How would Dr Sands explain the doctors who pass the exam but are poor doctors? There are some so called specialists I never go to or send an enemy to. Obviously there has to be standards of care in all industries, but a way to assess pt outcomes based on decisions a Dr makes is a far better way to determine,their competence than some standardized test!

There are too many in medicine for reasons other than taking care of patients, that is the heart of the problem!

If you really think about it its the gov't who puts the public at risk by not treating its employees fairly, poorly maintaining the needed infrastructure and work environment and wasting money while creating inefficiency in the system. Government shares some of the responsibility for making it more difficult for doctors and nurses to do their jobs properly!

Ma Comrades, all doctors should come under BahamaCARE Also, place a cap on cost prescriptions must be a higher priority over the minister health in conjunction security minister dispatching hundreds corned beef policeman's to raid the poor and near peoples grocery cupboards.

> Wowee - now the doctors and nurses acting like true gubmint of the bahamas employees..... what we gotta take a test and try do something round here???

Sands is absolutely right. If you cannot pass basic professional knowledge examinations as part of demonstrating your proficiency and entitlement to be certified as a medical doctor with a license to practice then you should not be allowed to practice medicine or refer to yourself as a medical doctor. Too many of our people are dying as a result of our government and the Bahamas Medical Association permitting unqualified individuals to hold themselves out as MDs. These individuals should not be employed as MDs within our public healthcare system nor should they be licensed as private practitioners. The situation Sands is confronted with should have been dealt with by Minnis when he was Minister of Health (MOH) under the last Ingraham administration. Minnis's failure to address these matters when he was MOH suggests that he might have been more adept at waiting on tables than practicing medicine as a UWI trained doctor.

There is nothing wrong with re-certification programmes to get promoted ....... straight across ALL government Departments ...... clerks, teachers, nurses, policemen, accountants, doctors, lawyers etc, and do away with automatic ACR 3 ratings for annual increments ....... It makes civil servants LAZY and COMPLACENT.

What slso needs to happen is that should be some agency that pore patients who have had problems wid substandard, inferior Doctors care can go to get justice!!!!
Cannot ever recall any Doctor being sued for malpractice????

Office of The Ombudsman ........ duhhhhh

I applaud Dr. Sands for taking an unpopular stand for the good of the people and the country. This is what we need in government.

"*this month, heads of medical departments will rank senior house officers – junior doctors who work under the supervision of consultants and registrars – based on their performance. Likewise, the SHOs will rank the various medical departments, such as paediatrics, internal medicine and surgery, based on their preference.*

*doctors view Dr Sands as an elitist who, having gained his medical certifications in the United States, is unfamiliar with the “inadequacy” of Caribbean post-graduate medical programmes for which claims of bias are rampant.*

This is absolutely LAUGHABLE, these people CANNOT be saying that UWI has a substandard medical program. And if by some stretch they're right, they shouldn't be practicing anyway, so they prove Dr Sands' point. The other day they were trying to convince someone that they could earn their entire PMH salary by making phone calls from their "other" job.

It is standard practice at hospitals worldwide for doctors to recertify. I agree 1000% with Dr Sands. There are doctors walking around in white coats who are dangers to their patients. Their colleagues know who they are. I am told that there is a culture of "social promotion" in the medical field. This is not restricted to the Bahamas. Teaching hospitals are reluctant to fail students because theyve put so much time into their studies. But some of them have to be failed, it's the life of your relative they playing with.

I don't see what the big deal is. 95 % percent of modern medicine evolves around several drugs, pain killer, antibiotics, blood pressure agents, blood sugar control agents and last but not least viagra (lol) . The other 5% you refer the patient to a consultant.

**I disagree. And you would too if it's your baby or your parent that has to be diagnosed.the graveyard is littered with persons who were given a few tablets and sent home. You want to roll the dice with your child?**

In order to prescribe anything you first have to diagnose. In my opinion (I could be wrong) the most important skills that a physician needs are analysis and diagnostic ability. The foundation to both I guess is a HUGE knowledge base, you need the know a vast amount of conditions and their causation and you need to know how they present. You need to have a very good understanding of the different body systems. You also need to know what treatments are available for various conditions. In our country you might have to be McGiver. A doctor who just walks around in a white coat and hands out pills as you describe isn't much of a doctor. and they definitely shouldnt have the title senior house officer.

Just wait until you need a "real" medical doctor!

Good for Dr. Sands! He is absolutely right! If you can’t pass a test, then you can’t be a MD. Go back to school or pursue a different career. In fact, one has to wonder, how did these so called MDs get to be MDs??

*The demonstration fears reflect junior doctors’ agitation over impending changes within the public healthcare system that will impact their future. This month, heads of medical departments will rank senior house officers – junior doctors who work under the supervision of consultants and registrars – based on their performance. Likewise, the SHOs will rank the various medical departments, such as paediatrics, internal medicine and surgery, based on their preference.
“Using an algorithm with appropriate oversight, people will be matched to a department,” Dr Sands said.
However, not everyone will make the cut. Dr Sands expects that about 100 SHOs will not be chosen to participate in a residency programme within one of the medical departments. Those who do not make the cut will be mandated to participate in a “foundation programme” geared towards preparing them for private practice. At the conclusion of the programme, they will be required to take a Special Purpose Examination (SPEX) to qualify as a private medical practitioner. Those who fail the programme or the exam will be forced to exit the medical profession.*

There are several different issues at play which have NOTHING to do with producing quality doctors. Firstly Sands is the one who complained about consultants not being in hospital long enough to earn their pay. What qualifies them, if that is true to assess their junior staff. In addition, a medical school decides who is fit to become a Dr, that is why they have rigorous exams etc.. The Bahamas Medical Council decides fitness to practice in the Bahamas based on criterion they have already determined (so a foreign Dr has to meet the qualifications of the BMC to work in the Bahamas). What Sands is proposing is limiting the number of Dr's allowed in the various departments at PMH through a certification process, those who fail that process have to take an exam to determine if they are fit for private practice. If they fail that exam then they **cannot** be a Dr. **This is nonsense**. What they should be doing is moving some of the dinosaur consultants who have been in the system for 30+ years and create room for Dr's to move up in the system. Next they should not allow foreign Dr's to work in the junior Dr posts and stop letting foreign Drs who marry Bahamians have the right to go into private practice since they are competing with Bahamian Drs in a limited market and for positions and lastly, the BMC and **them alone** gets to determine fitness to practice not the MOH. I understand that the BMC has a continuing education criterion for annual practice so this is enough.

**I smell something more nefarious at work here that has NOTHING to do with the competence of Dr's**

You sound like one of those UWI trained MDs who should not be an MD or the parent or grand parent of such an MD!

Not at all just a person who can read and think at the same time! Consider if the AG made the same demands about lawyers etc. You graduate from law school, become registered at the bar and them have to take an exam to see if you can go into private practice? That is ridiculous!!!
Meanwhile you can sell numbers illegally, make lots of money, influence politician to make it legal and do whatever you want. This is telling people education does not pay!

These guys afraid to take exams are NOT representative of UWI med school graduates. UWIs program is RIGIROUS. the program they have here under the banner of "UWI" is doing the students a disservice. I'd recommend they all hightail it to Jamaica if this is something they really want to do.

IT IS ABOUT TIME!!!