Opinions of Thursday, 3 November 2005
Columnist: Dekuwmini, Mornah
Society places different values on different professions based on the services provided. The social prestige placed on such professions creates a demand for them which inevitably leads to adverse selection in the sense that the best brains are attracted to such professions. It?s no wonder that the Ghana medical school of the University of Ghana, the KNUST medical school and the UDS medical school are the most competitive schools in these three universities. The highly debatable question that naturally arises is whether such professions demand such brains.
Time and time again, medical professionals are seen rampaging. In fact demonstration for certain demands to be met has become the norm in most professions in Ghana. Dialogue is almost always the last resort. How ironical! The larger society has paid dearly for these bitter experiences. Just recently, a renowned actress Miss Suzzy Williams died in a motor accident at a time doctors where on strike. Her boyfriend who I believe is a victim of circumstances is facing the full wrath of the law. The nation lost out in two respects: Firstly the loss of a life that contributed so much to the entertaining industry and secondly; the time and resources wasted in the arbitration process. Probably her life could have been saved. Probably that was her time. May she find peace in her rest. But who is to take blame? The doctors, the policy makers or the society?
Without jumping the gun, let?s ask: why were the doctors on strike? Obviously they were not satisfied with the conditions of service among other things. And which are these conditions of service? Your guess is as good as mine (salaries and job satisfaction)
Ghana produces some of the best medical professionals in the whole world. In the 2002 Ghana Medical Association Annual Report, the number of Ghanaian doctors in the state of New York alone stood at over 1500 doctors ? far more than what we had in the whole of Ghana. (I can imagine that the situation is even worse now). I even hear people say, ?Ghanaians are generally more intelligent?. Then why are we still where we are? Doesn?t this occasion a kind of paradox in your mind? I refuse to be deceived that Ghanaians are generally more intelligent. I also refuse to accept that the excellence in Ghanaian doctors is attributable to better training. I however accept that Ghanaian doctors are among the cr?me de cr?me of the profession. Does it sound to you that I am just playing with words? Then what accounts for the excellence if it is neither due to better training nor general intelligence? Basically I think the institutional set-up and the social perceptions cast our best brains into the sector while other countries do not.
For instance while at the secondary school with school rivalries always at its peak, there was this missionary school that always performed so excellently in the WAEC exams. As students, we could only get two reasons ? either they were given ?appor? (leaked exam questions) or they had very good teachers. In fact in most of the courses at this school, there were no teachers. It so happened that this school rigorously selected its students nationwide and have the number capped at 50. There is no doubt that they select the best students and that this brings about academic jealousy and competition amongst the students. They did not have access to ?appor? nor the best teachers. The same analogy goes for the medical profession in Ghana where the best few are selected.
With the best brains in the profession, naturally demand for them will be high. We are fast loosing our doctors and nurses to western countries ? the supposed ?brain-drain?. I have heard people argue that ?if our medical professionals are that good, why not produce more and export ? simple economic logic?, they will conclude. Unfortunately it is not as simple as they see it. This argument is porous in two respects. The first is that if others are interested in our doctors because they are good (remember they are our best brains) does not mean we can continue to produce more since we do not have an unlimited supply of ?best brains?. Secondly, even if we had an unlimited supply of ?best brains?, given the resources available for training the doctors, increasing the numbers beyond a certain point will make us inefficient and this will subsequently take away all goodwill we had in the profession.
If one takes a closer observation of the medical profession, one will realize that most of the experienced medical practitioners are fast abandoning practice and taking up new assignments mostly in administration/management. In nine out of ten health centers in the country, the administrative head is usually the most skilled and experienced medical practitioner ? the longest serving. Some examples are: the head of the Ghana Medical Services, the CEO of the Korle-Bu teaching hospital and the CEO of KATH. The situation is even more worrisome now as the Master of Public/Health Administration programmes in the University of Ghana Business School are now flooded by medical professionals. This is enough indication that more want to go into management rather than practice. Have doctors trained for over seven years suddenly become good managers? And where are the trained managers? Are they becoming doctors? No! It is unacceptable to say that they combine the two vocations. For all I know, they have 24 hours like me (even though I think they possess most of the finest brains in the country).
What does this tell you? It means that even if we were to curb the international ?brain-drain? problem, we will still find the same brains leaking within the system as doctors are fast changing professions. Let no one misjudge me. I am not saying these medical professionals turned managers are performing badly in their new professions. In fact evidence is that they have performed much better than some trained administrators. Does this occasion to you that they probably chose the wrong professions in the first place or does it confirm that we have the best versatile brains locked-up in the medical field in Ghana who are capable of switching professions so easily?
As children, we were made to understand by our families and the society that, you must be ?extremely good? to be a medical doctor. Politicians have publicly broadcast that we need the ?best brains? in the medical sector. When we grow, and realize that we are ?extremely good?, we naturally fall for medicine. A friend of mine, who completed SSSCE with me in 1998 and whom everybody knew was ?extremely good? was not lucky to gain admission to the KNUST medical school. He forced his way through the ?back door? but was later discovered and was given the exit. He went to the University of Ghana to join in the ?open race? (competition for courses), but this time he was two years behind me. As fate will have it, he failed to make it to the medical school there too. Frustration set in. My friend left his (our) Church and became a self-acclaimed pastor, preaching the coming of the end of time. He finally found abode in the psychiatry. Pathetic this may sound, this is a true story. A case of excellent brain wasted. Who is to blame? If I were a psychologist, I would have said he was under mental self pressure to satisfy/meet societal ?irrational? expectations even where it was not socially optimal. There are thousands of such people walking about on our campuses ? pale shadows of their former selves.
Thousands of students are admitted into the sciences in the University of Ghana who usually come to compete for places in the medical school. At the end of the day, less than a hundred are taken while those taken on merit are less than sixty ? you can get a place once you can pay full fees. What happens to the majority left? They fall in love with frustration and disillusionment (or frustration falls in love with them?). Even though everybody on campus knows the psychological disequilibrium associated with those who do not get to go to the medical school and the potential threat of ruining the lives/careers of these ?unfortunate best brains?, nobody considers a career re-planning and development programme for them. I usually guess without fail that medical school list is out each time I hear people sing ?This world is not my home? I?m just passing through?? ? the louder the song, the higher the number of frustrated victims. This is a song not of gratitude to God but of disappointment with man and his institutions. This means that after selecting a few best brains from the many, the larger number is made to go without the brains again as there is no motivation for any other thing else.
Where I come from, if you said you gained admission to the University, the first question that usually comes is what course and this is usually followed with the suggested answer: medicine? If you said no and answered physics, chemistry, sociology or economics, you are treated with contempt. Even those who have never stepped foot in class will say ?he is in the university doing pure physics, chemistry etc? and the implication usually is that he is no better than those of us home. However if you said medicine, you see all mothers giving their daughters to you and all the girls coming to you ? I must admit that this made some of us jealous of our colleagues. So why the blatant disregard for other professions? Saving a life is the greatest virtue in society. That is what humanity is all about but is that where our ?best brains? belong?
Currently, there is technology that allows the individual to have virtual access to a medical professional through the computer and the internet. Thanks to inventions by researchers and people who use their brain endowments. All you have to do is state: ?I experience head-ache, with intermittent chills amidst sweating. It started two nights ago. I am 25 years old. I have taken paracetamol as first aid? and hollaaa, your prescription is on the screen. Thank God for good brains, good uses of them and good inventions. That is the future!
An anti-HIV virus is being tested on some AIDS patients in some worse affected African countries. This was the product of serious research in the laboratories by researchers ranging from biochemistry, biology to human anatomy. It is important to note that most if not all of the medical discoveries are not by doctors as in physicians. They are by researchers who spend good time in the laboratories using their endowments ? their brains.
In the early years after the second World War (I wonder if my grandparents regarded it as a world war), the world experienced a great economic depression. John Maynard Keynes proposed economic solutions that lifted most economies out of this great depression in the 30s. Thank God once again for quick brains for quick responses.
When we go to school and the best brains are selected for the medical profession, with the remaining best brains made to go waste as they usually believe their future is uncertain, the implication is that the ?less best brains? are left for the other professions. Unfortunately, it is these less best brains that turn out to manage the macro system of which the medical profession is just a minute part. I am not a mathematician but I know that if two is greater than one, then managing two (in this case the macro system) will be more difficult than managing one. This is fundamentally true even in the homes (Parents managing more than a child face more difficulty than those managing just a child. The same goes for men in polygamous marriages). If we can draw on the ?scientific? principle that what happens to the whole affects the parts, then one can say that the ?poor brains? managing the whole will definitely make inefficient the functioning of the parts. Now let me ask. Do you think we are in such a trap in Ghana? I guess I can conclude that we need bigger brains for bigger problems.
I stand to be corrected, but the medical profession to me do not give much room for our best brains cast in there to original but have to follow strictly laid down procedures as in prescriptions and treatment. No room for deep thinking and originality. I should think that is why in developed countries like the US you don?t need to have being rigorously trained in sciences to be a doctor.
If we realize computers are programmed to perform the work of doctors, if we find our doctors moving to take managerial positions (i.e taking macro assignments), and hear our doctors complaining of job satisfaction, it is an indication that the profession is underutilizing their brain capacities. When this happens, frustration sets in. There is no bigger prison than mental prison. We may find our doctors busy attending to a thousand and one patients in a day. They do not even have time for their families. The girls who rushed in for them will be having hard times having to stay at home all alone most of the time. However you never find our doctors so busy thinking solutions ? I mean using their endowments. Probably they do not have the time and I wonder if the time will ever be there. Nothing is more frustrating than using the mind in a woefully sub-optimal way. For a profession that is increasingly becoming more procedural, it?s not deserving of all our ?best brains?.
Once in school, we were given an assignment considered difficult by all. Only one person could solve the problem. When the professor came to the class, he asked that someone come to solve the problem on the board. A class of nearly 80, we all sat quiet and one boy went to solve the problem. Everybody was amazed. Everyone was full of admiration for the boy ? may be he should have been in the medical class. What did the professor say? Our expectation was massive praise but alas, we were disappointed. ?Ooh, every rationally foolish person could do this by just following procedures?. He said. For those of us who could not solve the problem, what were we?
If we had the best brains and even the frustrated ?young best brains? that could not get to the medical school repackaged to feel that they can contribute meaningfully and not be wasted, in the pure sciences such as physics, chemistry, biology, biochemistry, engineering doing research and bringing about inventions, in the social sciences such as economics/management thinking economic solutions to problems and in sociology thinking solutions to the numerous and growing social problems, there would have been greater satisfaction and benefit to all. The satisfaction and benefits come in two ways. Firstly, the ?big brains? gain satisfaction from getting to use their intellects more efficiently. Secondly, the macro system benefits from the high thinking minds prescribing solutions to the numerous and complex problems that we face (which are not for lesser thinking minds).
May be in the past we made the mistake of giving our best brains to the wrong profession and frustrating those who could not cast themselves in. May be it was the best thing to do at the time. However, their revolt in the form of their desire to take much larger thinking positions in society is enough manifestation of the fact that times have changed hence the need to change. The people are speaking in high voices. Let?s listen to them. Let?s give our doctors and our ?best brains? a chance. But who are the ?we?? Society, Policy Makers, Educationists and the individual all have to be mentally revolved. Let?s rethink our policies. Let?s change our perceptions and let?s grow our society. We need our best brains in this time of development to do big things!