Prof Jim Finucane with the winner of the James Finucane Prize in Medicine Dr Ameer Adrian Al-Arrayed, Bahrain
Outgoing Chairman of the Department of Medicine at RCSI-Bahrain Prof Jim Finucane tells Dara Gantly what’s striking about the Bahraini university is its similarity to its parent medical school in Dublin.
The graduates of 2013 have been conferred with their medical degrees and are waiting to hear back from hospitals on their offers of internship. And while they are about to take their first steps on their career paths, the academic staff are busying themselves for the next round of student interviews for the autumn intake. Such is the constant flow of activity at most medical schools, and RCSI-Bahrain is no different, according to the Chairman of its Department of Medicine, Prof Jim Finucane.
Indeed, one of the striking things about RCSI-Bahrain — a constituent university of the College of Surgeons in Dublin — is just how similar the institution is to its Irish counterpart, he explains.
“Essentially, we reproduce almost 100 per cent what goes on in Dublin,” said Prof Finucane, who is coming to the end of his five-year stay in the Gulf State. “It is exactly the same curriculum; the exams are exactly the same — at least the written exams are — and they are held at the same time. The external examiners in the clinical disciplines are also the same people, insofar as is possible. So really we are reproducing what goes on in RCSI Dublin here in Bahrain.”
Medical graduates from the College are awarded the degrees of Bachelor of Medicine, Bachelor of Surgery, and Bachelor of the Art of Obstetrics (MB BCh BAO) of both the National University of Ireland and of RCSI Bahrain. In addition, they receive the Licentiate of the Royal College of Surgeons in Ireland (LRCSI) and the Licentiate of the Royal College of Physicians of Ireland (LRCPI).
Retired fully
Speaking to IMT from his office in Bahrain, Prof Finucane explained how he had been retired fully for two years from this post as Consultant Physician/Endocrinologist at Beaumont Hospital when the then President of RCSI-Bahrain Prof Kevin O’Malley approached him and a number of his colleagues to become Department Heads. In his case it was the Department of Medicine, with Prof John Murphy and Prof Niall O’Higgins becoming Chairmen of the Departments of Obstetrics and Gynaecology and Surgery respectively.
“It was supposed to be for two years, but like everyone else here, I was very happy and was asked to stay on. So I am finishing up in a couple of weeks’ time after five years.”
Prof O’Higgins left Bahrain approximately 18 months before and was replaced by Prof Martin Corbally, while Prof Andrew Curtain took over from Prof Murphy about six months ago. However, the three foundation Heads were back in Bahrain earlier this month for the conferring ceremony and the presentation of three new prizes for the best students in each department: the James Finucane Prize in Medicine, the Niall O’Higgins Prize in Surgery, and the John Murphy Prize in Obstetrics and Gynaecology. “Maurice Manning [NUI Chancellor] said to me, ‘you must be one of the few people who has a medal named after them while they are still alive’,” said Prof Finucane, with a smile.
Of course, the College is on a smaller scale to Dublin. With just three faculties — Medicine, Nursing and Research — RCSI-Bahrain does not teach dentistry, physiotherapy or pharmacy, although further expansion has not been totally ruled out. “I know that it has been on the horizon at some stage in the past, but nothing concrete has happened in that respect. But I think there would be a demand for these other disciplines in future,” commented Prof Finucane.
Naturally, the student numbers reflect the fact that the College has just three faculties, but including nursing, the student population would be in the region of 2,000. “The majority of the nursing students are Bahraini, and about 40 per cent of the medical students, but there are 40 other nationalities represented in the medical school at various stages,” commented Prof Finucane. So of the 63 new doctors who were conferred with their medical degrees this month, just less than 30 of these are Bahrainis.
Student numbers
Expanding the student population is already in train. While 63 graduated from medicine this year, the incoming class to senior cycle 2 has 95 students. “I’m currently involved in interviewing potential students and for the 130 places already this year we have had more than 700 applicants — and there is plenty more time to come. They are really of a very high standard and would be acceptable anywhere.
“And I think — without wishing to blow our own trumpet — that the caliber of our graduates to date is higher than anything coming from any of the other schools in the Gulf area.”
Many of the university’s international students would be from other Gulf States like Saudi Arabia and Kuwait, but a significant number are also from North America, particular Canada, and many will now be returning to their country of origins to take up employment.
The University is staffed in the main by academic and administrative personnel from Ireland and Bahrain, with clinical tuition provided in the King Hamad University Hospital and other healthcare facilities of the Ministry of Health and the Bahrain Defence Forces Hospital.
According to Prof Finucane, the teaching is undertaken by between 35 and 40 clinicians whose primary place of work is in the three hospitals affiliate with the College. These would mainly be local Bahraini doctors, although there is a strong contingent of hospital consultants from Egypt and other Gulf States.
Of course, Bahrain is not Ireland, and Ireland is not a country still recovering from serious civil unrest that first broke out in February 2011. The vast majority of protesters over two years ago were Shia Muslims who, despite being the majority of Bahrain’s population, have resented being politically marginalised and being, in their view, discriminated against by the ruling Sunni Al Khalifa family.
In the resulting response to the protests — which the Bahraini government’s own independently commissioned report, the Bahrain Independent Commission of Inquiry (BICI), determined was excessive, with reports of widespread torture of detainees — many of the hospitals associated with RCSI-Bahrain were the location for documented human rights abuses.
Non-sectarianism
The RCSI accepts that there has been a “polarisation” of the medical profession in Bahrain, and indeed in Bahraini society generally, but stressed it has been doing everything possible to overcome this by providing medical education in a “strictly non-sectarian environment”.
Prof Finucane is resolute on this point. “I have not been aware in the five years I have been here of a single incident of a sectarian nature that has affected the student body. It just doesn’t happen. I’ve never heard or seen anything like that.
“There is absolutely no discrimination in terms of students attending the three hospitals: we are never asked is this person Shia or Sunni. There is no notice taken of that whatsoever. And they have absolutely free access to all three hospitals. There is no question of them being discriminated against on sectarian grounds.”
Prof Finucane accepts that sectarianism can become an issue further along for doctors when they are seeking employment. “It is often stated that this is on the grounds of security, which isn’t further explained.”
Yet he emphasised that over the previous three years the College had not had a single graduate who did not get an intern job, whether that was in the Kingdom of Bahrain or abroad.
IMC accreditation
Meanwhile, international accreditation — from the Irish Medical Council — was first requested by the RCSI in 2010, and the Council had been due to visit in April 2011 — just two months after the start of the unrest. The Council has yet to send an accreditation team to the Gulf and says it has no plans to do so in 2013.
Prof Finucane would like to see the Medical Council come out and accredit the university as soon as possible. “We are in a position to compare ourselves with the same evaluation criteria as in Dublin, and our results are just as good, and that is through all the cycles,” he said.
He believes the lack of accreditation could pose difficulties. “I think our graduates would be in a slightly anomalous situation if they wanted to go to Australia and somebody at an interview said ‘How come you have got an Irish degree’ – which they have, or two Irish degrees, one from the NUI and one from the RCSI — ‘and yet your medical school is not yet accredited by your own Medical Council’. I think that is an anomalous situation.
“In practice, it may not be that important, but certainly we would prefer to have the school accredited and we would be delighted to co-operate in any way necessary for that to happen.”
Prof Finucane sees RCSI-Bahrain as being a positive influence on the health service in the Kingdom of Bahrain, in that it brings “international educational standards” to the country.
Yet a new report from Ceartas — the independent, non-profit organisation that seeks to promote human rights through legal actions — has suggested that the act of accreditation by the Council could “facilitate” violations of individual rights within the Bahraini health system and support alleged acts of torture and other forms of cruel, inhuman or degrading treatment or punishment that it says continues to be reported at the Bahraini hospitals affiliated with the College — acts that should be investigated as part of any impending accreditation visit by the IMC.
Commenting on the report from the Irish Lawyers for Human Rights group, Prof Finucane said many of its findings “puzzled” those at the College — particular the allegations of continuing ill treatment or torture of protestors or prisoners in the hospitals. While he would find himself in one or another of those hospitals every day of the week, he had never seen anything nor heard the remotest suggestion that once the troubles finished in the spring of 2011 that such instances reoccurred.
“I have just met a young doctor who qualified a couple of years ago; he was one of our best graduates. He spent the past 12 months in the Emergency Department in the Defence Forces Hospital, and I said, ‘Look, this allegation has been made’. He said that is total nonsense. He replied: ‘If there was anything at all like that, they would have to come through my department and I can tell you I have not seen anything remotely that would support that in the last 12 months.’ So I would love to know what the evidence is for some of these allegations.”
Shia-Sunni conflict
He added that the Shia-Sunni conflict had been ongoing for 1,300 years, or “300 years before Brian Boru took on the Vikings in Clontarf”.
But given our own history, the difficulties of sectarianism are all too familiar to the Irish. Prof Finucane elaborated: “If you go back 30 or 40 years and you went to the Adelaide and you said ‘My name is Seán Ó Loingsigh, can I have a job please’, you would have been told what to you.
“But such sectarianism has never surfaced here between the student body or the staff, and the good thing about it is that I wouldn’t have a clue whether somebody was Sunni or Shia.”
Prof Finucane has only a few more weeks before returning home. But he leaves behind him an expanding college contributing significant to a country often in the headlines for the wrong reasons. He also leaves, of course, a student prize to always recognise his contribution to the developing medical school.