Guyana

Background:

Guyana currently has approximately 2.1 doctors per 10,000 people (compared to 2.8 per 1,000 people in the UK). Prior to the establishment of the School of Medicine in the University of Guyana in 1985, Guyanese who wished to study medicine did so abroad, in countries such as the UK, India, the Soviet Union and Cuba.  The Guyana Public Hospital Corporation (GHPC), the large referral and teaching hospital in Georgetown, established a two year Diploma programme in Orthopaedics & Traumatology in 2009.  Whilst this was a huge step forward, the specialists it produced were not necessarily prepared for independent practice without further training.  Despite this, the programme was quite successful, producing ten graduates who are still working in the specialty in Guyana.

World Orthopaedic Concern’s involvement:

In December 2016 World Orthopaedic Concern UK (WOC UK), which is a specialist society of the British Orthopaedic Association (BOA), and the Institute of Health Science Education at GPHC signed a memorandum of understanding (MOU) concerning curriculum and faculty development for a new four year postgraduate Master’s degree (MMed) programme in Orthopaedics. & Traumatology.

Our first task was to devise a curriculum which would be submitted to the University of Guyana for approval.  I proposed to the British Orthopaedic Association Training Standards Committee that we could use the UK Trauma & Orthopaedic Curriculum as a template.  Professor Philip Turner, then president of the BOA, kindly agreed to this.  The current British curriculum was duly adapted to suit Guyanese requirements.  In this endeavour I received enormous help from Dr Khan, a senior orthopaedic surgeon at GPHC, and Lisa Hadfield-Law, educational advisor to the BOA.  The Masters programme was ratified by the University of Guyana in June 2018, and since then has admitted 3 residents to the programme.

WOC UK facilitates the programme through regular visits by Deepa Bose to oversee residents’ progress, and through monthly Skype teaching sessions run by UK consultants.  In addition, WOC provides part funding for UK consultants to visit and teach in Guyana, usually for a week at a time.

Current needs of the MMed programme:

Although we have made a huge improvement in orthopaedic education in Guyana, as described above, there is still an urgent need for support of the programme.

Deepa Bose visits the country regularly (it being the country of her birth), and has identified the following aspirational needs:

1.     Faculty development programmes:

The change to a robust, transparent and assessment-driven curriculum has meant a huge sea change in the way that residents and faculty work.  Focused courses on how to conduct workplace-based assessments and objective structured clinical examinations (OSCEs) are urgently required.  Although the number of orthopaedic faculty is small (around 6 people), the faculty development courses can include other surgical faculty in GPHC, given sufficient notice and planning.

2.     Focused training courses for residents:

There is a definite need for short focused training courses on communication skills and other “softer skills” for Guyanese residents, since these skills are not traditionally taught or assessed in the country.   There is also the need for focused courses on specific topics to which they have limited exposure, such as orthopaedic oncology, and management of major trauma.

3.     Exposure to UK training in orthopaedic subspecialties for Guyanese residents:

Our goal is to eventually have orthopaedic surgeons who are able to practice independently, and competently to an acceptable world standard.  As a part of this aim, the Institute of Health Science Education at GPHC and WOC UK have discussed the possibility of Guyanese residents spending up to 12 months in the UK, gaining exposure to the fields of trauma, spinal surgery, arthroplasty and paediatric orthopaedics.  We would welcome any assistance in achieving this goal, particularly in respect of facilitating GMC registration.  The Medical Training Initiative scheme would tie in very well with this.

4.     Regular UK faculty:

There is also a need for more UK faculty to regularly engage with both Skype teaching and regular short-term visits to Guyana in order to oversee the delivery of the curriculum and provide input into the recruitment process and local examinations.

Conclusion:

WOC UK and the Institute of Health Science Education at GPHC would heartily welcome any assistance and support which can be provided by the Royal College of Surgeons of Edinburgh for the MMed programme.

Further information on the link in the JTO article can be found here.

Link person:

Ms Deepa Bose

Consultant Orthopaedic Surgeon, Queen Elizabeth Hospital Birmingham

Chairman of World Orthopaedic Concern UK

Vice Chair of the Trauma & Orthopaedic SAC

Educational secretary to British Limb Reconstruction Society

E-mail: deepa.bose@uhb.nhs.uk

            deepabose@yahoo.com