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DO NO HARM: the Hippocratic oath applies to our young doctors too

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Modern medicine owes its most deeply cherished ethic to a Greek doctor, Hippocrates, who lived more than 2,000 years ago. Known as the Hippocratic oath, it binds all doctors to a simple and fundamental principle: that their first obligation in the treatment of the sick is to do no harm. Hippocrates, however, had nothing to say about a society’s obligations to its doctors.

SEARCHLIGHT’s front page story last Friday, however, highlighted that our health system currently lacks the capacity to offer internships to all of our newly minted doctors, thereby leaving some of our youngest doctors in professional and intellectual limbo, awaiting a slot in the internship programme.

For St Vincent and the Grenadines (SVG), this situation carries urgency for two reasons. First, the governments of Cuba and SVG expended hundreds of thousands of dollars to fund the medical training of these young doctors and naturally, our society deserves a reward on that investment. Second, these young doctors expended thousands of hours in training to enter the medical field and it is therefore a reasonable expectation that they would be allowed to complete this process by entering certified internship programmes.

Between the hard rock of limited internship slots and the hard place of unemployed young Vincentian doctors, we are left with a simple question: what can we do?

This dilemma that afflicts SVG is in fact a Caribbean wide problem. Indeed, in 2015, a dozen graduates from UWI medical school in Barbados threatened to sue the Barbadian government because of insufficient internship positions available to meet the needs of graduating students. A similar situation exists in Jamaica.

For SVG, solving this problem requires recognizing the limited, but real, choices available to us. The first, of course, is to increase the number of internships we offer. But this has major budgetary implications, since we would also need to increase the number of hospital beds and senior supervisory doctors, consistent with maintaining certification as an accredited internship programme.

We could also take another look at the length of our internship programme with a view to shortening it, if that could be done without compromising on quality. In SVG, our interns do two years. In Barbados and Jamaica they do one year. And other islands are equally free to set the content and duration of the internship as they choose. Here in SVG, if we follow the Barbadian and Jamaican protocols, we will double the number of interns who pass through our programme in a two-year cycle.

This may not solve the problem in its totality, and certainly not immediately. But within one year we would see meaningful change. And this allows us to establish a third platform of support for our newly graduated doctors. Every doctor knows a thing or two about biology. And they know something about chemistry too. At a time when we are perennially short of science teachers in our schools, we can do no harm in putting some of our most highly trained scientific minds in one-year stints in our classrooms. Indeed there remains a host of non-clinical work, particularly medical research with local and international organizations, that our youngest doctors can do while they await entry into an internship. Our doctors have sworn an oath to us. There is no reason why we cannot swear an oath to them.

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