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Opinions of Saturday, 10 December 2022

Columnist: Desmond Appenteng

A medical school in every region, how feasible

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It is a fact that the solution to the country’s numerous challenges in the health system lies in the production of highly qualified, competent health professionals and medical scientists to provide promotive, preventive and curative services to meet the health needs of the nation and the global community through world class excellence in teaching, research and dissemination of knowledge.

Ghana Medical Association (GMA) at its 64th Annual General Conference in Bolgatanga in the Upper East Region called for establishment of medical Schools in every region to ensure easy access to medical education and to resolve issues of inadequate number of Doctors in the country. Ghana’s Patient to Doctor ratio as of February 2022 stood at 1:10, 450 this fell short of the WHO recommended ratio of 1:1,320 and commonwealth recommended figure of 1: 5000.

The Medical and Dental Council of Ghana gazetted 10,139 Doctors comprising 232 fellows, 526 members (specialist), 7037 general practitioners, 22 temporary Doctors and 2, 322 on its provisional register (House officers) for the year 2022

The figures above excluded the 4, 773 Physician Assistants and Certified Registered Anesthetics ( comprising 3, 506 permanent and 1, 267 on the provisional register).

Medical education in Ghana has become extremely expensive over the years. University of Cape Coast Medical School since its inception never admitted any regular student no matter the passion or how brilliant the student may be. As of 2008 the school was charging GHC 4,000 and now over GHC 10, 000 with the graduate entry costing over GHC 20, 000 per year. University of Ghana medical school as of 2020 stopped admitting regular students and none of the students currently pays less than GHC 6000 with the graduate entry programme costing over GHC 20, 000 a year.

KNUST school of medicine as of 2020 reduced it intake of regular students with most of the students being fee paying of which parents are made to pay over GHC 12, 000 per year. The story is not different from other public medical schools across the country.

Glancing through Medical and Dental Council's website, I saw logos of the two most prestigious private medical schools namely Accra College of Medicine and Family Health medical school. None of these schools charges less than $10, 000 per year. Medical education in China, Russia and Ukraine cost as low as $3,000 even with the best state of the arts teaching and learning materials, so one may wonder why the schools in Ghana are changing such exorbitant fees.

Medical training is a form of apprenticeship. It is a fact that house officers (newly train Doctors) until they are posted to various hospital for trained on the job, are novices as far as medical practice is concern despite the number of years spent in the classroom. It is also a fact that a doctor may not practice over 70% of what he studied during an undergraduate training.

Considering the current economic melt down currently being faced by Ghana and the fact that establishing a medical school is capital intensive, it is impossible for any government to build medical school in the remaining 11 regions in the next 10 years if every region is to have a medical school.

However the country can built satellite campuses at various regional hospitals with state or the art teaching and learning facilities where students admitted to our traditional medical schools are made to spend 3 years on main campus and the last 3 years at the various hospitals where these satellite campuses are. This will bring the student close to the patient and to allow them to learn on the job. This if properly implemented will allow various medical schools to increase their yearly intake.

The country can also formulate a policy aimed at improving curriculum for training Physician Assistants or better still retraining the practicing Physician Assistants in specialty programs tailored towards the country’s current healthcare needs. With detailed lecture in Human Anatomy, Physiology, Pharmacology, Microbiology, Pathology, Obstetrics and Gynaecology, Psychiatry, internal medicine, Patient management and Pediatrics, the Physician Assistants will fill in the gap and make Ghana proud.

But this cannot be achieved if the Physician Assistants still remain under the current Medical and Dental Council whose members sees these cadre of practitioners as a threat to the survival and relevance of medical doctors in Ghana.

The Minister of health was in Parliament few weeks ago to answer question relating to his ministry where he enumerated challenges the ministry is facing as regards posting of newly qualified Doctors to deprived areas of the country and he carefully put before Parliament, prerequisites for acceptance of posting to deprived areas of the country by newly qualified Doctors.

Same was confirmed by the president of Ghana Medical Association later same day on citi fm. So Ghanaians would want to know if building medical schools in every region will ensure that the Doctors will automatically accept postings to deprived areas and will not have to be paid 50% of their basic pay as allowance among other demands as motivation to accept such postings?