The evolution of medical education in the Commonwealth Caribbean

ABSTRACT

Medical education had taken place in the Commonwealth Caribbean for well over a century, influenced by political, economic, geographical and professional factors. The establishment of the University College of the West Indies as a College of London University in 1948 (UCWI) allows us to describe three distinct periods pre-UCWI, UCWI and post-UCWI. In the pre-UCWI period, some British doctors were supplied by the Colonial Medical Services (CMS), based in London. The lack of colonial medical schools meant that natives had to train, at their own cost, in the United Kingdom (UK), United States of America (USA) or Canada. UK graduates (unlike North American), returning home, were allowed to serve as unpaid apprentices in CMS hospitals where they often received exemplary and rigorous training - in service from well qualified and dedicated doctors. By World War II, however, most of the CMS hospitals needed rebuilding, but the war postponed plans for this. The UCWI began in 1948 in this colonial setting. It was financing by the British government and supported by all Caribbean colonies except the Bahamas. With a London curriculum modified to accommodate Preventive Medicine, Public Health and Dentistry, the Medical Faculty aimed to train general practitioners; but many graduates opted for specialist careers instead. Staff shortages in Government services continued, especially in the Lesser Antilles. However, the new medical academics at Mona quickly made an international name for the school from the clinical strength of its graduates, the quality of services and the output of research. Politically by the late 1950s the major colonies had achieved a measure of self government, giving them local Ministerial control of higher education and health affairs, and they inherited from the CMS all the physical and manpower problems and administrative structures, warts and all!! This period also saw the birth and death of the West Indian Federation (which would have had responsibility for the UCWI). Extramural centres built in each island had little impact on medical affairs. The College became an independent University (UWI) in 1962, and awarded its first degrees in 1967.(AU)