Notes for Address by the Principal at Medical Consultation, Trinidad Hilton, 6 August 2002

Medical School

What will a fully-fledged teaching hospital at Mt. Hope consist of?

Good research and clinical staff

Associated support staff including nurses and technicians

Outstanding students from Trinidad and Tobago, the rest of the region and the world

Research Centre to facilitate ground breaking research

Research facilities for all aspects of clinical medicine

Access to facilities for clinical diagnosis and treatment

Access to patients and their medical records for experience, information and study

What will be its value and impact?

Establishing links with other research institutions, teaching hospitals, medical schools and universities to ensure that research and clinical practices remain up to date and to contribute to the growth of knowledge. A standard of health care linked to International Best Practice.

Continued close interdisciplinary collaboration with other UWI departments in research such as health economics, biotechnology, environmental sciences and chemistry

Access by para-clinical staff to Laboratory services in order to ensure quality control

What impact will the establishment of a fully fledged teaching hospital at Mt. Hope have on the teaching internship facilities in the hospitals in Port-of-Spain, San Fernando, Sangre Grande and Grenada?

The introduction of a fully fledged teaching hospital will ensure that the integrated Teaching curriculum is followed.

The increase in the number of internships at Scarborough and St. George’s, Grenada and at other regional hospitals will strengthen the quality of care at those institutions and broaden the clinical exposure of students. Strategic development of students for clinical exposure.

How can the value of the St. Joseph Health Centre and its proximity to Mt. Hope be optimised?

Once it has been upgraded, it can be used as a General Practice Clinic to facilitate teaching and research in general practice methodology. It’s proximity to Mt. Hope makes it ideal for exposure to clinical training in public health and family medicine since it can tap the local population (Curepe, St. Joseph, Valsayn, Bamboo, Champs Fleurs etc.)

Is there a role for other health centers across the country?

The teaching hospital can work with health centers to provide greater clinical experience for students in family medicine and general practice. This could be part of their general training or internship and will introduce them to social sectors who are poorly served and to a comprehensive understanding of the medical issues facing the population.

Consolidate research in areas such as family medicine, paediatrics and surgery where strengths currently exist as well as medical crises such as chronic diseases, cardiovascular diseases, diabetes, cancer and HIV/AIDS

Expose students to clinical training in the major medical issues facing the population

Provide graduate programmes to facilitate specialization in areas of the greatest need

Strengthen the relationship between theory and practice on a daily basis for both teachers and student thereby improving quality of instruction as well as health care

What is needed at Mt. Hope in terms of space etc?

The existing hospitals, including the adult hospital, needs to be fully commissioned to allow students access to patients, from their first year, as required by the curriculum. This would make for a better-trained doctor.

Access to the General Practice Clinic to facilitate teaching and research in general practice methodology

Space to develop a full-fledged Research capability is necessary and development of a graduate programme is necessary

The provision of adequate facilities for interns to include on-call rooms, structured educational programmes and adequate time-off for continuing study

The teaching hospital and health centers can institute jointly education programmes in public health and hygiene in local communities.

Can the teaching hospital play a meaningful preventative health role in the school system with the school age population?

It can work with the educational authorities to teach sound medical practices to children, building on the experience of the 1950s and 1960s when nurses visited schools to teach hygiene. This is crucial given the changes in lifestyle and diet and the alarming increase in obesity and diabetes. Education on basic issues such as diet, exercise and hygiene will lead to a healthier juvenile population.

Exposure to young people is important to medical students in the areas of family medicine and paediatrics.

What kind of relationship will be appropriate with the NWRHA?

In order to ensure that the teaching hospital fulfills its mandate, the relationship with the NWRHA must be more explicit. A memorandum of understanding that defines clearly the responsibilities of the NWRHA and the University is necessary.

Who will fund what?

The University of the West Indies will work with the Government to work out a reasonable, fair and mutually beneficial funding arrangement. The teaching hospital concept involves Higher Education, Market Demand issues and Health issues. The update and upgrade programmes for medical professionals drawing on local, regional and international resources

Stakeholder relations to strengthen professional capacity and positive impact of the profession on the health sector.

Stakeholders include the public health sector, the private health sector, the other Faculties of UWI, other research institutions and international health organizations, NGOs and CBOs, and the secondary and primary schools

Increased collaboration with all stakeholders including the Professional Regulatory bodies to ensure that the medical school fulfill its mandate to train graduates of the highest calibre, conduct research and undertake clinical practices relevant to the needs of the society and profession

Community health: preventative approach.

Outreach to the national and regional community to set standards for health care

Spread of knowledge and greater awareness of the importance of health lifestyles including diet

Provide a pool of clinicians and support staff who will move between the teachings hospital, the public and private systems, raising standards for diagnosis and treatment

University can supplement arrangements with Government with private sector funding from local and international sources for specific purposes.

The NWRHA will be asked to fund the cost of clinical and other public services that UWI staff performs. If an agreement is reached for UWI to take full responsibility for the teaching hospital, additional negotiations will be required. The important thing is to agree on the concept, make a commitment to make it work and agree on a time frame which must be strictly adhered to.

What will be the knowledge implications for the health sector?

Strengthening research and clinical knowledge of local health issues: a corpus of expertise will then be available for the public and private health sectors. Dissemination of information and best practices nationally and regionally

Teaching hospital will act as a magnet for collaborative research with other local and international institutions

Understanding of traditional medical treatments and the possibility of their development

Increased community outreach through schools and health centers will create a greater awareness of healthier life styles, practical knowledge for diagnosing and treating minor illnesses

AIDS Dental Clinic

A full teaching dental hospital would allow us to specialize in niche areas such as the provision of dental treatment for patients living with HIV/AIDS. You are well aware of the difficulty that patients with HIV/AIDS experience in getting access to appropriate treatment, a state of affairs that we have an obligation to change. By working with the proposed regional Training, Education and Research Centre for HIV/AIDS in the Faculty, we can design a programme and identify the staffing requirements to meet this urgent medical, social and educational need.

Miscellaneous

We need to bring the delivers and resources together with a view to rationalization

The plan has always been to have a teaching hospital. We are now in a position to make that a reality.

Set up a committee with the key players to make the teaching hospital a reality in order to develop a knowledge based health system

Provision of expertise, based on first hand experience, for the formulation of public health policy

Teach the population the basics of preventative health care for a healthier population and to restrain medical costs.

Disseminate the results of research in areas of cries- chronic diseases, cardiovascular diseases, cancer and HIV/AIDS – to educate the public

Disseminating information through workshops for practitioners, community workers, NGOs, schools in preventing, treating and managing disease

Serving the public with a high quality hospital service in the range of areas, starting relatively small at first and expanding as capacities build

Links between other hospitals and health centers and the Medical School will strengthen the health system and hospital care system all around.

A Learning culture will be established as a matter of habit throughout the health care system.

Conclusion

Yesterday, the Hon. Prime Minister mentioned the importance of information and knowledge in today’s world and he talked about the national surveillance system in Health.

“Knowledge must inform health sector plans,” he said.

How can we optimize our options if the knowledge generating centre of the Health system and the knowledge delivery center of the Health system, our only national medical school, is not integrally involved and is not an integral part of the national knowledge and information system for health.

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