Professor Louise Dubras moved to Derry in June 2018 after being appointed Foundation Dean of the Magee Graduate Entry Medical School (GEMS). The collapse of Stormont coupled with the Department of Health’s view that the school did not demonstrate ‘need and value for money’ led to delays.
Finally, in May of this year Deputy First Minister Michelle O’Neill announced that it had been approved and would open in September 2021.
In an in-depth interview with Derry News reporter, Garrett Hargan, Professor Dubras speaks of her elation after discovering the long wait was over, about the hundreds of people who have expressed an interest to date and the wide-ranging benefits that training doctors locally will bring.
She also refutes any suggestion that the school will ever be relocated, talks about the prospect of health science courses moving to Magee to complement the medical school and new build projects in the pipeline which will enhance the learning experience for medical students in the city.
For readers who may not know, can you provide a brief background of your career path before taking on the role as Foundation Dean at the Magee Medical School?
I’ve been a GP for a long time. My clinical background is that I worked in Southampton looking after homeless people for a long, long time. I was lead GP for a homeless service.
From a university perspective, I worked at the University of Southampton for quite a long time and had increasing roles in leadership and ended up running the medical degree programme.
I went from there to King’s College in London where I was the Deputy Dean of Medical Education. We were doing a huge curriculum change in this very big medical school, one of the biggest schools in the country with about 410 students each year. So it was very sizeable and quite a challenge.
Then I became the Interim Dean of Medical Education for nine months and then was ready for a new challenge and that’s when this job came up.
I arrived in Derry in June 2018.
I was really excited about coming here because it was an opportunity to establish something new, obviously with a focus on General Practice. An opportunity to bring my own values to the school and my personal values which have kind of always been about social justice, access and community-based healthcare.
It really aligned with the university’s plans. And that’s me in a nutshell.
What are your thoughts on the city having lived here for two years now?
It’s wonderful, I have felt so welcomed here. I was born and grew up in the Channel Islands, Jersey, and it’s a small community, coastal and I’m kind of used to being in a place where people know other people and I’m used to being somewhere that I can get to the sea. From that perspective I’ve loved it.
But I’ve done things like joining Altnagelvin Hospital’s choir, I’m probably the worst member of the choir, but it’s just been lovely and a brilliant way to get to know people.
I’ve started running, I joined Star Running Club. Everywhere I’ve gone I’ve been impressed by just how much of a welcoming place the city is.
Why did approval for the medical school take so long?
It took a little bit longer than I was expecting. But although the journey was a little bit longer and a bit lumpier than I had anticipated, it’s worth it. I think the outcome is a really great one.
At this month's Western Trust meeting a member of the board said the Department of Health put obstacles in the way. Is that true?
No, I don’t think so. It’s been a very thorough process of working with the university to develop our outline business case. And I think the civil service have a responsibility to make sure that these things are robust. At the point where we submitted our final business case to them in October of last year I was confident it was well put together and robust.
There was time required for them to consider that. And the Assembly was not in place which was an added dimension to the decision-making process because the civil service aren’t in a position to make that level of decision.
So it took longer than any of us expected but with the benefit of hindsight, that was not wasted time.
And the GMC process was ongoing in parallel anyway. They visited us in July last year and we did have to pause the process until such time as we had confirmation of student places.
But once we resumed the process we were able to pick that up fairly quickly.
A little bit longer but I wouldn’t say there was deliberate obstruction at all.
How did you feel when it finally got over the line?
Oh goodness, delighted. The announcement by the Deputy First Minister in May of our places was just so welcome and then the confirmation that we had by the end of June was equally, each step has been fantastic.
But the one that made me feel most excited was the point where the GMC gave agreement that we could recruit staff and students. That was the most significant for me when our external regulator said it was happy for us to progress.
There is some fear in the city, which has been highlighted by local councillors, that the school could be moved given the history of courses being transferred to other campuses. Are there any guarantees that the medical school will not be moved to another campus?
I don’t think there’s any question about that, Garrett.
How many applications have you received so far for the course?
They all go through UCAS and we don’t know how that is going until various UCAS deadlines are passed.
This morning we had the first of a series of webinars with people who are interested in studying with us. We had 100 people on this morning wanting to know about the programme.
We’re running a test centre for The Graduate Medical School Admissions Test (GAMSAT) and we filled up our places within a week. There is a real interest in coming to study with us.
Has a date been set for the GAMSAT?
There are two opportunities, one is usually September and the other March. We became registered as a GAMSAT centre as soon as we got the go-ahead to recruit students.
Because it’s an Australian company that runs GAMSAT, it’s the kind of gold standard for anyone going in to graduate entry medical school courses.
Our September/October sittings are full and they will release the dates for March and as soon as those are released people will be able to register.
But in order to apply, people don’t have to have taken GAMSAT in those dates.
There’s a two-year grace so if someone did it in 2019 they would still be eligible for our first round of applications.
You’ve pointed out that it is not a post-graduate course or limited to people with medical qualifications, but open to anyone with a 2:1 degree. What fields have applicants come from so far?
The beauty of our programme is that we don’t limit it to people with bioscience backgrounds. My experience working with students on other GEMS courses and also the experience of our partner medical school, St George’s in London, is that there’s a real mix of prior backgrounds.
You might have people coming in who’ve got Masters of even PhDs in biomedical related subjects but equally I’ve worked with people who’ve come in with degrees in music, who’ve been geography teachers, lawyers, and the interesting thing about graduate entry medicine is that we teach it; students work in mixed groups so you’ll find you might have somebody with an English degree working with someone who has a Masters in mechanical engineering or a BSc in biomedical sciences and actually they all learn from each other and are all engaged in that journey.
And the people who are non-bioscience in background learn fast and by the end of the first year they are all at the same level and all really benefited from that diversity in backgrounds.
At this stage would you know anything about the geographical spread of applicants?
We have a database of about 350 people who have been interested in following the programme and have probably been in contact with us for about three years.
They’re fairly widely dispersed, quite a lot of them are from NI and spread out here. Some expressing interest from GB and other international students but there’s a limit to the number of international students any medical school can take.
That’s set by the UK government because of the way clinical placements are funded and also going into the foundation programme to become fully registered with the GMC.
There’s a cap on medical courses partly because of what it costs to train doctors but in addition to that it’s about the capacity of hospitals and general practices to take those students.
We’ve got lots of interest but limited to what we can do internationally.
What specific facilities do you need in order to provide the type of first-class course you envisage?
We have a building identified for refurbishment. We will have students on campus for their first year and part of their second year. After that they’re largely out on clinical placements and coming back to campus for certain weeks, tutorials and so on.
The estate plan is comprehensive to accommodate those students and we’ll be providing them with a range of resources; rooms for learning anatomy, for learning clinical skills, communication skills as well as standard tutorial rooms.
Do you have those in the current buildings at Magee?
Is the aim to still have a new building along the riverfront (artists's impression below)?
Absolutely yeah, we still intend to have our new building but we have the wherewithal and are ready for first intake on the campus.
Would the theory element of the course be taught there once it’s ready?
That would be the expectation, yes.
Is there any timeline that you’re aware of for that?
As you know, the funding for that is within the City Deal process so there will be the standard contractual stuff that will go on. But we have space on the campus to not be pressured for time and ultimately our new build has to be right. It’s not like we’re going to have to move out within a particular timescale.
Seventy students have been agreed to begin with a view to increasing that to 100. Are you confident it will be increased to 100 and in what timescale are you looking for that to happen?
There are ongoing discussions with the Department for the Economy. In our business case we had a sense of how we want to grow year on year but we’re certainly happy to be delivering 70 doctors a year because that is a substantial addition to the Northern Ireland medical workforce.
Does Ulster University have enough experience and expertise to supervise the medical school at council level?
One hundred per cent, absolutely. You’ve heard us talk about the rigorous GMC quality assurance process and a lot of that process is about testing out with us, in a very robust way, a whole range of things that include senior level governance, support, commitment, resources; so the GMC wouldn’t be permitting us to progress if they weren’t confident in the university’s ability to deliver this.
Can you say anything about the plans for on-site teaching facilities at Altnagelvin that were mentioned at the recent Western Trust board meeting?
We’re at an early stage of those conversations and obviously we’re working in a partnership with the Trust and we’ll be having conversations with them and with our colleagues at Queens University Belfast. So it’s early days yet with that.
Were these plans included in a business case that has already been submitted?
Oh yes, it’s costed. Absolutely.
Was it with the department of health because a number of departments have said they have no knowledge of it?
I can’t remember the details about which department, it was included in the capital requirements within the City Deal.
Should health science courses (Physiotherapy, Occupational Therapy etc) move to Magee to complement the medical school and build upon that positive progress, and would you like to see them come?
As you know there’s been a consultation on the future location of those courses which has been paused because we’re running a full equality impact assessment. So we’re aiming to resume that shortly. I think from an educational perspective, the more health professionals you are able to educate in the same place the better.
Do you think the medical school approval will aid that case?
I think it’s a significant element.
Are you confident it will happen and are you personally pushing for that move?
It’s subject to consultation, Garrett, so I can’t pre-judge the outcome of a consultation. But you’ve read the consultation document so you know that that’s the university’s preferred outcome (relocating courses to Magee).
What do you think about a cross-border university named in honour of John Hume that would link UU Magee, the Institute of Technology in Letterkenny & Sligo and North West Regional College (NWRC)? It has been proposed by the Irish government’s Higher Education minister, is that something you’d be supportive of?
I think we have to recognise the impact of John Hume as a politician, peace maker and honorary graduate of the university. So John Hume had immense impact and I think we are very keen to work with the Hume Foundation to recognise his contribution in whatever way is most appropriate. And of course, as you know, his daughter is a GP locally so I think commitment to health and social justice are all things which align very much with my own personal values.
We have a very strong working relationship with our colleagues at the Letterkenny Institute of Technology, with North West Regional College, so I think from my perspective, the university is going to continue to deepen those working relationships.
Student numbers have dropped at Magee every year since 2015. Does the university have to show that it is committed to the campus by delivering on long-promised expansion to 10,000 students?
I think the mere fact that the university is committed to the school of medicine and training of doctors in the city is evidence of its commitment.
Are you aware of a wider strategy to deliver on that promise?
I don’t think there’s any doubt about the university’s commitment to the city, as I said, certainly in terms of training doctors, we’ve already talked about the university’s preferred outcome for the health sciences consultation so I think there’s absolutely no doubt about the university’s commitment.
I'd imagine you have a busy year ahead, what has to be done to ready the school for students in the coming months?
As you can see from the university’s marketing material and my tweets and so on you’ll see that we’re actively marketing to recruit students. And we’ll continue that with webinars, we’ll be running the GAMSAT test in October, we aim to run our interviews in January//February of next year whether they are in person or virtual because of COVID. That will be us progressing student recruitment.
Then there is staff recruitment which is due to go out in the next week or so. We have a recruitment strategy to get all of those people in post in time for the first students.
There’s the building refurbishment, there’s procurement of our virtual learning environment and various other bits and pieces.
So, you’re right, there is plenty to keep us out of mischief.
Looking to the future, what will the course bring to the city, and ultimately when these students are able to graduate, how much will that mean to local health care?
My goodness, there are so many benefits. One is that we know from really good research over time that if you train doctors locally they stay local. And will often choose general practice as a career.
What it can do for the city first and foremost is, it will grow our health profession workforce. Second is, there is also a huge opportunity to improve morale amongst the workforce who are currently here because they can see real benefit in brining on the future.
There’s nothing more exciting than actually working with medical students because they’re amazing people and you know that they’re going to make brilliant doctors.
The third thing is that there’s a real opportunity to improve recruitment anyway, because people like to come to places that are involved in medical education.
And another benefit is the fact that medical students don’t just stay in their university, they like to get involved with the local community through classes and societies, so they will often run resuscitation training courses for kids in schools, they might work with a range of community groups doing volunteering. So I think everywhere you turn you would see real benefits to the school the medicine and these students in the city.
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