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Medical Council of Mauritius

COMMUNIQUE

SP MEETING REPORT- 05/09/2014 Concerning recognition/ listing of University of Technology (Mauritius) as a Medical Institution under the Medical Council Act.

I have been instructed by the Medical Council of Mauritius to publish this communiqué in the press and in the website of Council.

Dr K.DEEPCHAND Registrar Medical Council of Mauritius

Council has taken note of a number of press articles published in “Le Mauricien” (on 28th August 2014, 3rd September 2014 and 4th September 2014) as well as in the online edition of l’express newspaper of 5th September 2014. The Medical Council wishes to highlight the following:

1. According the Medical Council Act, the Council is the sole body empowered to

register practitioners in medicine in Mauritius, likewise TEC is governed by the Tertiary Education Commission Act and UTM is governed by the University of Technology, Mauritius Act;

2. Council wishes to highlight that regulations which provided for the listing of

medical institutions are made pursuant to sections 42(1)(a) and (b) of the Medical Council Act and Council, after considering the credentials, background and other relevant matters relevant to an institution may either recommend or not recommend the listing of an institution to the Minister. Within the parameters of the law, the Minister may, notwithstanding the fact that an institution is not recommended for listing, still proceed with the listing of a University;

3. It is recalled that Council, prior to the emergence of disturbing facts surrounding

Padmashree Dr D.Y Patil Medical College, which led to the setting up of a Fact- Finding Committee set up by the Tertiary Education Commission as well as an Enquiry Committee set up under the Ministry of Health and Quality of Life, recommended the listing of UTM as awarding body for courses run by Padmashree Dr DY Patil Medical College. Council’s recommendation for listing was made to the Minister of Health and Quality of Life on 30th January 2014. Council received an email from 2 Indian students of Padmashree Dr D Y Patil Medical College on 7th February 2014 and following this, matters of grave concern were voiced out in the public domain about the quality of course run by Padmashree Dr D Y Patil Medical College. Council held a special Board meeting on 21st February 2014. Following the meeting Council decided the following:

a. to no longer recommend the listing/recognition of University of Technology(Mauritius) UTM, given the serious allegations with regard to the training provided to the postgraduate students of Padmashree Dr D Y Patil Medical College and also because of allegations of forged records.

b. to set up a committee to fully investigate into each and every allegations levelled against the Medical College

4. On 21st February 2014 the Senior Chief Executive of the Ministry of Health and

Quality of Life wrote to Council stating the following:

I. The views of the Ministry of Tertiary Education, Science, Research and Technology were sought and the latter has stated that legal clearance be sought with regard to the definition of a “medical

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Medical Council of Mauritius

institution” as defined under section 2 of the Medical Council Act.

II. Legal clearance has accordingly been sought from the state law

office and the latter has sought clarifications regarding –

(a)the terms of the Memorandum of Understanding (MOU) between DYP Worldwide Ltd (DYP) and the University of Technology Mauritius (UTM) and, which indicate that the programme is owned by both UTM and DYP;

(b) provided UTM has been authorised by the Tertiary Education Commission to provide courses leading to a diploma in medicine, it may be prescribed as a medical institution for the purposes of the courses in medicine dispensed pursuant to the MOU; and

(c) clarifications whether UTM under the MOU is providing undergraduate or postgraduate course, or both in medicine.

III. Clarifications on the above were sought from the Ministry of Tertiary Education, Science, Research and Technology.

IV. in the light of recent press articles where serious allegations have

been made against DYP Worldwide Ltd, further clarifications are being sought by this Ministry from the Tertiary Education Commission and the Council will be informed accordingly. However, it would be appreciated if the Council could seek additional information in respect of any provision incorporated in the Memorandum of Understanding to ensure that the various provisions are being complied with. You may also wish to request a copy of the last report of the International Monitoring Committee to ensure that the recommendations satisfy the requirements of the Council for the listing/registration of the University of Technology, Mauritius as a “medical institution”.

V. in view of the above, it would be appreciated if you could submit

your recommendations to the Ministry.

5. Council notes that in a letter dated August 22, 2010 sent to the Tertiary Education

Commission, it (the Council) stated the following:-

“the Tertiary Education Commission is therefore being requested to ensure compliance with all the elements laid down in the Clinical Training Framework for postgraduate medical training in Mauritius failing which Council will not recommend the recognition/listing of the concerned postgraduate medical institutions. The specialist qualifications awarded will consequently not be recognized for the practice in medicine in Mauritius.

6. Council further notes that on 21 February 2014, Cabinet decided that “a team of

academics from the UK be invited to undertake a quality audit of all tertiary education institutions in Mauritius.” It stands to reason that courses run by “all tertiary education institutions” would include courses run by Padmashree Dr D Y Patil Medical College.

7. Council further notes that despite written requests and reminders issued to both

the Tertiary Education Commission and to the Ministry of Health & QL, Council has not been provided with any of the findings of Fact Finding Committee report and the Enquiry Committee report. Council also notes that the quality audit of all tertiary education institutions in Mauritius reflects the importance attached by Cabinet to the reputation of Mauritius and it would be very unwise for Council to proceed with any listing of a tertiary medical institution in Mauritius before it is in presence of all relevant facts.

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Medical Council of Mauritius

8. Council wishes to highlight that if the UTM may, in law, set up a medical school, it

does not follow that all the graduates of UTM are automatically eligible for registration. Normally, the listing of an institution by the Council takes around 6 months.

9. Council wishes to highlight that its Special Committee (as mentioned at para 3(b))

found the following matters of grave concern with courses run by Padmashree Dr D Y Patil Medical College in Mauritius:

a). During interview with the Consultant in Charge of the Subramanien Bharati Eye Hospital and Dr Sharma – Dean of the Padmashree Dr D

Y Patil Medical College, the following shortcomings came into light -

there was one postgraduate student who was left without any academic support due to absence of a Professor and an Associate Professor of D.Y. Patil Medical College since June 10, 2013 ( i.e.about nine months). It is common knowledge that both academic and clinical training are sine qua none components of a specialist postgraduate training. Due to absence of these grades of teachers, there has been a big deficiency in the training of the postgraduate students in question;

b). Consultants in charge have been designated as lecturers as per the Memorandum of Understanding between Ministry of Health & QL and Padmashree Dr D Y Patil Medical College. Some consultants in charge expressed satisfaction about the Padmashree Dr D Y Patil Medical College academic staff, but others had serious reservations about the profile of certain professors;

c). At interview, at least two consultants in charge confirmed that there was no professor from Padmashree Dr D Y Patil Medical College for almost one year, namely in ophthalmology and surgery. Council considers this as a serious lacuna in training. The consultants in

charge themselves started the academic training like seminars, literature reviews, thesis, etc which were should have been under the responsibility of Padmashree Dr D Y Patil Medical College academic

staff;

This issue was left unaddressed being given the consultants in charge were responsible for clinical training only;

d). Certain consultants in charge were not even aware that there existed a logbook for entries regarding clinical activities and interventions carried out by the Post graduate students. When asked

as to who was supposed to certify the veracity and accuracy of entries made in the logbook, the responsibility was shifted on Padmashree Dr

D Y Patil Medical College academic staff, whereas most of the clinical

activities, interventions and surgeries were under the general

responsibility of a consultant in charge;

Council is very sceptical about certain entries in the logbooks. A matter of particular concern was the fact that certain postgraduate students in surgery had done very few or no interventions independently or even under supervision. They were present either as “observers” or “assistants”, yet they have graduated as surgeons (MS);

e). Consultants in charge stated that they were involved only in organisation of clinical/practical examinations, but had no say either in its conduct or marking. The Dean confirmed that certain students were given “grace marks”, which explained the 100 % pass rate in all specialities. - a very unlikely occurrence in most foreign medical

institutions;

f). The methodology of selection of postgraduate students was

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Medical Council of Mauritius

questioned by certain consultants in charge, which explained the profile of some of them;

g). The issue of students without registration with the Medical Council of Mauritius was also raised. Some consultants in charge stated that it was not their responsibility to countercheck whether they were registered or not. They assumed that this preliminary verification must have been done by Padmashree Dr D Y Patil Medical College administration;

h). As explained the Dean said that those students who were not registered with the Medical Council of Mauritius acted only as observers and did not examine patients, neither write in case folders or sign prescriptions nor did they do any interventions or Surgery. Council views this very seriously in that postgraduate students who are supposed to have “hands on” training were allowed to continue their training as observers;

i). Consultants in charge confirmed that there was no dedicated accommodation for postgraduate students at night. In certain cases an improvised arrangement for one postgraduate student was made in the office of the consultant in charge, while for other cases, the postgraduate students were simply not staying on site for night duty. This was particularly true when there were more than one postgraduate student on night duty in different academic years. One cannot overemphasize the importance of being “resident” doctor on duty when doing postgraduate training;

j). Consultants in charge were also asked about any Quality Assurance exercise by the University of Technology (UTM) to ensure proper implementation of postgraduate training leading to award of MD/MS degree by this institution. They unanimously stated of not being aware of any such exercise;

k). From the Memorandum of Understanding, International Monitoring Committee reports and interview of consultants in charge, it was evident that there were various shortcomings. In fact Council noted that in the light of the report of Fact Finding Committee set up by the Tertiary Education Commission, the latter even had to resort to requesting Padmashree Dr D Y Patil Medical College not to enrol new postgraduate students until they satisfied requirements of the Medical Council and the clinical training framework;

l). The issue of informed consent forms specifically for postgraduate students and staff of Padmashree Dr D Y Patil Medical College to be able to examine and intervene on patients were raised. Compliance with this was uncertain;

m). Before the start of the postgraduate course, consultants in charge had drawn the attention of the authorities about the inadequate facilities at the J.Nehru hospital for postgraduate training. Nevertheless, in total disregard to this, the training was launched.

10. Council further wishes to highlight that its concerns about the quality of courses run by Padmashree Dr D Y Patil Medical College in Mauritius are further buttressed by reported comments of students of Padmashree Dr D Y Patil Medical College who will refuse to submit themselves for assessment by the Post-Graduate Board of Medical Education. Council takes note that the Minister of Health and Quality of Life has, by the establishment of this Board, ensured the protection of patients. Since the Board has been constituted, 51 applicants who have applied for registration as specialists have been assessed and 17 have failed the assessment and have not been registered by the Council as specialists. Amongst those who have passed there are a good number of them who are experienced practitioners

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Medical Council of Mauritius

11. At its sitting of Wednesday August 27, 2014, Council took note of the fact that it

has been deprived of the Fact Finding Committee report of the Tertiary Education Commission and the Enquiry Committee Report of the Ministry of Health & Quality of Life. These reports are fundamental and would have thrown more lights on the post graduate courses in medicine being offered by the Medical College in question.

12. Council is not engaged in any profit-making exercise and acts, within the parameters of the law, striving to ensure the safety of patients.

13. Other institutions namely TEC and UTM, involved in the Padmashree Dr D Y Patil

Medical College issue are invited to shoulder their responsibilities vis-à-vis the

Mauritian public and to take note of Cabinet’s decision of 21st February 2014.