Fiji: Many of us who were involved with the planning of the post-graduate Master of Medicine (MMed) program in Fiji under the FSM started in 2001 to discuss a 4-year post-graduate training program, to emulate the 4 to 5-year Fellow training program in New Zealand and Australia. Since I have taught in both programs, Fellow in New Zealand and MMed in Fiji and Samoa, the main difference is the supervision and the quality of the supervisors. The more Fellow supervisors that a trainee has, the better the training as one will use many techniques to get out of a tight situation, as many supervisors will add to the solutions of how to tackle the issues. There are different ways of tackling issues and thinking through issues in the Fellow program. The Fellow program (via examinations) has a higher and better reputation in Australia, New Zealand, and UK, as the MMed is not considered as a specialist’s qualification in these countries. Fiji is using the MMed level as their minimum standard for post-graduate training to be called Specialists in Fiji. Fiji also accepts the Fellow as a higher specialist qualification. 

 Samoa: As we have not defined the top level of the medical qualifications in Samoa, I believe, that Samoa should aim for the “Fellow” level via examinations, just like the standards in New Zealand and Australia, to be called a Specialist or Cardiologist or Consultant, and be compensated as a Specialist. The MMed level should be the stepping stone to being given the chance to go and get the Fellow level in the UK, New Zealand, or Australia. The previous Government and our current Government had asked for the appropriate levels to be called Specialists. If we are sending our patients to New Zealand under the Overseas Treatment Scheme, we should aim for New Zealand and Australian standards. It is a recommendation set before the government to set the highest level at the Fellow level, so that, doctors can climb to the level of New Zealand, Australia and the UK. 

 USA: The degree for medicine in the USA is the MD, the Doctor of Medicine, just like the OUM’s degree. It is a post-graduate degree, after doing a Bachelor’s degree. It is a 4.5-year degree. Once a doctor in the USA passes the USLME 1 and USLME 2, they will graduate with the MD degree and will be able to work in the US hospitals. The first year out of medical school is called the Intern Year. After the Internship year, then the doctor becomes a Resident in a 4 to 5-year specialist training program of specialization in whatever field, like cardiology, endocrinology, general surgery, cardiothoracic surgery, etc. There are written and oral exams and tough supervision. Once they pass this specialization, they have the title “MD with Board Certification in Cardiology or General Surgery” or whatever field of specialization they took. The MD with Board Certification is comparable to the Fellow qualification in New Zealand, Australia, and UK, because both have curriculums for training, proper written and oral examinations and tough supervision with great professional standards, by a reputable organization like the RACP (Australia & New Zealand), RCP (UK) or the US Boards. 

 UK: The training in the pathway to get the Fellow in the UK is a bit longer than NZ and Australia. The first part of the Fellow program is to get the membership qualification, which takes about 4 years. There are a lot of written and oral exams too. In Internal Medicine, everyone gets the MRCP first (Member of the Royal College of Physicians), before continuing for another 5 years to get the Fellow qualification. The MRCP is not a specialist qualification in NZ or Australia or the UK, but NZ accepts the MRCP as part of its Fellow training programs. It exempts part of the Fellow training program in NZ if you have the MRCP. Some doctors from Samoa are now going through this pathway to get a Fellow in O&G from the UK, via examinations and supervision. The Visas to UK may be easier to secure than Visas to train in New Zealand and Australia. It is a pathway that our Government in Samoa may need to look at, to expedite the Fellow training in all areas of medicine, not just O&G. Australia is trying to make it easier to register foreign doctors, to enable them to work in Australia, due to doctor shortage. 

Read Part Five in tomorrow’s edition.

Professor Asiata Dr. Satupaitea Viali is the Professor of Medicine of the National University School of Medicine and the Professor of Medicine and Interim Clinical Dean for the Oceania University of Medicine (OUM).