IN SEARCH OF THE ‘DOCTOR’ TITLE

A few months ago, I was on the receiving end of a very bitter parent’s lamentations. As a mother, she had invested everything she had in sending her son to medical school. In the second year of training, she had come to the realization 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 the stiff competition in securing a place in a public medical and dental school in Kenya, traditionally, only the A-students have managed to secure a spot in the prestigious courses. The advent of privately sponsored programmes increased capacity in the schools but did not lessen the competition and the top medical and dental schools in the country are only still able to accommodate the A-students. The private universities expanded capacity to absorb the B-students but despite this, the country has still not managed to meet the demand to train doctors.

This gap has led to a lot of Kenyan high school graduates seeking training in medicine and dentistry in medical and dental schools across the globe. The destination is highly determined by the cost, leaving many of these future doctors heading East and within the East African Community, where the cost of training is a lot more affordable. As a result, countries such as Russia, Ukraine, and Czech Republic and India have become extremely popular with the students. Currently we are receiving approximately 300 new doctors trained outside our borders every year.

Training outside of East Africa has its challenges. The course is prolonged by the need to do one year of language as most Eastern European and Asian countries will teach in their local language. Cramming medical terms in English is hard enough, doing it in a foreign language is no mean feat. Some of the 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.

After six to eight years, the graduates come back home armed with their degrees, ready to get into the profession but their challenges are a long way 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 requisite minimum requirement score in high school prior to joining the medical school. As per the rules to the Medical Practitioners and Dentists’ Board Act (Cap 253), this is a minimum average grade of C+(Plus), with a minimum score of B(Plain) in Biology, Chemistry, either Mathematics or Physics and either English or Kiswahili. For those in the GCSE system, the same is observed with equivalent scores as determined by the Commission for University Education.

Thereafter, they must do an attachment at a local teaching hospital for a period not less than four months, under supervision of specialist doctors. Once they complete this process, they will sit an examination that encompasses both a written segment and a practical segment (clinical examination). It is upon satisfying the panel of examiners that they will be eligible to proceed for a one year internship at an approved training hospital. Successful completion of the internship programme then allows the doctor to be duly licensed to practice in Kenya.

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 recognized by the East African Community reciprocal recognition agreement, their journey is straight forward. They have the same privileges as those locally trained. This is because these schools have all complied with the standards set across East Africa and agreed upon by all medical and dental regulatory bodies in the region.

Those training outside the East African Community need to avoid potential pitfalls. It is upon the student to ensure that their secondary school performance results is in compliance with the set minimum grades or else they will not be eligible to practice in Kenya after they earn their degree. It is also imperative that they ensure the medical school they intend to study in is recognized and approved by the Commission for University Education in Kenya, most especially when they have secured scholarships. This is the reason why the Medical Practitioners and Dentists’ Board has introduced student indexing. Each student going to study outside Kenya needs to ensure that they have notified the Board of their intention and the university they will be attending and had their high school certificates approved for the course.

It is important to note that however good the training out there may be, disease patterns vary and hence practical exposure to patient care will differ. In places where malaria for instance, 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. It helps them to familiarize themselves with local disease patterns.

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. Having a degree in Medicine or Dentistry is not an automatic pass to being eligible to practice in Kenya. One is only eligible when they have met the criteria set by the Medical Practitioners and Dentists’ Board. It is the Board’s mandate to ensure that the doctor they register and license to practice in the country has been proven to be well trained and is a safe doctor.

Ignorance is no defense. A degree without a license is just an expensive piece of paper to the patient!