Kigezi International School of Medicine (Graduation 2004)

Wesley Church - Cambridge, England - 22 May 2004

Dr Hansing, our President , Dean Message, Distinguished Guests, Members of the Faculty, Colleagues and Friends,

First of all, congratulations to all our new graduates.
Congratulations to each and every one of you.

You should be proud to have completed the challenges of our International MD Programme and to have studied medicine on at least three continents.

You should be proud that you have achieved our School’s standards, which are the same high standards required of all physicians practising in the US.

You should be proud that you have made your commitment to the highest standards of medical practice.

We do not compromise on our School’s standards. You in turn must never compromise on the standard of care you give to those who entrust themselves to you.

With this pride you need humility.
Humility to recognize that graduation is just the start of your medical career.
Humility to recognize your medical education continues throughout your life.
Humility to seek help from your colleagues, your sisters and brothers.

You have all committed yourselves in public by reciting the WMA’s Declaration of Geneva both to serve humanity and to serve the needs of each individual patient. Some 80 national medical associations representing millions of physicians worldwide share these principles.

To do good
To do no harm
To be faithful and truthful
To keep your patients’ secrets
And to be just to all.

These are all enshrined in the public declaration you have given.

They must be internalized as your conscience, to act as a compass in the good and the difficult times ahead to enable you to make the right judgment for your patients.

You are joining a profession that is trusted by patients and by the wider public.

That trust has been earned over centuries, it needs to be renewed and earned by each one of you.

In his study on patient safety in care and research, the WMA Fellow Dr Mike Magee showed that there has been a fundamental shift in the patient / physician relationship away from an authoritarian and paternalistic model towards partnership and team approaches. In the six developed countries studied, trust in physicians was very high whichever health system was in place.

You need to earn the trust not only of your patients but also the trust of your colleagues.

In the Declaration, you have asserted that:

“My colleagues will be my sisters and brothers.”

This has recently been distorted to infer, in the immortal words of the Immediate Past President of the UK’s General Medical Council, that we were a “cosy club” , a self-serving clique, a conspiracy against the laity - but it is the reverse.

This trust is a must.

You will already have witnessed the importance of teamwork, the interdependence of the wide variety of primary care, medical and surgical specialists and their clinical teams.

It is the trust in the competency of your colleagues, trust in their skills, and above all in their judgments based on the values we all share, that is fundamental to the highest-quality care of our patients.

There will be many pressures on your practice of medicine – pressures from your patients, pressures by your employer, third- party payers, and from different sections of the community for you to abandon your values to accept second best, to accept bribes, and even to kill people. Only if you have sold your professional soul will others realize what a danger you have become to your patients.

So beware !

There is indeed a worrying trend in the UK. In contrast to the USA and Canada, Dr Magee found in his study the greatest variance in “attitudes” between patients and physicians exists in the UK in the physician’s choice of treatment and their appointment scheduling for consultations. Pressures are for physicians to conform to the expectations of what the State system is able to provide rather than the needs and wishes of their patients. This disturbing trend in the UK needs to be reversed. It is the patient’s interest and safety that should be the top priority in the doctor’s mind, not the political system of providing care.

Brotherhood and sisterhood does not tolerate any cover-up of medical errors.

Patient safety is paramount. Medical “errors” are a significant part of the burden of disease borne by our patients. A tendency to make mistakes is part of the way the normal brain functions. This needs to be recognized and processes put in practice to anticipate errors. Listening to the views of your patients and those of your colleagues helps prevent mistakes.

You have a duty to recognize this propensity both in yourself and in your colleagues so that those who put their trust in you and your colleagues are safe.

But today we must celebrate.
Celebrate your achievements.
Celebrate your commitment.
Celebrate your future career in the service of humanity and your patients – there can be no more rewarding journey to have embarked upon than a career in medicine.

Good luck and God-speed each of you on your own way.