Radical changes to Zimbabwe medical training draws criticism

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Two radical modifications in the training of medical doctors in Zimbabwe have caused a ruckus in the medical fraternity where they have met with fierce disapproval, reports University World News.

Starting in August, the University of Zimbabwe has introduced an intermediary four-year biomedical science degree programme as a precursor to traditional medical courses such as the Bachelor of Medicine and Bachelor of Surgery, Bachelor of Dental Surgery, Pharmacy and Drug Discovery, Forensic Medicine, and Medical Laboratory Sciences.

The new degree is part of university-wide curricula and programmes changes aimed at integrating a new higher education model into the system. The model, known as HTE 5.0, focuses on innovation and industrialisation.

Concurrently, the government is amending the Health Professions Act to allow the transfer of junior doctors’ training from the Ministry of Health and Child Welfare to the Ministry of Higher and Tertiary Education, Innovation, Science and Technology Development.

The Zimbabwe Senior Hospital Doctors Association (ZSHDA) said the tinkering with medical studies has been done without adequate consultation of key stakeholders, while the planned decision to put junior doctors under the higher education ministry during their housemanship period is being done in the interests of political expediency rather than concern for identifying the best candidates.
“Instead of getting students who have 13 to 15 points who join the medical degree as before, students of different medical programmes will all have to do the biomedical degree first, and then the medical school chooses who goes on to do the new Bachelor of Medicine and Bachelor of Surgery (MBChB) and other health science degrees from those who will have passed,” Dr Shingai Nyaguse, ZSHDA secretary general explained to University World News.

“Housemanship is said to be embedded in the new degree. This was decided upon without wide relevant stakeholder consultation. It was not even a consultative process for those involved but a directive. As such, even lecturers and the Medical and Dental Practitioners Council of Zimbabwe (MDPCZ), which regulates the practice of doctors, were not involved. There is no plausible reason given for the change,” Nyaguse said.

“It is however common knowledge that this was a politician decision. The government is trying to come up with docile doctors who won’t challenge the status quo. But we are worried about the compromised candidate who will be poor compared to the current graduate,” she added.

Nyaguse said historically the training of junior doctors during their housemanship has always been the responsibility of senior doctors who can act as both clinical and educational supervisors, with the MDPCZ playing an overarching and quality control role.

MDPCZ Registrar Josephine Mwakutuya said the council took great exception to the impending amendment of the Health Professions Act to effectively remove control and supervision of the training of medical and the dental practitioners from those who train and register them.

“The professional regulator (MDPCZ) specifically controls and supervises all matters affecting the training of medical and dental professionals as provided for by Section 30 (1) (b) (c) and (m) read together with section 71 of the Health Professions Act (Chapter 27:19). These fundamental roles of the council are critical in ensuring that only competent medical and dental professionals provide healthcare to the public of Zimbabwe,” she said in a 3 June 2020 letter to professional members.

Mwakutuya said the proposal by the Ministry of Higher and Tertiary Education to assume control of the training of doctors without consensus from MDPCZ and the medical and dental profession at large poses a very serious concern for the council, with ramifications regarding the eligibility of registration with the council and its support for such qualifications on international platforms.

Professor Paul Mapfumo, University of Zimbabwe vice-chancellor, said the biomedical degree and many other new programmes were still being accredited by the Zimbabwe Council for Higher Education.

“The biomedical degree is coming after two years of consultations, and consultations do not always mean that we follow what people have said,” he said. “Consultations, if we take them objectively, they are about people being heard and we have done that over two years … (for) those who cared to listen, cared to make input, we have done that internally and outside.”

The new changes will also see the training duration for the MBChB and Bachelor of Dental Surgery programmes being extended from five years to six and clinical training restructured to accommodate 10 weeks of psychiatry rotation, 10 weeks of anaesthetic rotation and 10 weeks of family medicine rotation.

 

Full University World News report

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