Doctors find difficulty in taking up surgery training - 11/9/2006

link to The Independent

Doctors find difficulty in taking up surgery training

Maltese doctors who want to specialise in surgery are finding it difficult because of a recent change in the training system in the United Kingdom.

At present, doctors who want to specialise in the surgical sector undergo training in Malta and sit for the foreign exam also known as the Membership of the Royal College of Surgeons (MRCS).

The MRCS is a professional qualification in the United Kingdom obtained via a postgraduate medical exam involving both written and clinical examinations. The examination is held by the Royal Colleges of the UK and is notoriously difficult.

The exam incorporates both examination of the candidate’s knowledge of basic medical sciences, as well as the clinical skills required for the diagnosis and management of disease and operative techniques. Changes to the exam in recent years have put more emphasis on communication skills and professionalism. Obtaining the MRCS is a prerequisite for anyone wishing to take up a specialist training post as a surgeon in the United Kingdom.

However, junior doctors in Malta who want to specialise in surgery are finding it difficult due to a change implemented this year.

This year, doctors first have to have a training post in the UK after which they will be accepted to specialise in surgery.

“We have to compete for the limited training posts with other British doctors who also want to take up surgery and this seriously limits our possibilities,” said one doctor. “I really feel that there is no future for me right now.”

President of the Association of Surgeons of Malta Gordon Caruana Dingli explained that two main changes took place in the past few years.

“The first change was brought about when Malta joined the EU. Previously, doctors would go abroad to specialise and then come back to work in Malta. However, since EU membership, many doctors are going abroad to study but very few are coming back.”

Mr Caruana Dingli added that it is becoming increasingly difficult to find a training post in the UK, and as a result it will be harder for doctors who wish to specialise in surgery.

“The UK was always the most popular country for surgical post-graduate training, due to its connection with Malta and the language,” he explained.

However, Mr Caruana Dingli said surgical training in the UK is going through a radical change.

It is very difficult for English students to find a training post in the UK, said Mr Caruana Dingli. “Previously, surgery training was offered to everyone and only a few became consultants. Now they only offer training to a few selected doctors who will eventually become consultants.”

“We are now in the process of setting up a formal training structure for surgery here so that doctors need not go abroad to further their studies.”

Mr Caruana Dingli said links had already been established with the UK and Pisa to hold training sessions for Maltese doctors.

Between 70 and 80 per cent of doctors who graduated in 1999 left Malta to study and work abroad. Over half the medical graduates start applying for jobs overseas as soon as they complete their housemanship, according to the Medical Association of Malta.

MAM general secretary Martin Balzan said that 60 per cent of doctors leave to work abroad. “Out of these, only one in 11 comes back. Apart from the brain drain, there is no additional skills gain,” said Dr Balzan.

Salaries in the UK - which are at least four or five times those in Malta - is one of the reasons why doctors are opting to leave for the UK. The basic salary of a junior doctor in Malta ranges between Lm4,000 and Lm5,000 pa, which increases if the doctor works a 58-hour week. On the other hand, junior doctors in the UK earn about £45,000 (Lm28,000).

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