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Postgraduate medical training in Malta

After trying to advise the Minister for Social Policy on how to run Mater Dei (June 11), Frank Portelli now decides (June 20) to tell him and the presidents of the local medical associations how to run post-graduate training here. He appears ignorant of the efforts already being made by these parties.

In many medical and surgical specialities, post-graduate training already takes place in Malta. In some fields (e.g. anaesthesia) the whole spectrum of training is provided locally. The medical associations have recently redoubled their efforts and have submitted their curricula for their postgraduate training, which have been approved. The De-partment of Health has advertised posts for post-graduate trainers and these have been successfully filled.

It has also been busy trying to fill a number of specialist trainee posts in practically all specialities.

Dr Portelli proposes that the Faculty of Medicine and Surgery should stick to undergraduate training. While the faculty recognises that it is the legal remit of the local medical associations to provide postgraduate training, it is concerned about the medical "brain drain" currently facing the country and what happens to its graduates who seek post-graduate training abroad. The faculty has been exploring ways with St George's, University of London (SGUL) of facilitating post-graduate opportunities for Maltese graduates.

Three presidents of Royal colleges and the dean director of the London Deanery are all members of SGUL. SGUL shares its site with St George's Hospital in Tooting, one of the biggest NHS hospitals in the United Kingdom.

The Trust provides the services of a district general hospital (secondary care) and specialist (tertiary care) services from three sites, an ideal opportunity for further training for Maltese graduates.

Graduates have problems finding training places abroad. Graduates could be encouraged to start their specialist training in Malta and continue this at St George's for a period and then return to Malta. The principal of St George's expressed an interest in UK graduates of SGUL doing part of their postgraduate training in Malta, thereby filling some of the gaps left by Maltese working at St George's, in addition to interchanges of staff at all levels.

I have arranged a visit by the minister to St George's at the end of July. Further, I am facilitating a meeting in October of the presidents of local medical associations with their counterparts in London, hosted at the High Commission, to which the minister is also invited, to discuss cooperation in postgraduate training.

While proposing an independent post-graduate medical centre in Malta, it does seem strange that Dr Portelli wishes to attach it to the Royal College of Surgeons in Ireland which has shown itself to be particularly uninterested in full cooperation with Maltese partners.

In relation to Malta its deputy CEO has written that the RCSI will "retain complete ownership of any educational venture" here and when invited to cooperate on establishing a graduate entry training programme refused to cooperate with the University of Malta. What can the RCSI offer in terms of postgraduate training?

As its name implies it is a body established mainly for surgeons and not medicine as a whole. The RCSI does not award degrees by itself but has to do so through an academic partner.

It is not a hospital and not on a hospital site; it can only act as a broker to gain access to hospitals in Ireland where Maltese post-graduates will have to compete with others for training places.

All this is in contrast with SGUL which is part of the University of London, is based on the St George's NHS Trust site and has direct access to the hospital and its training places.

The minister, the local medical associations and the Faculty of Medicine and Surgery are aware of the issue of post-graduate training and are taking concrete steps to address the problem.

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Comments

Della Wainright MD FRCS (on 3/7/08)
Leo, many thanks for clarifying you comments. I too, agree with Dr Portelli's attempts and his relentless awarness and lead in this matter. I am however cynical as the position has not changed much since my days and some people are adamant to ensure a stutus quo. thanks.
Leo Said (on 2/7/08)
@ Joseph George Portelli and @ Della Wainright

I do not threat in any way and I am nobody's spokesman.

I am simply highly amused and hence my (cynical but well-meaning) remarks.

Nonetheless, I cannot but agree with Frank Portelli when he recommends full-time medical specialist staff for Mater Dei and for the Medical School. Moreover, I endorse Frank Portelli's view, namely, that the whole setup of medical and health services in Malta has to be revised and radically reformed.
Della Wainright MD FRCS (on 2/7/08)
Since when advice to an electing member of the public who is appointed as Minister denied proffessional advice? Democratic systems work on this principle, they seek advice, its a responsibility imposed by the electoral system just as making a decision is ther responsibility "the buck stops here" the famous Truman saying.

Ofcourse being a Dean one might forget there is a real world out there, which is paid for by money and blood of people. Living in a protective environment, hiding and brooding and now exposed through his own sneaky tone and words and vicious sheer arrogance makes one really wonder , if we need 2 Deans in the near future rather than the one other, that obviously is an emotive issue for Dean but Leo seems to buff this one for him.
Joseph George Portelli (on 2/7/08)
Laferla, Your words, quote "The view and opinion, remark and comment, which I quote above, is not only a greatest sin but also possibly, if not probably, a form of (political, professional) death sentence.

Yes, especially in Malta." to me this reads like a threat . Pehaps you should heed your own words.
Leo Said (on 1/7/08)
"Perhaps my greatest sin is that I believe that we should have full time Hospital Consultants and full time Clinical Lecturers as well as a full time Dean – all adequately remunerated, and deservedly".

The view and opinion, remark and comment, which I quote above, is not only a greatest sin but also possibly, if not probably, a form of (political, professional) death sentence.

Yes, especially in Malta.
Dr Frank Portelli (on 1/7/08)
Prof. Godfrey Laferla, Dean, University of Malta, lashes out at me as he takes objection to my ideas.
Perhaps my greatest sin is that I believe that we should have full time Hospital Consultants and full time Clinical Lecturers as well as a full time Dean – all adequately remunerated, and deservedly.
We would then avoid the present situation – which is open to abuse.
A Dean who has 4 Jobs simultaneously – Dean , University Professor , a part time Hospital Consultant, and having to perform private practice in various clinics and private hospitals in order to earn a decent living.
His attack on myself and on the RCSI (Royal College of Surgeons of Ireland) is unbecoming of a Fellow Surgeon.
Clearly none of his ideas over the years have solved the brain drain – the tone of his letter is enough to discourage colleagues to return to Malta.
I personally have no problem with St Georges –my Daughter qualified through the St George’s graduate course – I was happier for her to attend St Georges rather than the local Medical School.
Lest the sins of the father be visited on his children.
Dr Frank Portelli MD FRCS(Ed)
Joseph George Portelli (on 1/7/08)
hi Godfrey, you had a lot to say. So how come you have been waiting for so long to consent to inofrm us that you had a plan all along. Its a pity that always the same people seem to have to raise awareness for someone else having to mull over all the letters and then explode in a detailed operation. I applaud you. However what intrigues me is the great concetration on one specific hospital ( when many great other citizens have opened doors even across the atlantic and the pacific) you remain convinced Tooting is the palce for Malta. You reason this on the fact that they want us already. It reminds me of the Groucho Marx saying, "I would not belong to a club that would accept me as a member" Or today we say there are no free lunches. Whatever dean, its dissapointing not to have as high an aim as possible for such a plan, you may hit alower target - great lesson to know what our graduates rely on.

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