Void in specialist training threatens medical brain drain - 29/4/2005

link to The Times article

Void in specialist training threatens medical brain drain
Cynthia Busuttil

Up to 70 per cent of doctors with basic specialist training are planning to leave St Luke's Hospital to seek employment either abroad or in private hospitals, according to the Medical Association of Malta (MAM).

MAM general secretary Martin Balzan told The Times one of the main problems was that the government was "dragging its feet to organise and finance higher specialist training".

This, he explained, was leading a number of doctors, who would otherwise stay in Malta, to seek employment abroad, where they would be able to further their training and specialisation.

"The government needs to organise and finance higher specialist training in a proactive way, without being passive," he stressed.

Apart from this, he said, working conditions for doctors at the local hospital needed to be made more attractive.

A number of nurses and midwives have already taken the plunge and left the country to seek employment elsewhere, said the Malta Union of Midwives and Nurses (MUMN) president, Rudolph Cini. Although the rate of departures was not as high as doctors, Mr Cini said it was becoming easier for those wishing to specialise to move abroad.

"We are running the risk that they will go abroad to specialise and never come back," he said.

Mr Cini pointed out that only last week did the Health Division give the green light for the employment of nurses and midwives who graduated last year. He said if nurses kept on finding "closed doors", they were more likely to leave. He added that most young people were not finding it difficult to leave Malta to work abroad, especially since EU membership opened more doors for locals wishing to work in another member state.

Mr Cini said the number of nurses who graduated annually was adequate for the level of service that existed at present. However, to provide the optimal service more nurses were required.

Although discussions between the health authorities and the MAM have started, Dr Balzan said these were "preliminary" and added that the two parties were still "far away" from a solution.

Of serious concern, Dr Balzan said, was the fact that a number of doctors with as much as six years experience, and who were able to shoulder responsibility and work independently, were opting to move to another country to work.

"These are not easily replaced," he said, stressing that employing a newly graduated doctor did not substitute one who was already trained.

In response to the answer to a parliamentary question where it was stated that the number of doctors had increased by 64 in the last two years, Dr Balzan stated that if one had to include all those on paid study leave, unpaid study leave, emigration leave, maternity and pregnancy leave beside the many doctors who worked either part time or on a 20-hour basis, the real number would dwindle.

Dr Balzan said the anaesthesia department was of particular concern since not only was the local hospital losing its Maltese trainees, but also foreign trainers. The department is vital for the hospital since anaesthetists are needed during surgery.

Despite concern about a brain drain within this department, Dr Balzan said the problem was across the board.

Dr Balzan said figures showed that over 80 per cent of doctors who graduated in 1999 and 50 per cent of those who graduated in 2001 had left the country.

Moreover, foreign doctors, especially those from Eastern European countries who were working in Malta, were opting to work in mainland Europe, especially in countries which bordered their homeland, thus continuing to contribute to the local brain drain.

Dr Balzan pointed out that a shortage of doctors would have repercussions on patients by increasing waiting lists and waiting times.

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