We have a shortage of doctors, therefore, we need to train more. According to the Ministry of Health in Samoa, there are about 120 doctors currently working in Samoa.

According to the World Health Organization (WHO), Samoa needs about 200 doctors minimum to cater for the number of people in Samoa, with an ideal ratio of 1 doctor to 1,000 people. So, we need to train another 100 doctors to cater for Samoa.

The Fiji School of Medicine which became the Fiji National University (FNU) has trained about 60 doctors currently working in Samoa, the oldest is about 80 years old and has retired. The output of doctors from FNU is only about 2 to 3 per year now. Only 3 of the Samoan FSM graduates are working overseas in NZ and New Caledonia, and the rest are working in Samoa in our health system in hospitals and the private sector.

Since the beginning of OUM in 2002 and the beginning of the NUS SOM in February 2014, these 2 local medical schools have added more than 50 doctors to the current pool of 120 doctors in Samoa, putting out 7-10 medical graduates per year. The dream of our leaders to set up medical training facilities in Samoa to provide doctors has been realised as I looked at these numbers. We are also now training medical students from the Solomon Islands, Cook Islands, Tuvalu, Tonga, and the Pacific region.

Last year, SOM graduated its first Solomon Island doctor. Several doctors from Tonga and Tuvalu have graduated. The PNG Medical School had graduated about 10 doctors with 9 working in Samoa and 1 in New Zealand. Samoa had stopped sending medical students in the 1990s to PNG due to safety concerns. Otago had graduated over 20 graduates with only 4 working in Samoa. Auckland Medical School graduated 2 doctors, and both are working as senior doctors in Samoa.

 If OUM and SOM graduate 10+ doctors per year for the next 10 years, we will have the 100 doctors that we need by 2033. There are currently about 50 Samoa students in the NUS SOM program and 19 OUM Samoa students in the OUM Program. If all these students graduate as doctors in the next 6 years, we will have another 69 doctors in our workforce. There will be 7 new doctors graduating from NUS SOM at the end of 2023. FNU and other medical schools in New Zealand or Australia could contribute 2 or 3 per year.

The Ph.D. qualification is a research degree, and will not enable a medical academic to manage and treat patients, but a qualification of a Fellow will enable an academic to treat and manage patients as a Specialist, and do research and supervise research as this is part of the Fellow training program.

Publication is also part of the Fellow training in Medicine. I am talking specifically about the clinical Fellow training programs in the hospital in surgery, paeditarics, internal medicine and its specialties, and Obs & Gynae, and not Public Health and General Practice. In the specialization in Surgery in New Zealand, one must have a Ph.D. now to ease the entrance to the Fellow training program as there is a lot of competition to get in. The Surgical Fellow program consists of 2-4 years of study before the Part 1 written exams and oral exams is done to progress from junior registrar to senior registrar.

After 4 to 5 years of advanced training as a senior registrar, depending on the type of subspecialty in surgery one takes, then the senior registrar will sit the Part 2 exams, again written and oral exams, to get the FRACS. The senior registrar is also expected to publish some of their work. In New Zealand and Australia, without getting the Fellow by examination, one will not be able to be called a Specialist or Consultant Physician or a Cardiologist or Endocrinologist, or Surgeon or Paediatrician, etc.

The problem was that no one with a Fellow qualification would come back to Samoa and the Pacific because of better pay compensations in New Zealand and Australia. There are currently only 2 Fellows working in Samoa – Prof Satu Viali and Prof Alec Ekeroma. Samoa has other Fellows in Australia and New Zealand - 3 with FRACS in General Surgery, one in ENT, one in General Medicine (FRACP), one in anaesthesia (FRACA), and one in Obstetrics and Gynaecology (FRACOG).

About 3 or 4 others are working towards the Fellow qualification.  I was one of the first Pacific doctors to get the FRACP in New Zealand, and the demand for my skill level as a Samoan was huge, despite huge financial offers, I returned to serve the Nation. It is a choice now, as I can go back anytime to help the Pacific people in New Zealand and Australia, but the call of God on my life to be in Samoa is very strong despite the many difficulties of staying.

I have done all this work, to show our medical colleagues that we can achieve the best medical qualification in Samoa, and be the best doctors for our people. The colleagues with Fellow qualifications who are staying back overseas, all contribute to our nation in many ways.