Dr. Salem Beshyah,
PhD FRCP
Consultant Endocrinologist,



A response to this article :click here


Dear Colleagues and Friends,

I am not of the habit of responding to posts on the net.
However, I found myself obliged to do so. I apologize for responding in English


(the reason being that the laptop I am using is not enabled to write it in Arabic easily). There are a few points that are worthwhile discussing here and now though if we do this elsewhere, people can only laugh at us.

1. By Libyan Laws and regulations INTERNS, HOUSE OFFICERS,
JUNIOR HOUSE OFFICERS or what ever name you call them are DOCTORS and Not STUDENTS. We are all students of medicine and only those who plan to retire can stop being a student (I have been a student of medicine since 1974; but I have passed my medical schools exams in 1980). However, if we return to the Technical definition of a doctor and a student and applied to our Interns, INTERNS ARE DOCTORS as they have passed the qualifying exams and they are registered (in the UK and USA and supposedly in Libya as doctors and they are classed as such and they use the
pre-nomial title(Dr.) like the rest of the members of the medical profession and they enjoy the privileges that are only available to doctors such as certifying the deaths, helping in surgical operations and prescribing drugs
etc. Such privileges are traditionally and historically those of doctors only.

Should Interns be students, there is no need for them to pass the exams to move from fifth year and to the internship year. There are places that treat interns as
students. In Libya, we have chosen to follow the UK model and this has been in force since the graduation of the first group of home grown Libyan doctors in Benghazi.
When I was an intern, my monthly salary in 1981, 150 Libyan Dinars to compare this to the current payment in question you need to translate it into USD dollars at 1980 exchange rate and allow for the lower cost of living then. An
Italian made bed room suite costs only 750 Libyan Dinars and my first ever car with (air conditioned Honda civic II costed my late father 2150 Libyan Dinars.

I leave the rest for you to calculate depending on your interests. Over and above all of this we really had agreat time working for people like Ibrahim Sherif, Mohamed Abu Baker, The late Abu Baker Mansouri and others in Medicine and Mansour Benhalim in Pediatrics and many more in many specialties.


2. "Students" vs. "trainees": some people (mainly lay but evidently some professionals too) do confuse the words.
In all professions (medicine being no exception), in-service training is a well established status. "Doctors in training" is a description for all grades of doctors being trained to become specialist or consultants. However,
these people are responsible professionals and they offer services though they are being supervised by "fully trained doctors who are capable of working independently". Once doctors are fully trained they are capable and are eligible of practicing independently in both public and private practices. The duration of such training periods are different in different health care systems. Traditionally, the longest training periods are in the UK system.

3. The fact that we are arguing points like 1 and 2 above
reflects the chaotic status of higher medical training in our country. Producing doctors is very expensive business and extremely serious business
too. I have therefore a few points that I wish to raise:

3a. We should only produce enough doctors for the needs of
our country (+/- 10 percent allowing for natural loss. 3b. Medical schools should recruit the right number of medical students and should compete amongst
themselves to recruit students of the highest caliber so that they will have pride in graduating "employable" doctors by setting the best curricula and by implementing these curricula with the highest academic standards
3d. Medical schools must liaise with the hospitals so that the latter can accommodate these graduates for their internship year of practical training. The medical schools have a joint responsibility with the hospitals and ministry
of health that the internship year eventually produces and emergency-safe doctors who can compete for higher training programme at regional, national and
international levels. This can only be possible by creating a mentoring system throughout the years of medical school education and particularly in the immediate periods after graduation to foster professionalism and increase the awareness of these young people about the opportunities for training locally and further a field. This may require that students should be encouraged to undertake elective programmes away as part of their final year (between 4th and
5th years) or alternatively during the internship years. This requires that the schools build bridges of cooperation formally and informally with the outside world and encourage
students to make use of all available opportunities. Students must be supported to obtain sponsorship for such extracurricular activities (of fairly competitive basis and not on WASTA or family/tribe favoritism).
Sources of unrestricted sponsorship may include private and public funds or special charities.

4. With a country like ours, having qualified doctors after
their internship year not even capable receiving basic training programmes in their chosen or needed specialties is really embarrassing. Many of these doctors are roaming around as UNPAID CLINICAL ATTACHEMENT in our own hospitals
is a shameful situation. All these doctors can be easily absorbed into in-service training programmes to cover the immediate and long term needs of the national health services. This is a more important agenda item to be
considered rather than facilitating entry of doctors from other countries or building hospitals for Libyans to be treated abroad by Libyan funds.

I know it was long response..... I am sorry for this I wish
our younger colleagues all the best in their endeavor for higher specialist training and self-accomplishment as successful physicians and surgeons to serve our Libyan men, women and children and help ease the suffering of humanity
worldwide.

Kindest regards


Salem Beshyah,
PhD FRCP
Consultant Endocrinologist
beshyah@yahoo.com