SOME of us were very happy the National Democratic congress (NDC) manifesto for the 2024 election was titled: “Resisting Ghana”. However, we have not yet seen a resetting at the Medical and Dental Council (MDC), an institution that has a critical role of shaping young medical doctors for independent practice. The current law and policies are outmoded and do not grant the practice of contemporary medicine in contemporary times. Every year, we read in the news and social media how young medical doctors cruelly refuse postings to certain parts of the country.
The general public often criticizes these young doctors of utilising the taxpayer’s money yet refuse to go service at certain parts of the country. “You don’t expect different outcomes when you repeat the same methods for the same processes.”
Politicians and older doctors often chain out reasons such as accommodation, social amenities, education for their kids and so on, being the reason why they refuse posting to certain parts of the country without engaging the young doctors to find out their side of the story. Again, so much fear of victimisation is instilled in the young doctors in such a magnitude that they refuse to put across their concerns or even advocate for changes in the system.
These politicians and senior doctors are very much aware that, hospitals often rent private accommodation facilities for doctors if government accommodation is not forthcoming. Also, social amenities like water, electricity and so on are better provided at the regions the young doctors refuse posting.
Interesting, the income young doctors make at the regions they refuse posting far exceed the locum income they make at the regions they chose to stay. What then makes a young doctor refuse posting to certain parts of the country?
I will start the answers with a scenario: After weaning a two year boy from milk, his parents gave him a bow and arrow and asked him to go into the forest to hunt for wild animals. While the parents are confident that he is well prepared for the task at his age, this boy set off cursing his parents for being cruel by leaving him to the mercy of a forest he knows very little about.
In the end, he will refuse to enter the forest alone and look for specific parts of the forest with experienced hunters who can come to his aid should a wild animal attack him. Therefore, young doctors refuse posting to certain parts of Ghana because the skills they obtain at the house-job training does not give them any confidence to practise contemporary medicine independently.
A young medical doctor who did six months surgical or obstetrics and gynecology rotation at Korle-Bu Teaching Hospital does not get the opportunity to have his hands-on practical surgical skills either than preparing the patients for the surgery and postoperative management, yet this doctor is posted to Sandema District Hospital where case volumes are hernia repairs and caesarian sections to practise medicine after completing a house-job.
While policymakers may be confident that he/she is up to the task, the young doctor in holding his/her morals or ethics in high esteem, will refuse the posting. However, he/she will remain around hospitals he/she can still receive aid from senior doctors so that he/she does not expose patients to unnecessary danger.
Again, should a medical doctor accept posting to Sandema District Hospital, he/she knowing very well that he lacks skills to confidently practise contemporary medicine independently, will seek assistance from hospitals with senior doctors who can teach him/her skills. All in attempt to save himself/herself the embarrassment of not being able to manage cases because the general public thinks once he/she is called medical doctor he/she must manage all cases in the hospital although he/she did not receive any skills that gives him/her confidence to independently manage even simple life saving procedures.
We have witnessed several cases of failed surgeries performed by some of these young doctors who end up transporting the patients to hospitals with specialists or consultants for correction surgeries in Ghana. However, our so called experienced policymakers think otherwise and pretend this is not a menace in Ghana.
Six months’ rotation in surgery or obstetrics and gynaecology during house-job is very inadequate for a medical officer to put a patient on the surgical table and operate. In countries like the US, UK and so on, unless a doctor has at least 3-years specialist surgical qualification or obstetrics and gynaecology qualification, that doctor cannot put a patient on the surgical table and operate because they value the lives of their citizens.
In Ghana, however, the only surgical qualification or obstetrics and gynaecology qualification a medical officer has, which grants him the right to perform all kinds of surgical operations is six months rotation in surgery and six months rotation in obstetrics and gynaecology. This is very dangerous to our citizens.
After seeing my colleagues in these very situations, and after carefully reading and analysing the practice of contemporary medicine in countries who give total value to “life” I decided to enrol myself in a specialist programme after completing my one-year mandatory house-job. Per this decision, I am currently been victimised by the MDC.
I noticed something was grossly wrong with the house-job; what the so-called policymakers expect from young doctors after house-job and the general public perceptions about the role of a medical doctor. Also, another danger faced by young doctors in Ghana is a silent phenomenon of “conspiracy negligence or conspiracy killing of patients”. I will reserve this particular point for another time.
I am also currently not interested in practising medicine in Ghana, although I am a trained neurosurgeon according to the world standard with over 150 peer review publications because of the misinterpretation of laws to victimise me by the MDC.
Resetting Directions
- Phase off the house-job system because it is outmoded and does not give the young doctors any confidence to independently practise contemporary medicine as a medical officer in contemporary times.
- Phase off the medical offices position because it is outmoded and does not add any value to patients in contemporary times.
- The minimum qualification to practise medicine in Ghana must be specialist certificate in accordance to the practice of contemporary medicine in contemporary times.
- After induction of newly qualified doctors, they should be enrolled in the Ghana College of Physicians and Surgeons who will distribute them to specialists and consultants in various hospitals across the country for them to undergo three years mandatory specialist training in specialties of their choices.
- Medical officers should also be mandated to do same to obtain at least specialist training.
- Enhance the training of medical assistants (MA) to replace the medical officer position.
- The Ministry of Health should only post specialists or consultants to health facilities in the country. Specialists or consultants have confidence to independently practise contemporary medicine and will not refuse posting to any part of country.
As I indicated “you don’t expect different outcomes when you repeat the same methods for the same processes.” Holding onto the current outmoded MDC laws and policies will give a cyclical refusal of posting to certain parts of the country.
I have always heard “the law is the law”, however, the law is obsolete if it does not serve the needs of contemporary times. It is obsolete if it denies the citizens the very fundamental needs they seek; “quality healthcare” as stipulated in the millennium development goals.
The Writer is a Biomedical Scientist, Neurosurgeon, Neuroscientist and Professor at University of Technology and Applied Sciences (UTAS).
PROF. DR SEIDU A. RICHARD
Follow our WhatsApp Channel now! https://whatsapp.com/channel/0029VbAjG7g3gvWajUAEX12Q
