Thursday, March 28, 2024

PEOPLE & THINGS: Education quotas

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Last Tuesday the Democratic Labour Party (DLP) Government celebrated its five-year (60-month) anniversary and simultaneously became the longest serving Government in this nation’s history.
No prime minister here has ever called an election after his Government’s five-year anniversary and it is therefore likely that we will now continue to be preoccupied with discussions about the logic of having waited this long.
This distraction is unfortunate for several reasons, not least of which is the likelihood that we will miss the opportunity to properly discuss recent comments attributed to president of the Barbados Association of Medical Practitioners, Dr Carlos Chase.
He suggested the need for a reduction in the number of doctors being trained and this statement provides a rare opportunity for me to stand in support of a minister in this DLP administration who disagrees with Chase.
Minister of Health Donville Inniss reminded Chase that while Government remained committed to funding the education of doctors at the University of the West Indies (UWI), there was no commensurate commitment to employing all of them.
This seems entirely reasonable to the thousands of us who pursued professional accreditation outside of medicine, and thereafter found ourselves competing with several colleagues who were equally qualified for the few available jobs in this small country.
There are, of course, two sides to this issue which should in fairness be teased out before commenting on the “rightness” of Inniss’ position.
I was reminded by several of my friends in the medical fraternity that this profession is in many ways different to that of accountancy and political science. A doctor is not fully trained and qualified to practise until he has completed pre-clinical and clinical components, as well as an in-service attachment referred to as an internship.
Internships are not uncommon within professions such as law. However, the doctors are, to some extent, special since they are generally paid for theirs. It is this factor that could justify Chase’s suggestion that we train only those doctors whom we can afford to put through internship, if indeed that is what he was suggesting.
If, however, his arguments were more general and he referred to employment (post-training), then there are a few things that need to be said in response.
It is perhaps not well known that the UWI has over the years kept the numbers of doctors and lawyers graduating comparatively lower by adhering to a strictly enforced quota system, which is presumably linked to the population of the country that these professionals would serve in.
The medical and legal faculties would take only the best qualified, artificially raising the bar of entry into these schools to the point where several people completed first degrees in related disciplines, in order to gain entry into medical and legal schools. In contrast, entry into the other schools was easier since more places were available.  
In both instances, matriculation requirements would normally be designed to ensure that a qualified student had the necessary grounding to study that discipline and sufficient academic competence to make him likely to succeed.
This is the case as it related to all schools, but competition meant that several qualified potential doctors and lawyers were denied entry into these schools over the years because of space constraints, while the vast majority of political science aspirants would be admitted.
The practical impact of this type of quota system was that it ensured the medical and legal professions would never become crowded, would always attract the best qualified and most enthusiastic students, and graduates would easily find work after qualifying.
Defenders of this tradition argue that the medical and legal professions are easily amenable to this type of regulation since they are tightly regulated by both law and tradition. Those professionals are expensive to train and the services they offer are badly needed in this society.
These arguments are reasonable but it is difficult to see how other professionals trained at the UWI can be regarded differently in a progressive society.
If one were to take, for example, the case of lawyers, these professionals should technically be no more expensive to train than historians if it were not for the fact that law professors are more costly.
It would therefore seem that law has earned this “rank” by virtue of other factors, the most obvious one being that the vast majority of our politicians and policymakers are lawyers themselves and would naturally want to accord special privileges to their elite group.
However, it is unclear how the wider society benefits from this system and, worse yet, it is highly likely that the cap on numbers being trained will result in higher costs to the consumer consistent with demand and supply principles.
In the case of medicine, an effective quota system was maintained over the years, especially because there was a single medical faculty located in Jamaica. More recently, a new campus was opened in Trinidad and we have followed suit in Barbados.
In each instance, the new campus has expanded the offering of places to Barbadians and effectively expanded the quotas, which are further modified by virtue of the growth in popularity of offshore medical schools in the Caribbean.  
Potential medical students can therefore now shop around for places, safe in the knowledge that they would either be funded by our Government or secure a generous scholarship from one of these offshore facilities.
The upside of all this medical training is that doctors will become more plentiful in the not too distant future, while the downside is that these new doctors will face challenges similar to those encountered by accountants, historians and even political scientists in finding work.  
While Dr Chase prefers to see this oversupply as a cup that is “half empty”, I prefer to see the fact that we are prepared to invest so heavily in the training of doctors as a cup “half full”.
To my mind they should be grateful to get to the starting line and battle their way up the professional ladder like the rest of us.  
• Peter W. Wickham is a political consultant and a director of Caribbean Development Research Services (CADRES).

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