Postgraduate specialist training at the Fiji School of Medicine: what do the students think?

Introduction: Postgraduate specialist training was established at the Fiji School of Medicine in 1998. Since then, most students who have earned a one-year specialist Diploma have not completed a Masters, and many have since migrated overseas, or entered local private practice. Because the retention of Masters graduates is much higher, it is important to understand the reasons why so many students have dropped out, and whether interventions could be put in place to improve Masters completion rates. Methods: Semi-structured interviews were carried out between 2004 and 2006 for 36 out of 66 Fiji doctors who had trained to the Diploma level or higher by 2004. Nine senior consultants were also interviewed. All were asked to describe their experiences and impressions about postgraduate training in Fiji. Results: Feelings about the postgraduate programs were mixed. On a positive note, many felt they had learned a great deal and developed further as doctors because of the programs. Others expressed disappointments about under-resourcing of teaching, unsatisfactory clinical supervision, and distressing levels of conflict between their duties as a clinician in a public hospital and academic expectations. Many dropped out because of a combination of heavy clinical and academic workloads alongside disappointments about various aspects of the course. Discussion: The postgraduate programs at the Fiji School of Medicine hold considerable promise in helping to meet the specialist workforce needs for Fiji, but more attention needs to be paid to how to retain more enrollees through to Masters graduation. Attention to improved clinical supervision in the hospitals, ensuring manageable clinical workloads, and trying to avoid conflicts between academic and clinical expectations may help more students to continue through to graduation