Local doctors struggle to attain specialisms

| 30/03/2015 | 25 Comments

(CNS): More than a dozen Caymanian doctors who have qualified as family or general practitioners are having difficulty securing the funding they need to advance their qualifications, which will leave an important gap in local healthcare provisions as older local doctors come up for retirement. With some of his own constituents impacted, Ezzard Miller has called on government to seize the opportunity to help them with the funding they need to move on to specialisms to boost the country’s local medical profession.

Cayman News Service

Cayman Islands Hospital, George Town

Miller told CNS that he is aware of at least 14 doctors who have struggled for several years to find the cash to further their medical qualifications over and above their licence to practice as family doctors. He said if government was to foot the bill to train the current group with a partner hospital in the region to undertake residencies in their elected specialist fields, it would cost government around a half million dollars but guarantee future succession in the local profession. The MLA said that the sum is not an excessive amount when set against the annual government budget of more than $600 million.

But at the moment no funding has been made available to the doctors, who are very keen to advance to a specialism.

Miller, who was health minister in the 1990s, said that while government does fund the first medical degrees, the cost for a specialism is often way beyond the earnings of a general practitioner, leaving these qualified doctors stuck in that role and unable to develop their careers any further, despite the shortages and need for specialist physicians, who are being recruited from overseas instead.

He said creating a new fund to help train local doctors would not only incentivize more local people into the medical profession in the first place, it would also ensure that, as local doctors head towards retirement, there are new young professionals qualified to take their places.

“I urge government to seize the opportunity to help develop our own already qualified doctors into much needed specialisms,” Miller said. The MLA is sure the government could organize partnerships with overseas hospitals, and could even factor it into contracts with those facilities that Cayman Islands patients are sent there for overseas care to help with the specialist training of Cayman doctors.

With at least 14 doctors currently in this predicament, Miller said the figure could grow rapidly as around 30 young Caymanians are currently studying for medical qualifications overseas. When they return, they will also be limited to family practice and the problem will balloon.

“If government doesn’t address this, in two to three year’s time we could wind up with doctors stuck in never-never land as they can’t make enough money as family doctors to save for the required fees and can’t get the training they need to move to a specialism,” he said.

Doctors will have to be brought from somewhere else, Miller warned, unless local doctors can get access to the necessary training. He said none of the doctors were interested in short-cuts but they want to get the specialist experience they need.

Emphasizing this as an opportunity to address the shortage of local specialist physicians, Miller urged government to help with the funding and access to hospitals for residencies.

“It is important that these doctors get the board certification and specialty training if we are going to raise the bar locally. Instead of depending on bringing in licensed doctors, we could help our own qualified medical professionals be the ones to fill the specialist openings in future,” he added.

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Comments (25)

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  1. Highlander says:

    Specialization in any field requires a residency in that field which comes right after medical school. In Us system that residency is a minimum of 3 years for let’s say, Family Practice. General surgey is 5 years plus fellowship of 1-2 years in a subspecialty.

    So before you know it, a physician has invested 15 years of his life after high school to become a surgeon, for example. That surely deserves a good compensation. Starting salary in US is 200,000 plus benefits. In 5-10 years of experience median salary is 450,000, for a surgeon.

    Most physicians go to school with a heavy student loan that they pay well into their 10-15 year of practice. No specialist will come here to earn 150,000 and paying student loans on top of that. Society has to understand that a well trained doctor has to be well compensated when they have people’s lives in their hands in order to ensure quality of care and vested interest.

    We need to learn lessons from the Germanwing copilot episode that was working for a 25000 salary while having 150 lives in his hand.

    One way to deal with this issue is to have a joint fund from government and local investors to help with scholarships and loans. Those qualified, will sign an agreement to come back to the community and serve for a specific period.

    At some point we have to realize that healthcare is basic necessity in our community. How many more hotels do we need as oppose to well trained doctors?

  2. Capt'n Obvious says:

    The good ones will have no issue, the crap ones will struggle. Such is life.

  3. Anonymous says:

    The “good” ones that qualify to go overseas never come back to the Island. The government will be left holding the bag again if they pay to send the local ‘untrainables’ away on top of their typical resident salary. Nice try Ezzard – next time do some research!

    • Anonymous says:

      They aren’t left with much choice. When they come back to Cayman they are told there is no position for them. “Oh we have a contract for this person and we cannot do anything about it.” THAT is why they are migrating.

  4. Anonymous says:

    In the US at least, if you want to specialize you take an internship and then a residency on staff at a hospital or institution practicing that specialty. They pay YOU for this. But you do have to qualify and be hired, you can’t “buy” a specialty with any amount of funds. What Miller is saying makes little sense..

  5. Anonymous says:

    3000 a month puts you in the top 1% of earners in the world when there is no tax deducted.

  6. Anonymous says:

    You mean you make a 150k a year and you can not afford further study ?

  7. Anonymous says:

    Don’t we have a school here “St Mathews”?

    • Anonymous says:

      St Matthews is not even a full, four-year medical school. Only the first two years are done here in Cayman; students must then go abroad to other medical institutions in order to complete their training to qualify for a degree.
      In any event medical specialty training takes place in large teaching hospitals with academic programs in place. There is presently no such institution in the Cayman Islands.

  8. Diogenes says:

    How do foreign doctors obtain their specialisms then? Surely the obstacles must be the same. Do other countries governments subsidise the costs of obtaining specialist qualifications?

    • Anonymous says:

      Nope, government doesn’t subsidize the cost for people to obtain specialist qualifications…they call it student loans

    • Anonymous says:

      Some do, actually. Typically it is done to incentivize a doctor to then go work in a (typically rural) area where the specialization is needed.

    • Sharkey says:

      I am sure other countries do not pay unless they have a contract of future employment, this only makes sense.

    • Anonymous says:

      I had to fund my own.n for thr life of me I cannot seen, on my salary, I would not have.

      • Anonymous says:

        Why the thumbs down? Studying to further your career is a choice rather than a necessity. Also on the substantial salaries a doctor receives, if they are so committed to obtaining a specialism, they can well afford to pay for themselves. Part of the entitlement culture I guess! Handouts for the well off and crumbs for the poor in Cayman.

  9. Anonymous says:

    The HSA can refuse Caymanians the privilege to further their education, but fund some of their own nationals to study here and travel overseas to complete their pharmacist qualifications on full pay. Our people are always sidelined in this our country.
    Another was being employed in a specialist position, he was told his salary would be higher than the person he was relieving. Surprisingly it blew up in someone’s face, because he was not qualified at the time. How can Caymanians survive, when the shoe is always on the wrong foot. Think about the changes that are needed at the HSA, would they help?

  10. Anonymous says:

    Just maybe Miller should leave this up to those who know. The HSA surely could provide a loan for suitable candidates. Why would government fund? Do what everyone else has to do in such circumstances, fund from their own substantial salary.

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