Postgraduate medical training in Malta

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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