Magee or not Magee – Time for for a graduate entry medical school in Derry / Londonderry?

 

There is definite support in Derry for Ulster University’s proposal for a graduate entry medical school at Magee campus.  After 53 years of exasperation that the city does not have a full sized university, actual excitement for such ideas is always tempered by fear that it will not happen.  But at least the city’s response is definitely positive – unlike the apparent reactions in Belfast and Coleraine.

A medical school in Derry should be a no brainer.  There are two strong arguments for it.  Firstly, there is a city-wide consensus that the substantial expansion of Magee would be the primary mechanism for getting our economy moving forward.  At present it is the weakest sub-region in Northern Ireland, arguably the weakest in the whole of the UK.

As former universities minister David Willetts remarked when he was in post in England, any deprived city that wants to strengthen its economy should get itself a university.  Derry has been saying this for more than half a century, but governments in Northern Ireland have been reluctant to listen.

While the number of students at Magee’s medical school would be a long way short of the size of expansion we are all looking for, it is another definite step in the right direction.  And the statement of intent by Ulster University in itself is very welcome, as is the appointment of Professor Hugh McKenna as Dean of Medical School Development at Magee – Hugh has shown himself resolutely and determinedly committed to achieving a medical school at the campus.

The second reason is financial.  At present, the Western health trust spends £13m a year on locum doctors.  It is widely said that university regions benefit from the 60-20-20 rule.  Sixty per cent of graduates will still be living within 20 miles of their university 20 years later.  Consequently, the best way of addressing the shortage of doctors in the north-west is to train more doctors there.  The south west can benefit, too, if much of the work experience takes place in the South West Acute Hospital.

While that is how it is seen in Derry, other places are believed to regard it differently.  It has been widely reported that Queen’s University is anything but delighted at the idea of a competitor educating medical students.  This is despite the fact that training more doctors in Belfast might do little to increase the supply in other parts of NI.  And, as Ulster University Vice Chancellor Paddy Nixon often remarks, at present there is no doctor training taking place in any university above the diagonal line between Belfast and Galway.

It is also rumoured that bioscience academics in Coleraine are pretty miffed about the training taking place in Derry.  Competition between Coleraine and Derry for university places is nothing new.  It worried many in Derry that when Simon Hamilton was health minister he referred to support for a medical school in the north-west, without specifying that he meant Magee.  Despite that, it is reassuring that the DUP has expressed in the Assembly its strong support for the proposal – as have all the major political parties in Northern Ireland.

The other concern, of course, is the attitude of what might be a direct rule administration.  Will Westminster ministers avoid taking decisions, because they see themselves as interims?  Or will they take the important decisions that will move Northern Ireland on?  If so, that must include tackling the strategic challenges facing our NHS, including long-term staff shortages.

Underlying all this is one major dynamic.  Brexit.  We don’t know what impact Brexit will have on universities and skills.  But the voters – damn them – voted to reduce immigration.  If (a big if) they get their way, then the UK must do more to grow our own skills.  And the skills do not come any more important for our society than producing more doctors.

Paul Gosling is a freelance writer and is also co-ordinator of the University for Derry group, which is lobbying for the substantial expansion of Derry’s Magee campus. Follow him on Twitter…

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  • Hibernia

    An irish medium medical school at Derry would be a hige stimulus to the North’s economy.

  • Brian O’Neill

    Is there even such a thing in the republic?

  • the keep

    How exactly?

  • Brian Smith

    Any new expansion at Magee faces two problems:

    1) Typically students don’t want to go there. It’s never been a popular campus. Many courses there under recruit and the Coleraine and Jordanstown campuses have to pick up the slack. Thus causing resentment as Magee has a better staff to student ratio purely on the fact that there’s low numbers on courses.
    2) The city itself. Belfast is more attractive as a student city and Derry is seen as a cold house by a considerable amount of Protestant students. There’s never been a push for Derry to sell itself as a inclusive student city, the assumption seems to be that Derry is somehow owed and anything else doesn’t matter.

    Until those two issues are sorted out, Derry is never going to be a proper university city. I suspect however that they won’t be sorted out and it’ll be good money thrown after bad as usual.

  • Vince

    There are very few medical students in NI who study Irish even to GCSE level and fewer still who would be fluent in Irish. Such an argument would be insufficient in itself. Better arguments are location, potential training sites in Altnagelvin and Causeway, possibly some cross-border arrangement with Letterkenny, and a need for NI/Ireland as a whole to train more doctors. Given huge numbers of current postgraduate vacant training posts, there is merit in that final argument.

  • Korhomme

    You mean a medical school where the language of instruction is Irish?

    There are problems with this idea; the important international textbooks and academic papers are in English. Students throughout Europe need a reasonable ability in English to be able to follow such texts and keep abreast of things. English is the lingua franca of the medical world. It’s even possible today for students from the UK to study medicine in some continental countries and universities for all the instruction there is in English.

    How many teachers are there who could take classes in Irish?

    Irish as a teaching language seems to me to be a very regressive idea.

  • Paul Gosling

    That is not my understanding of the statistics.

  • Korhomme

    I thoroughly approve of, and support, the idea of a graduate medical school in N Ireland. Not just because I think that such students are likely to be more mature, but, pragmatically, because NI simply needs more medical graduates.

    I studied at Queen’s as an undergraduate. The curriculum was delivered by experts in their own fields, so the detail that we were required to memorise — memorise and not necessarily to learn or understand — was almost overwhelming. Yet much of this detail was unnecessary in clinical practice — or not detailled enough for your particular branch of medicine. The course then took 6 years, though this is reduced to ‘only’ five.

    A graduate medical school takes people who have completed a primary degree in another subject; the course usually lasts four years. The totally superfluous rubbish that we had to learn is omitted — students learn what is really necessary. Medical schools in the US are graduate entry. The only possible snag with such an arrangement is that such schools can expect the student to have chosen their specialty by the time of graduation, with their studies specifically related to this. Traditional medical schools produce a ‘generalist’ who only later specialises.

    Did you watch ‘Incredible Medicine: Dr Weston’s Casebook’ which was recently on BBC2? Dr Weston — more accurately, for she is a surgeon, Ms Gabriel Weston — is such a graduate. She did a degree in English before starting her graduate medical studies, training then as an ENT surgeon. She has written several books on medical topics as well as becoming a TV ‘personality’. Her progress is now what will become for many, not just in medicine, a “portmanteau career”.

    Should such a graduate school be in Derry? Plenty of arguments in favour, but ultimately this is a political decision.

  • andrewjohn
  • Fear Éireannach

    Graduate medical students are more mature than the average occupant of the Holylands and may view their choice of city differently. The problem is that Magee was crippled and then people observe that it isn’t successful and use that as an excuse to cripple it further.

  • Am Ghobsmacht

    Slightly off topic (but not much) did Farry not have plans to expand Magee but they had to be put on hold due to insignificant finances?

    The point being that merging (and selling off parts of either) St Mary’s and Stranmillis would have covered a great deal of the cost?

    I think a university and a relaxation of the licensing laws would do Derry the power of good, I think it has potential to be the Galway of the North. It’ll take work but the basic frame is there.

  • Jimmyz

    Link doesn’t work – maybe you need to brush up on your irish lol 😀

    Any anyways if there is one, I can’t see there being demand for another.

    Seems utterly pointless to me, what next Irish speaking Pilots ?

    There is little enough money without wasting it on vanity projects like this I am afraid.

  • Jimmyz

    St Mary’s and Stranmillis should be merged and religious Education done away with.

    http://www.irishtimes.com/news/education/liam-neeson-backs-campaign-for-integrated-schools-in-north-1.2967014

    Education and religion should be totally separate.

  • Jimmyz

    I concur, any new campus must be situated in a neutral environment that is welcoming to all.

  • Goretti Horgan

    This does not reflect the reality of either student or staff figures at Magee. First, it is as/more difficult to recruit to Coleraine as to Magee. The figures for UGs on both campuses are very similar but Coleraine has about 1,000 staff and Magee only has about 300. Not sure any Jordanstown student would agree with you about that being a more attractive proposition than Magee and Derry city.

  • Am Ghobsmacht

    Indeed, we spend a lot of time complaining about how various services are either cut, closed or have their potential neutered on account of financial constraints but aren’t prepared to clasp the nettle and re-jig the education system which could release millions upon millions of pounds in terms of savings, asset sales and reduction in the duplication or triplication or ‘whatever-times-4-lication-is’ of services.

  • Korhomme

    Education and religion should be totally separate

    Agreed. Education should be entirely secular. Not just the delivery of education but the pedagogical instruction of teachers needs to be secular.

  • Pete

    “The only possible snag with such an arrangement is that such schools can expect the student to have chosen their specialty by the time of graduation, with their studies specifically related to this.”

    That’s not the case for graduate entry programmes in the UK though, as far as I know.

  • OPB58

    To a large extent the medicine course at Queens is already a graduate programme given the large proportion of its intake which are already graduates from a range of disciplines. Their presence along with new entrants to third level education can be be quite intimidating to the freshers.

    Definitely, being a graduate is a way to bring a more mature student into the medicine courses but also brings a lower academic level as most of these graduates did not have the qualifications to get into medicine when they first went to university. Also being a graduate does bring a greater commitment to study as the student has already committed a huge amount of funding to the first 3/4 years of their course.

    Whether graduates trained in Derry will stay in the west is moot and unknown. One of the major problems for recruitment is down to the migration of graduates from the course to NZ and Australia where the workload and hospital work is much more suited to learning rather than service provision. By paying fees for students who will stay for an initial 4 years in the system rather than just for F1/2 as at present.

    It will always be difficult as to recruit to SWAH as it is a hospital placed in the wrong place by a SF minister buying votes in FST. Currently, almost every discipline has to immediately ship out its patients to other hospitals for proper consultant care. For example, all head injuries are transferred immediately to the RVH, all broken bones and orthopaedic injuries are just x-rayed plastered and sent to Altnagelvin. The hospital is operated by mostly locum consultants and junior doctors.

    The money to be made by locum consultants and junior doctors is at least twice that on contracts and there is a major financial incentive for consultants and doctors to remain locums. Only a major review of workforce management and development will make any change.

  • Theelk11

    Most of these new doctors would be GP’s however their training would greatly help the hospitals in the north west with provision of medical staff.
    Most junior docs are finishing their initial foundation training and heading straight to Australia or New Zealand, this is because of the appalling rotas and poor working conditions. For instance half of the training jobs in emergency medicine in this region are unfilled for posts starting next August. All the trainees all want to work in Belfast which is where they live and are settled. This means the “sticks” go short and rely on locums which means they are labelled as unsustainable and so it goes on.
    The big Belfast hospitals do well out of Queens, its high time the west looked after its own medical provision.

  • Korhomme

    You may well be correct; my comment was based on my understanding of the US system. Certainly, here F1/F2 is usually a very general post-graduate training.

  • andrewjohn

    It was an April Fool on Brian.

  • Korhomme

    …a lower academic level…

    I dispute this absolutely. My grades at the Advanced level of the Senior Certificate wouldn’t get me into medical school today. But that’s not my major gripe.

    The idea that you have to have half a dozen A* grades to gain entry to medical school is, in my opinion, fundamentally misguided. It’s an easy way to sort candidates of course, but the idea that the most academically qualified students make the best doctors is erroneous. Doctors certainly need reasonable intelligence to study the undergraduate/postgraduate course; but what such A level results don’t reveal is the empathy that students need, their understanding of patients and their ability to communicate with them. I see this as a major failure.

    I can relate it to my own experience; the most ‘academically’ gifted seemed to enter rather esoteric specialities, such as neurology. In those days, before scans were available, the diagnosis had to be made by careful study. But the result was always a very detached air from the physician who presented such patients to us students as an advanced exercise in diagnosis, something that seemed to have more in keeping with the solving of ‘The Times’ cryptic crossword than with medicine. Such physicians struck me then as being utterly cold blooded; an obscure diagnosis was the thing, communication with the patient or understanding of their concerns was a trivial matter that the GP, who by being a mere GP was clearly a semi-moronic individual, should explain and sort out; great men didn’t concern themselves with trivialities. I found the experience at such a demonstration quite embarrassing; I wasn’t alone in this.

    I was reinforced in this view by reading a more or less contemporaneous account in one of the medical magazines; a concert pianist was produced before a group of students, his history was explained and the clinical signs pointed out. The pianist asked the great man, ‘What is the diagnosis?’ To which the great man replied, ‘I will write to your doctor’. The pianist repeated the question, and got the same answer. The diagnosis, the students were told when the unfortunate had been taken from the room, was Parkinson’s Disease, at that time more or less untreatable, a rigidity and tremor of muscular action with a poor outlook. The great man had not felt it in him to be able to tell the pianist that his, the pianist’s, career was now markedly limited if not over, his earning ability reduced. If that is what the requirement for high academic success brings, a total lack of empathy, just count me out.

  • Vince

    There is a bit of chicken & egg here. The more that graduates go away the worse the situation is for those left behind – perpetuating the cycle. It has to be said that there is also some mercenary behaviour with doctors signing up with locum agencies rather than working in recognised training posts. Even the Belfast hospitals are finding it difficult now, this year worse than last with next year promising to be worse again.

  • Katyusha

    Seems utterly pointless to me, what next Irish speaking Pilots ?

    ?
    How do you know your pilot isn’t an Irish speaker already?

  • Katyusha

    The ironic thing is, Belfast is a pretty horrible student city. There’s a reason it can’t retain its student population at weekends.
    Whereas Derry is a great city in terms of its welcoming and laid back atmosphere. I love Derry; but I went to QUB simply because they offered the course I needed. It seems pretty idiotic to choose Belfast over many of the other cities in this island solely on the basis of location, especially, as AG notes, Galway, which Derry certainly has the ability to mimic.

    And as FÉ notes below, graduate students are more likely to be more mature about where they study, rather than going to a university simply because their friends are going there.

  • Damien Mullan

    This really does go to the crux of the university status of Magee, given the cut backs of late.

    It’s a no brainer that Magee should be Ulster University’s main campus. It’s hinterland is much more populace than that around Coleraine, given the population of Donegal is 160,000 and the Derry’s urban area has a population of 100,000. Plus, the close proximity of Letterkenny and Derry, creates the equivalent in the northwest of Ireland of the Central Belt Glasgow/Edinburgh axis in Scotland.

    This would obviously have to be worked out in conjunction between the NI Executive and the Irish government, made more complex with Brexit, but it would provide the widest possible educational opportunities for a large population all in close proximity.

  • Conchúr Ó Conghaile

    Funnily enough my father when he was in UCG back in the day doing his medicine degree managed to get a scholarship due to his proficiency in the Irish language. He managed to game the system as he had grown up in An Spidéal

  • John Lyness

    Good idea ! See Swansea, Cornwall, etc and Australian and US med schools etcetc
    Ciotog1600.

  • Hibernia

    With the vast number of irish medium schools springing up across the North, it seems only a matter of equality that we should be able to consult a doctor in the same language of our island. In order to facilitate fully fledged Irish Medium health centres it follows we need an Irish Language med school

  • Old Mortality

    ‘ It is widely said that university regions benefit from the 60-20-20 rule. Sixty per cent of graduates will still be living within 20 miles of their university 20 years later.’
    Not true of the very best universities, with the possible exception of Stanford. Most of the graduates from such places did not enter them to learn a trade.
    This is yet another familiar and depressing argument that throwing more and more public money and inventing more public sector jobs will produce a strong economy. Just another indoor relief scheme for dear old mendicant Derry, A much better idea would be to encourage more people to leave the place and find productive employment elsewhere.

    ‘And the skills do not come any more important for our society than producing more doctors.’
    As opposed to the skills that might be required to create the businesses that generate the income which pays the taxes out of which doctors are fairly generously remunerated.

  • SeaanUiNeill

    NUI, Galway has a bi-lingual campus. Their Scoil n nEilaíochtaí Sláinte teaches bi-lingually I’ve heard.

  • SilentMajority

    ‘Just another indoor relief scheme for dear old mendicant Derry,’

    Typical bias comment representative of why this place has had problems. You should explore the reasons for this and why you have such thoughts. In a sense the whole of NI is a ‘indoor relief scheme’ paid for by the UK tax payer but this is not allocated equally and hence what you view as ‘old mendicant Derry’ is only a place with dignity asking to be treated equally.

  • Brian O’Neill

    Who teaches medical students? Do they need to be part time medics or just academics? If medics are they not hard to get as they are busy raking in the cash in practice?

    I hear Queens finds it difficult as it is to recruit staff for their medical school. A big question is can Magee actually recruit the staff to man such a school? I don’t know the answer. Can someone enlighten us?

    Also you can’t force medical students to become GP’s. I don’t see how Magee will have any more success in churning out GP’s than Queens does. Being a GP is not an attractive career for medical students. until the Government sorts out the crisis in the GP service no amount of medical school will fix the problem.

    I am a big fan of Derry / Londonderry but I can’t help thinking this is just another example of unnecessary duplication. Like the old St Marys / Stranmillis teacher training college debate. It could be an expensive folly.

  • Pete

    In my experience, in the preclinical years, teaching was done by academics.

    In the clinical years, teaching tended to be done by clinicians. Teaching was less “structured” in the clinical years, and the onus is a lot more on the student to learn for themselves. In terms of actually running the courses/medical school, I imagine that tends to be done by clinical academics.

  • 05OCT68

    Where is your evidence that Derry is a cold house for protestant students? The hall’s on Duncreggan road & Strand road are in areas that would be considered neutral. Student land around Park Ave again is just that, student land. My daughter studied at Queens, she was accepted to Magee but she wanted to study away from home & be only two hours from home. There must be students from Belfast for example who would want the opportunity to study away but still be close to home.

  • 05OCT68

    Mendicant indeed & to the great shame of those those who administered NI for nearly a century. There are those in our city that would argue that we only had a road to Belfast to get the bands up for marching season, what other reason would you want to go to Derry for? As for skill required to create businesses you do know that pharma companies sponsor scholarships, & research at other medical schools, material sciences have seen advances as a direct result of cooperation between medical & engineering departments. See the auld “Derry’s great but it’s while far away & sure (insert any excuse you like)” bollix is not washing anymore. Mendicant? Derry needs to stop putting the hand out & start ripping the arm off.

  • AntrimGael

    Can I add tuppence without meaning any offence. Derry suffered a lot and has every right to be pissed off and angry BUT could I suggest Derry people start taking the chip off the shoulder and STOP blaming EVERYONE from Belfast for what happened to them? I have worked and played football with fellas from Derry but My God they took offence very easy and could whinge for Ireland.

  • 05OCT68

    I blamed Derry’s plight on an indifferent administration based in Belfast. I forwarded no opinion of Belfast citizens. You however forwarded an opinion of “Derry fellas”. You didn’t add to the discussion in fact you confirmed a stereotype held by many in our city.

  • Old Mortality

    From the post, it seems that the idea is to churn out doctors to work in the locality, not undertake advanced research of the kind that might interest the pharmaceutical industry.

  • Theelk11

    Again without offence I worked there for 10 years, absolutely loved the place and the people but I’ve never been anywhere with more half empty glasses…..despite the local populace being fit for a drink or two.

  • doopa

    Any stats on the proportion of people in Queens Medicine who already graduates? Seems odd given that they could complete their medical training much faster elsewhere? Nottingham offers a 4 year graduate entry program for example.