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| “The average person will never help you become better than them on purpose.” ― |
Most of you may be ignorant to the fact that in the Caribbean, internship year is not necessarily considered as a year filled with personal and career growth, but more of a year of misery, disrespect and dreaded belittling.
In the Bahamas, there is one public hospital on the island of New Providence; The Princess Margaret Hospital. Over the last decade the internship program has seen many changes which hospital administration and past and present Ministers of Health have mandated. There has been implementation of rankings which means that as a graduate of the University of The West Indies, you are no longer automatically given a spot in the internship program, regardless of the fact that the government financed your tuition for the last 5 years. Imagine the frustration.
Recently, the Bahamas Doctor's Union utilised their strike vote, which allowed all Junior Physicians to leave the hospital grounds until matters were resolved. You can read more about it here. So as a new physician, looking to work in the Bahamian system, find below an outline of what to expect as it's not always a bed of roses in paradise.
Everything, everyone failed to mention about Internship Year in The Bahamas
1. Application Process
Prior to the start of internship year, everyone seeking employment as an intern (also known as a House Officer) at the Princess Margaret Hospital which falls under the Public Hospital Authority (PHA)Unit, is required to fill out an application which can be obtained from the Hospital Administrators office or the PHA Corporate office or online here. It would be in your best interest to keep a copy for your records as paper documents often are misplaced.
2. Duration of Internship
The internship program runs for one year starting in July of each year. It is broken down into three month increments and divided over the four core specialty rotations; Internal Medicine, Surgery, Obstetrics and Gynaecology and Paediatrics.
The incoming internship group is divided into an even number of persons which would allow for ten persons to be allotted to each specialty for the designated timeframe. Last year was the first year where it was mandatory for two persons of each group to complete their rotation in the sister hospital on the island of Grand Bahama, at the Rand Hospital. Prior to this, an intern could request to complete a number of their rotations at the sister hospital.
3. Purpose of Internship
Have you ever wondered where the term "intern" originate from? After performing a very superficial Google search, I found that it originated from the medical community. It was a term given to a doctor who held a medical degree but lacked a medical license prior to World War I.
It was then adopted by other professions and each profession tailored the purpose to suit the demands.
During our orientation week, we were informed that the sole purpose of the internship year was to gain clinical competence in the care of the adult/paediatric patient, with the "patient" being the curriculum.
Despite it feeling like everything but this, make it your duty, to learn guidelines and standard of care medicine even if it is not practiced. At the end of the day, successful completion of each specialties exam and gaining your internship completion certificate if the overall goal and your purpose.
It was then adopted by other professions and each profession tailored the purpose to suit the demands.
During our orientation week, we were informed that the sole purpose of the internship year was to gain clinical competence in the care of the adult/paediatric patient, with the "patient" being the curriculum.
Despite it feeling like everything but this, make it your duty, to learn guidelines and standard of care medicine even if it is not practiced. At the end of the day, successful completion of each specialties exam and gaining your internship completion certificate if the overall goal and your purpose.
4. Work Hours
Trust me here, as an intern your work week will equate to more than 40 hours. They will paint the lovely picture that your days is to commence at 8a.m. and end at 4 p.m. unless on calls.
You will learn that you get to leave when your Senior House Officer or the team/service you are on no longer has work for you to do. Some areas and persons understand the meaning of teamwork and will ensure everyone has at least one day off per week, and that everyone leaves in a timely manner each day. Pray to work with those people! It will make learning material fun and interesting and will allow you time to read around your patients to have engaging discussions on consultant rounds.
5. The System
The system is not one that is set in place to help you grow. I never thought I would be writing such a post but sadly, this is the reality.
After working here, wanting to help my fellow Bahamians, the health-care system is deplorable. You will be frustrated, you will be exhausted and you will find yourself on your knees daily in intercessory prayer for your patients because there is so much that can be done but isn't and in the eyes of administration you're just an intern.
In light of all of this, do your best to keep your personal development at the forefront. Please don't get buried in the system. It lasts but a year and before you know it you will be done with it.
If you can afford to do so, make plans to sit the necessary board examinations prior to your final year in medical school (and yes you do have time). You won't regret it.
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