The Medical and Dental Council (MDC) is working on a number of policy reforms in line with professional regulatory best practices to ensure that all doctors working in Ghana meet the minimum competency standards to provide safe quality healthcare services in the public interest.

Some of these reforms include the conduct of objective structured clinical examination for foreign doctors in 2022 and common national licensing examinations for both locally and foreign trained doctors, dentists, and physician assistants in 2025.

These policy reforms were informed by a report on joint visits undertaken in 2017 by the Parliamentary Select Committee on Health and the Council to some of the countries where Ghanaian doctors and dentists are trained in significant numbers.

These followed observations that the quality of some of the doctors trained outside the country leaves much to be desired. The evidence shows that most of the problems relative to the quality of training of foreign trained doctors and dentists are in trainees from Ukraine, Russia, Belarus, and China. These quality concerns are generating a lot of anxiety and disquiet among the professional fraternity giving the deleterious effect it has on patient health, safety and well-being.

From the data available to the Council, the major causes of the failure are attributable to some of the candidates having poor knowledge in the various disciplines in medicine including poor knowledge in basic sciences and basic clinical skills. The low standards of teaching in some of these foreign medical and dental training institutions has resulted in some of these students failing the pre-registration assessment examinations over several attempts. Some candidates have written more than ten times and still failed. As a consequence and in furtherance of improved training and practice standards in the public interest, the last Board took a decision in consonance with professional best practice to limit the number of times a candidate can write to five (5) attempts. So candidates who have attempted the registration examinations for five (5) or more times, will not be eligible to participate in further examinations of the Council, effective this year.

Additionally, some of the foreign medical schools admit students with poor West African Senior School Certificate Examination (WASSCE) results and others who studied General Arts (Literature in English, etc), Visual Arts, Agricultural Sciences, Technical and Vocational Skills (Carpentry, Building Construction), and Home Economics instead of the General Sciences (biology, chemistry, physics, mathematics, etc).

Also some of the WASSCE results slips with very poor grades (e.g. Es, Ds, Fs, etc.) were used to secure the admissions; grades that are inadmissible even for general university programmes in Ghana.

It is important to note that these poor training standards are not limited to Ghana. In fact member Councils of the Association of Medical Councils of Africa (AMCOA) share the same frustrations and concerns. For instance, the Medical and Dental Council of Nigeria issued a new directive in December last year making a structured clinical attachment in specified hospitals at the cost of the prospective candidates prior to sitting their licensure assessment examination compulsory irrespective of country of training.

The aim of the Council is to provide qualified medical and dental practitioners who would provide safe quality health care services to our people. It is the hope of the Council that in the medium to long term Ghana will have first level specialists in all our regional and district hospitals so that, at the very minimum, a district of say 300,000 people will have a specialist in women issues, children issues, general medical adult conditions, surgical conditions, psychiatric issues, and dental conditions.

Indeed as part of Council’s 50^th Anniversary activities, the Council is planning a medical training and practice conference later this year. The Council is working closely with other stakeholders including the Ghana College of Physicians and Surgeons and the Scholarships Secretariat to consider pragmatic ways of boosting the local production of undergraduate and specialist doctors in Ghana in line with the meeting the human resource needs of Government’s Agenda 111 Policy. As a consequence, the Council is proposing a policy to decentralise the training of doctors to the district and regional hospitals across the country.

The Council is pursuing an ambitious policy agenda for Ghana to be able to train up to 3000 doctors annually locally, but we need to do so in a responsible manner without compromising training standards for safe quality health care. It is Council’s hope that the stakeholders and Government will support investment in our local medical and dental schools and the postgraduate College to make this happen soonest.