Why some doctors who studied abroad are not allowed to practise
A few months ago, I was on the receiving end of a very bitter lamentation. A mother had invested everything she had to send her son to medical school, then in the second year of training, she learnt that her son had not met the basic requirements to join medical school.
He was forced to drop out of his desired course and seek alternatives.
Due to stiff competition, traditionally only A-students have managed to secure a spot in the prestigious courses at public medical and dental schools. The advent of privately sponsored programmes increased capacity, but did not lessen the competition for places. Private universities expanded capacity to absorb B-students, but the country has still not managed to meet the demand for doctor training.
This gap has led to a lot of high school graduates seeking training in medical and dental schools across the globe. The destination is determined by the cost, so many of these future doctors either stay within the East African Community or head East where the cost of training is more affordable. As a result, countries such as Russia, Ukraine, Czech Republic and India have become extremely popular with students. Currently approximately 300 new doctors trained outside our borders come back home every year.
Training outside East Africa has its challenges. The course is prolonged by the need to do a one-year language course as most Eastern European and Asian countries teach in their local language. Cramming medical terms in English is hard enough, doing it in a foreign language is no mean feat.
Secondly, some patients may be prejudiced against race, making it difficult to even touch them during medical examinations as part of learning. The hostile winters and long distances from home may challenge even the strongest of wills.
Also, however good the training out there, disease patterns vary and hence practical exposure to patient care will differ. For example, after studying in places where malaria is a rare disease, a student may fail their local examination if they had to diagnose a complicated malaria case yet they never saw a single malaria patient in six years of training. This is the reason for the mandatory four-month attachment for returning medicine graduates to familiarise themselves with local disease patterns.
After six to eight years, the graduates come back home armed with their degrees, ready to get into the profession, but their challenges are far from over.
First, they must present their documents to the Medical Practitioners and Dentists Board for verification.
This means that they must have attained the minimum score in high school prior to joining medical school. As per the Medical Practitioners and Dentists’ Board Act (Cap 253), this minimum is average grade C+ with a minimum score of B in biology, chemistry, either mathematics or physics, and either English or Kiswahili. For those in the GCSE system equivalent scores are determined by the Commission for University Education.
Thereafter, they must do attachment at a local teaching hospital for not less than four months, under the supervision of specialist doctors. Once they complete this process, they sit a written and practical examination. Then upon satisfying the panel of examiners, they can proceed for a one-year internship at an approved training hospital. Successful completion of the internship then allows the doctor to be duly licensed to practice in Kenya.
LACK OF INFORMATION
Lack of information about the process has left a number of young Kenyans frustrated. For those trained within East Africa in medical and dental schools that are recognised by the East African Community (EAC) reciprocal recognition agreement, their journey is straightforward. They have the same privileges as those trained locally.
This is because these schools have complied with the standards set across East Africa and agreed upon by regulatory bodies in the region.
Those training outside the EAC need to avoid potential pitfalls. It is upon the student to ensure that their secondary school results are in compliance with the set minimum grades or else they will not be eligible to practice in Kenya after they earn their degree.
Also ensure that the medical school is recognised and approved by the Commission for University Education in Kenya, especially for those who have secured scholarships.
This is why the Board introduced student indexing. Student going to study outside Kenya need to notify the Board of their intention, the university they will be attending and have their high school certificates approved for the course.
Many parents are willing to go the extra mile to have a doctor in the family. In the event one must send their child abroad to achieve this, the above pointers will help ensure that they get it right.
A degree without a license is just an expensive piece of paper!