent’s or family’s status in the society.
• All non specialist doctors serve the islands for a period of no less than 1 year (btw, now it is ONLY 6 months)
• All Specialists serve the islands for a period of 6 months
• All doctors who have done specialty without serving the islands give a service of 1 year to the islands.
• All those who refuse should get their licenses to practice medicine in Maldives revoked.
If we want the public to respect maldivians doctors and truly believe that maldivian doctors are not only in the profession for materialistic benefits extreme measures are needed.
I salute you, I am proud that there are Maldivian doctors like you. Keep up the good work!
Insha allah, if everybody works together you will succeed.
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