A few months ago I was invited to the University of Nottingham in the United Kingdom to observe and study how medical graduates leaving Medical School are absorbed into a structured training programme, which helps them develop generic medical skills before progressing to speciality training. This programme was introduced in the UK in 2005 and now has a proven track record. It seeks to provide junior doctors with a set of explicit standards that they must achieve through a series of work-based assessments that embrace all the key skills needed by doctors including non-clinical ones such as communications and multi-disciplinary team working.
The Foundation Programme in the United Kingdom (UKFPO) proved to be a resounding unequivocal success. Health officials and medical specialists in Malta recognised the value of this programme and the fact that accreditation at the end of the two years meant that a doctor could eventually pursue his/her specialist training in the UK.
A kernel of an idea was hatched and Health Department officials and leading medical experts from Mater Dei Hospital started working with representatives from the Department of Health in England and the UK Foundation Programme Office to secure a Foundation Programme in Malta. This was a hugely ambitious and unique task, which was seeking to emulate the success of Foundation Schools in the United Kingdom with the result of assuring that, at the end of the two year programme, doctors would be ready to enter speciality training and continue their medical career either in Malta or abroad.
A team of dedicated and committed medical consultants worked tirelessly on the project and, with the help of the UK Foundation Programme Office, the Foundation Programme Malta was finally born. This gold standard training programme for doctors was launched a few days ago and is a welcome initiative that will transform junior doctors' training in Malta.
Long months of delicate negotiations between the Maltese and UK governments have resulted in the setting up of this school that enjoys equivalence to any UK Foundation School. This type of specialist accreditation does not happen easily and is the result of the dedication and commitment shown by Maltese health officials and the local school directors. Added to all this is the quality infrastructure and high standards of medical training and students.
The Foundation Programme is described as the "gold standard" training programme for junior doctors in Europe and its introduction in Malta will enable trainees who complete the Foundation Programme Malta to successfully compete on the same level as those successful in UK Foundation Schools.
This new two-year foundation programme will be beneficial and constructive in more ways than one. It will benefit directly Maltese patients by receiving high-quality care delivered by doctors well trained in core clinical skills. For doctors, training will be structured and streamlined, trainee-centred, competency-based and flexible. For the health service, doctors should be able to progress more quickly and in a more structured way, reducing time wasted on unnecessary or inappropriate training.
The curriculum of the Foundation Programme Malta and the operational framework will be the same as that of the UK Foundation Programme. Trainees will document their assessments and competences in an e-portfolio provided by NHS Education for Scotland (NES). It is all a far cry from the past when junior doctors have had variable training experiences sometimes dependant on the supervising consultant of the time. Now they will have to demonstrate by the end of the training period that they have met explicit requirements for satisfactory completion of a programme, which is the mirror image of that in the United Kingdom and which will enable them to pursue their postgraduate education both locally and overseas.
As Derek Gallen, UK Foundation Programme national director, rightly said: "Setting up the Malta Foundation School has been an extraordinary achievement".
The setting up of the school in Malta is the result of the government's commitment to stemming the haemorrhaging outflow of our new medical graduates seeking accreditation abroad. This, combined with a strong dose of goodwill, sheer persistence and unyielding commitment from the key people involved, has been a classic case of thorough determination overcoming all the obstacles that one is usually faced when introducing a radically new concept in Malta. The Foundation School Directors have worked tirelessly to turn this vision into a reality, a reality that will finally meet the demands of a modern health service.
As the Foundation Programme takes its baby steps it will no doubt attempt to grow into Malta's leading benchmarking instrument for Maltese and non-Maltese specializing doctors. This will continue to enhance and confirm the top qualities that our Maltese doctors have always been internationally acclaimed for.
Ms Galea is manager of the Foundation Programme at Mater Dei Hospital.
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