Volume 15 • Issue 01 • May 2003
Editorial
This issue of the Malta Medical Journal is the first since
Malta committed itself to full membership of the European
Union. In our previous issue the pros and cons of accession to
the EU with respect to the Medical Profession were thoroughly
discussed in two invited articles. The areas covered included
freedom of movement, mutual recognition of professional
qualifications, specialist accreditation, working conditions and
social security issues. One aspect of Medical Education that was
not tackled was the potential impact of EU membership on the
Medical School.
In this Editorial I would like to focus on the effect recent
events could have on the role of academic staff at the University
of Malta with particular reference to the Faculty of Medicine &
Surgery, the Faculty of Dentistry and the Institute of Healthcare.
Educators in these intstitutions have been faced with a number
of tasks that they have, in general, tackled with admirable
dedication and fortitude. Lecturing, tutoring and supervising
undergraduates has placed increasing demands on the time and
limited resources (both infrastructural and financial) available
to these academics. The number of students has increased
steadily over the years. As a result, lecturers have found it
increasingly difficult to maintain the same high standards and
excellence of academic and clinical teaching that has indeed
been traditional and characteristic of our Medical School. There
is increasing concern that our young graduates may have an
excellent theoretical knowledge but could lack the practical skills
and the ability to act independently and responsibly in given
situations. Maximising application of their knowledge base in
the best possible manner is an acquired skill that requires
guidance throughout the undergraduate years and in the preregistration years.
However, the duties of members of academic staff extend
beyond ensuring the yearly production of graduates to be
employed locally in various health sectors. The teaching skills
of academic staff members differ. Lecturers need to deliver
factual information while stimulating intellectual activity and
curiosity in students at all levels. Accepted norms and practices
can then be assessed in a structured and informed fashion. Once
instilled into our graduates, this will ensure their ability to
participate in research and development, in the scientific
evaluation of research data and the development of new
concepts and practices without which a University cannot move
forward. The infrasturctural, financial and other support
services that are necessary for academics to fulfil this
commitment to student education need to be examined and, if
absent or lacking, established and improved.
In terms of employment, the vast majority of the lecturing
staff in the Clinical Sciences hold either part-time posts or are
Malta Medical Journal Volume 15 Issue 01 May 2003
paid on a pro-rata basis, calculated on the number of hours of
lecturing or tutoring. Whilst education and clinical practice are
often seen as a vocation rising above above financial gain, lack
of funding does have direct implications on morale and therefore
with regard to the pursuit of academic excellence. Any initiatives
in the field of research or contributions to University affairs eg,
membership of committees, organization of courses or
conferences, is done by highly motivated individuals often after
hours, at the expense of other commitments and with no
financial or other recognition. Indeed conference organizers
often have to wrestle with the quest for funding alone and for a
number of reasons cannot expect assistance from the University
Finance Department. For the majority of academic staff at the
Medical School, attendance at international meetings to present
local research often entails either out of pocket expenses or
finding external sponsors. The reputation and reknown of a
tertiary educational institution such as the University is
dependent on the performance of its graduates and academic
staff in academic fora locally and internationally. This factor
becomes of the utmost importance as we now enter an era where
we must compete with academics from other Universities in
Europe for research funding and recognition. We cannot expect
to participate fully in networks of excellence throughout Europe
if we are only expected to dedicate our time to processing
undergraduates through the mill and to providing clinical
services. It is interesting for example that the concept of
protected time for research and development has not been
adopted at the University Hospital although members of other
Faculties working in their respective areas do have this
possibility.
The autonomous function of the University and the Medical
School is often hindered by budgetary restrictions imposed by
the Ministries of Finance and Education. The University
therefore cannot be seen and cannot function as a nongovernmental organization. As a result, applications for funding
from certain sources may encounter problems. Similarly
interactions with the private sector or industry can be hindered
by certain administrative issues. Should these be overcome,
researchers embarking on projects that involve the formulaton
of contracts with local or international entities have no legal
office at the University to turn to for advice. As a result, contracts
dealing, for example, with intellectual rights or patents are often
not properly drawn up. Significant losses are subsequently
incurred after years of hard work by local researchers who did
not have the appropriate back-up when interacting with
international (and often better advised) partners. At the end of
the day, this translates in loss of revenue for the local University
departments, funds which could be used for further growth and
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development.
It is to be remembered that researchers in the medical field
do not have access to funds from Medical Research Councils,
Trusts, Foundations and Organisations unlike their colleagues
abroad. This dictates that research is oriented of necessity to
low budget endeavours and this may impose certain limitations
on the areas to be studied, the tools to be employed and the
magnitude of eventual outcomes. It is truly a measure of the
excellence, determination and hard work of our academics that
in this setting, research is carried out which can withstand peer
review and acknowledgement in international meetings and
publications.
If in the past so much has been achieved with so little, it
should now be possible to truly establish a research center of
excellence in the medical field that can compete effectively for
funding from the European Union and establish collaboration
on an equal footing with research centers abroad. A certain basic
infrastructure however needs to be established which caters
specifically for research endeavours and postgraduate education
and not for the education of undergraduates. Such a structure
needs to be able to function autonomously within the framework
of the University and Medical School. There is a need to
administer research funds in house whilst operating within the
framework of the Medical School and the Hospital. This
approach gives staff a sense of ownership which can then
translate into effective fund and project management.
Furthermore, our undergraduates receive an excellent tertiary
education which is financially supported and yet they are hardly
ever invited to contribute to research efforts. Their involvement
in research would serve to broaden their horizons and develop
their observational and deductive skills, attributes which are
essential to effective clinical practice. It would also serve to
prepare them for the real world. Other Universities abroad have
effectively harnessed undergraduate enthusiasm, energy and
efforts to the mutual benefit of all. What hinders our institution
from doing likewise?
I sincerely hope that in the coming years, we will see a move
towards a broader concept of medical education and the
function of the Medical School. The new hospital was conceived
with the notion of establishing a center of excellent medical
practice geared and equipped for research and continuing
medical education and professional development. The changes
necessary for the transition from a totally service-oriented to a
service- and research-oriented establishment can and need to
be initiated now. The challenge lies in establishing functional
bridges between the various regulatory bodies, the relevant
institutions and associations and the service providers.
Dedication, vision, expertise, goodwill and courage are essential
prerequisites. Will our Medical School rise to the occasion as it
has so admirably done in the past?
On behalf of the Editorial Board, I congratulate Professor
Godfrey Laferla on his recent appointment as Dean of the
Faculty of Medicine at the start of what promises to be a
challenging and exciting time in Medical Education. We all wish
him a successful tenure as Dean. His vision of the role of the
Medical School in the coming years which he shares with us all
in this issue augurs well for the future.
Finally I wish to reiterate my thanks to the Chairman and
members of the Editorial Board for their hard work and
commitment to the Malta Medical Journal, Mr Hilary Caruana
of Outlook Co-op for his invaluable advice and our sponsors
for their continuing support.
Josanne Vassallo
Editor
SECOND ANNOUNCEMENT
Fifth Maltese Medical School
Conference
4th - 6 th December, 2003
Intercontinental Hotel, St Julians
Call for abstracts for oral and
poster presentations now open
Deadline: 31st August, 2003
The Chairman, The Scientific Committee
Fifth Maltese Medical School Conference
University of Malta Medical School
Gwardamangia MSD 07, Malta
Email: medschoolconf@gov.mt
www.health.gov.mt/mmsc/welcome
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Malta Medical Journal Volume 15 Issue 01 May 2003