Photographer:Fotograaf: archive Observant
Riyadh stops sending medical students
MAASTRICHT. The Saudi Arabian government has decided not send any new medical students to Maastricht this year. Whether this also applies to the coming years is not clear. The main problem: the Saudis are against internships outside the Netherlands. The Faculty of Health, Medicine and Life Sciences, however, feels that this is necessary. Negotiations are taking place at the moment “to find a solution that will suit both parties,” says professor Geertjan Wesseling, co-ordinator of a special taskforce. He believes that the matter has nothing to do with the Saudi’s anger towards the Netherlands about actions carried out by Geert Wilders.
Saudi Arabia has been financing the so-called King Abdullah Scholarships (KAS) since 2007, for medical students who come to Maastricht and Groningen. The number was to be forty students annually for each of these two cities, and that for seven years; unfortunately the numbers were seldom or never reached. The students initially receive a one-year pre-medical training at University College, with an emphasis on English and biomedical basics such as biology and chemistry. The entire programme is in English in Maastricht and that is exactly what bothers the Saudi government, especially because the internships are abroad. The faculty organised these because the Saudi students cannot do internships in the Netherlands with Dutch-speaking patients. The Saudi government, however, sends the students to guest countries with a more than adequate scholarship, with the idea that they will not only learn a profession but also become acquainted with the language and culture. There has been a disagreement on this point between Maastricht and Riyadh for some time now, usually in the form of their representative in Berlin, the cultural attaché at the Saudi embassy.
This has now led to at least a temporary cancellation of the contract.
The faculty has been struggling with the Saudi students for a while. So far, this only reached the public in dribs and drabs; in general reports about the Saudi students were understanding and positive. At the party thrown by the faculty for the first – and until now only - graduates, four women who are now “doing very well in their own country” (Wesseling), to celebrate the awarding of their bachelor’s diplomas in 2010, there were no signs of discord whatsoever.
Nevertheless, the problems were there from the beginning, says Wesseling. To such an extent that slowly but surely “there was a risk of a negative atmosphere surrounding the Saudis”.
In the middle of 2013, this led to what is believed to be an alarming report by the then Director of Medical Studies, Ton de Goeij, which was carefully kept secret up until now. His appeal for help resulted in the creation of the taskforce headed by Wesseling. He was to solve the problems and formulate a long-term policy. Wesseling: “The Saudis have poorer study results compared to regular students. We have therefore raised the requirements in the preceding ‘pre-med’ training at UCM, and this will be taken even further. Their attitude is another issue. They stay away more often, from tutorials, from the Skills lab, even from exams. Group participation and complying with agreements, are a problem too. We didn’t respond adequately to matters. We should have given them a proper talking-to. They also complain a lot, even behind our backs, directly to the cultural attaché in Berlin. About timetable changes, test results, everything. This was another reason for their government not to send any pre-med students this year.”
A lot of things also go wrong in the master’s phase, during the internships. Wesseling: “That is the litmus test for a student. That is where you are really assessed on what you can actually do. Your subject-specific knowledge, your language skills, but also whether you can hold up as a person, or how you deal with patients’ pain and sorrow. We received less than good reports on all those issues from hospitals abroad, including Ireland and the United States.”
But if it is up to the Saudi government there will be no more reports from English-speaking countries, neither positive nor negative. They are demanding internships that are completely in Dutch, at least for the new batch of master’s students. This was the message to Wesseling and rector Luc Soete, both part of a Dutch delegation, some weeks ago in Riyadh. This has put paid to FHML’s plans, because the present situation, one-year internships, is already a compromise; regular internships last two and a half years. These have been partly replaced by more clinical courses in Maastricht.
Wesseling: “My interest lies with the students. A year is too short for decent clinical education. So far, they agreed to it but don’t do that even now. They also have different ideas about it: if you sit on a stool as an intern and observe the doctor, they feel that that is enough. We think that it is important that you are more hands-on with the patients.”
Are there any alternatives? One could revert back to what was once the point of departure: the course being given in Dutch. “The faculty is currently discussing the subject,” says Wesseling. The master’s programmes in Groningen, so including the internships, are in Dutch. Vice dean of education in Groningen Jan Borleffs says: “we are not dissatisfied with this”. The language requirements for Dutch have been made more challenging, “the standard needed to be admitted to the master’s programme is very high, just like for other foreign students who come here after doing an international bachelor’s”.
But Wesseling doesn’t believe it can be done: “It is just not possible to acquire language skills at a level that is high enough to work with Dutch patients.”
Another option is students doing their internships in their own country, Saudi Arabia. But that goes against the whole idea behind the KAS scholarship programme. What remains, says Wesseling, is “not to have contact with patients during the study. Then you would have a thinned out version of the doctor’s exams, a kind of remote course, meaning we would also have to request new accreditation.”
It is hardly a realistic option, that much is clear. Wesseling is still hoping he can change the Saudi’s minds. We are not looking for a conflict because the faculty also has other interests in Saudi Arabia. There is contact with medical faculties in Jeddah, Qassim and Jazan, for which Maastricht makes block books, professionalises lecturers and in general works on capacity building. The curriculum, along with supervision, has already been sold to a new medical faculty in Bukayriah. “So we would prefer not to have a quarrel,” Wesseling confirms.
In the meantime, he and his reinforced taskforce are busy carrying out improvements. Stricter selection of students both for the bachelor’s and the master’s programme is on the agenda. The attitude problems are being dealt with by monitoring attendance and participation more closely. If things really get out of hand, the Saudi cultural attaché in Berlin will be told and he will then speak with the students. “This has already occurred on a number of occasions,” says Wesseling. If there is no improvement, it will even be possible to have the scholarship discontinued. Things also have to be done in the faculty: lecturers have to improve their English, more knowledge and skills in the field of cultural differences.
The faculty is already diversifying. The Saudi programme is slowly growing towards becoming an international study of medicine, which also attracts other foreign students. There are already students from Kuwait and Oman. Would it be so terrible if Saudi Arabia were to stop sending new students completely? At the end of 2012, the Nuffic magazine Transfer wrote: (stopping the influx) ‘won’t make much difference to the UM’. The quote came from dean of medicine Scherpbier: “We made these choices based on content. We are not going to change things because of financial reasons or the Saudi’s cultural wishes.”’
Wesseling agrees: “I think it is important that we continue with a medical programme in English. Even if this means no students from a particular area.”