Editorial | What’s with China-trained doctors?

With Jamaica’s acknowledged serious shortage of healthcare professionals, it is urgent that the authorities do more to the deal with the problems of accrediting doctors trained abroad, especially in China.

In this newspaper’s view the statement issued on Sunday by the Health Ministry of an internal review does not go far enough. Indeed, given China’s continued rapid expansion as a global centre of excellence in science and technology, and its emergence as a global power, it is reasonable to expect that increasing numbers of Jamaicans will seek training in that country.

It would be unfortunate if such people returned to Jamaica with their newly acquired skills, yet find themselves in limbo, or a state of suspended animation, as is seemingly the case of several doctors, about whom this newspaper reported last week. It appears that before these new doctors can be licensed to enter the domestic healthcare system, rather than undergoing regular internships, they might be required to do much of the basic stuff they believe they are long past.

Based on The Gleaner’s reporting, at least 30 doctors find themselves in this situation, having returned to the island several months ago after up to six years of medical training in China.

They have been applying for internships in Jamaican hospitals, some of the affected young professionals say, only to receive, after significant delays, rejection letters and suggestions that they re-apply in 2026.

But there is no certainty that future applications would be favourably considered. Indeed, according to the doctors, their best option is to try to get into the next round of internships, in January 2027, for graduates from institutions that are not accredited by the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP).

PRECARIOUS FINANCIAL SITUATIONS

In the meantime, without domestic certification, licences or jobs, many of the young doctors face precarious financial situations.

This newspaper fully appreciates the need for regulation of the medical profession, where patients’ lives can be at risk and often dependent on the knowledge, skill and competence of doctors, nurses, dentists, pharmacists and related professionals.

CAAM-HP was formally launched in 2004 with a mandate of assuring that medical schools operating in the Caribbean met acceptable standards in the quality of education they delivered. CAAM-HP was, in part, a response to a proliferation of so-called off-shore medical schools operating in the Caribbean with any form of national or regional oversight or quality assurance.

Normally, new graduates from regionally accredited medical schools, who intend to work in the Caribbean, undergo a year of internship, with three months’ stints in four areas of speciality – obstetrics and gynaecology, internal medicine, general surgery and paediatrics. This is hands-on training.

After this, in Jamaica, they are eligible for full registration by the Medical Council of Jamaica and for receipt of a unique registration number.

Those who seek jobs in the public health system are required to be in the so-called 12-month senior house officer (SHO) programme, during which they work different areas of the health system, including primary health care. The SHO programme is also a prerequisite to work at the University Hospital of the West Indies (UHWI) and for entry into the Doctorate of Medicine programme of the University of the West Indies, Mona.

This month, Jamaica’s health ministry posted on its website that there are “additional requirements for graduates of medical schools not accredited by The Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP), also classified as locum interns”. These include providing copies of their medical degrees and proof that they passed key segments of their medical courses.

Having proved they qualified as doctors, the potential interns then undergo several months of observation, where they shadow, and are assessed by, medical officers.

CUMBERSOME SYSTEM

This appears an especially cumbersome system, especially for a country that is short of 500 doctors, in a period of highly advanced technology and where the doctors graduate from schools in a country on the cutting edge of global technology.

This newspaper presumes that medical schools in China, especially those that accept international students, are regulated and graded on a league table of quality. It can’t be difficult for the health ministry or any other regulatory body, domestic or regional, to engage these Chinese counterparts about institutions that pass muster, and therefore whose students should automatically make the cut for working in Jamaica’s health sector.

Accessing information on individual students, including and their grades and clinical performance, should also be simple, if the authorities are serious about getting things done, rather than creating artificial bureaucratic barriers.

This situation has echoes of the days when medical graduates from Cuba were viewed with suspicion and encountered barriers to working in Jamaica, part of which was an effort to hold on to old, snotty, closed-shop norms.

If there are specific issues with Chinese institutions, or the ones at which these doctors were trained, or the doctors themselves, these should be made clear up front. Otherwise, it’s not only these young doctors who are in limbo, but the patients whom they will potentially treat.