COMMON SENSE & EVIDENCE: 40 years of medical school
Published on: 7/29/07.
The Nation Newspaper | COMMON SENSE & EVIDENCE: 40 years of medical school

by HENRY FRASER



Oriens ex occidente lux (A light shining out of the West). – UWI motto

THIS YEAR, 2007, is the 40th anniversary of the Medical School of the UWI, at the Queen Elizabeth Hospital (QEH) in Barbados. The quiet, focused way in which the school has gone about the business of producing most of the doctors who now provide health care to 275 000 Bajan citizens and residents and more than a million visitors every year is nothing short of a miracle, considering how few Bajans seem to know that there is a medical school here, and that we train our own doctors!
Every so often someone quite close to me, who I assume knows all about my own work and the School of Clinical Medicine and Research, asks me what I do at the QEH, and expresses astonishment to hear that there is a medical school in Barbados! – In spite of the byline at the end of this column. So here are some facts about the best kept secret in Bimshire:
The University of the West Indies began in 1948 with its first 33 students. These were carefully selected medical students, who entered the medical faculty at Mona, in Jamaica. In 1963 the medical class expanded to 110 and teaching began at the QEH and the Port-of-Spain General Hospital in Trinidad. It started with a pilot project of six students from the class of 1968 going to each site in 1967. My own final year class of 1969 was the first class to divide completely into half who stayed at Mona and a quarter each going to QEH and to Port-of-Spain.

The early days

This "satellite" arrangement was known as the Eastern Caribbean Medical Scheme. The first vice-dean, in charge of the programme here, was the late Dr Harold Forde, who was succeeded by Dr (now Sir) Frank Ramsay. The first three lecturers appointed were Dr Forde (in medicine), Dr Joe Hall (obstetrics and gynaecology) and Mr Cyril Nelson (surgeon).
In 1974 students transferred after year three and did their last two years in Barbados. Mr "Mickey" Walrond (now Professor Emeritus the Hon. E.R. Walrond) moved from Mona to Barbados as the third vice-dean in 1975. The scheme gradually expanded, with appointment of lecturers in other disciplines, postgraduate programmes beginning (anaesthetics in 1977 was the first) and soon the programme was named a faculty and Professor Walrond was appointed dean.
An agreement was made in 1967, at inception, between the Government of Barbados and the UWI, in which the key points were that the Government would provide space to accommodate the teaching programme (offices, teaching space et cetera, accommodation for students – initially free) and the QEH would provide a library. It was agreed the QEH consultants would share in the teaching while UWI lecturers would share in providing consulting services to the QEH.
With a comprehensive change in governance in 1996, the faculty was renamed the School of Clinical Medicine and Research, while the Chronic Disease Research Centre (CDRC) was developed in 1992 as the research arm of the school.
But the further improvements in staffing and the high costs of such a tiny school have led to a plan
to upgrade and expand to a full Faculty of Medical Sciences, with students entering a full five-year programme from year one in September 2007.

Achievements of our graduates

Over the 40 years of its existence, our teaching has achieved an impressive record. Head for most of that time was Professor Walrond, with Professor Nicholson holding the reins in 1993 and yours truly appointed in 2001.
Over these 40 years we have graduated more than 800 doctors, many of whom in the first three decades have returned to serve their Caribbean countries. Many have been part of the brain drain, and achieved distinction in North America. And many have replaced the older generation of doctors in Barbados, or expanded our range and number of services.
The great majority, almost 90 per cent, of QEH staff and School of Medicine staff are UWI alumni, from the three most senior professors to the director of medical services at QEH, and from all but one head of department to the great majority of the interns.
It was not always plain sailing. The financial crisis of 1991 to 1994 and the QEH problems of 1999 to 2001 caused a major junior staff and postgraduate crisis, as young doctors emigrated in search of postgrad training, and there were many staff vacancies. But research collaborations between the school, the CDRC and the QEH have flourished, and expanded postgraduate programmes are now offered in nine specialties.
As I have repeatedly said and written, the partnership between the QEH and the School of Clinical Medicine and Research is one of the great success stories of the Caribbean. And with the Government and university investing in the upgrading and expansion of the medical school to a full Faculty of Medical Sciences, we expect to open our doors once again to other Caribbean students and to international students, as the QEH again becomes a centre of excellence.

The final messages

We've taught medicine at the QEH for 40 years.
We will take in first year medical students
at Cave Hill in September 2008.
As the programme expands economic costs contract.