Wednesday, October 27, 2021

College of medical excellence taking shape

If your goal is to build a Harvard-type of educational brand, then like the husband-wife team that runs DDT College of Medicine from BBS shopping mall in Gaborone, you necessarily have to be very choosy about whom you allow to darken the doorway of your lecture rooms and laboratories.

“If you look at really good educational brands, not everyone is admitted,” says Dr. Derrick Tlhoiwe, DDT’s Chancellor, citing the famed Harvard University in the United States as an example. “Once you let everybody in, you lower standards and dilute the value of the brand.”

This early in its brand-building exercise, DDT (motto: “Educating for Global Success”) only admits students who got 40 points and above in the Botswana General Certificate of Secondary Education (BGCSE) – dramatic departure from a norm where one too many tertiary education institutions (TEIs) aim for high enrolment numbers over quality of grades.

“Most students with 39 points couldn’t get a place during our first intake,” Dr. Derrick Tlhoiwe says matter-of-factly. “We deliberately kept our enrolment numbers low in order that we could maintain high-quality instruction. We rejected a lot of applicants with 39 points.”

Picking up on that point, Dr. Tumelo Tlhoiwe, the Vice Chancellor (VC), says that management made a conscious decision to not admit students who would have a hard time coping with a rigorous academic programme and end up failing. It often happens that someone who got poor BGCSE grades secures a place at some TEIs from which they acquire a certificate or diploma qualification. The rigour of DDT’s selection process is such that these applicants would not qualify to enroll for its programmes because, as the VC explains, BGCSE grades are considered even for applicants who graduated from other TEIs.

At 9 percent of GDP, Botswana’s education expenditure is among the highest in world but the outcomes are far below this level of expenditure and below those of countries in the same income group. Employers also still complain about the gap between classroom learning and skills that are required in the workplace. It is not too hard to tell why the latter happens. Notwithstanding the existence of oversight institutions, some private TEIs offer substandard education and, as commercial entities, are unable to balance the profit motive with the need to provide quality education. In many ways, DDT transcends the imperfections of current private tertiary education market because its business model explicitly recognises the need to maintain a healthy balance between the competing needs of good commerce and quality education.

For one too many Batswana students, tertiary education marks induction into the world of unending fun. That is perhaps not too surprising because present-day Botswana has a decidedly hedonistic character in which Tuesday is the only day of the week without an evening fun theme: Wednesday is Ladies Night, Thursday is the unofficial start of the weekend – Friday the official start, Saturday is when the weekend is in full swing, jazz sessions come on Sunday and Monday is Ribs’ Night. Then there is after-tears, after-party, “ma-one-one” stop-overs and a whole slew of entrenched merriment rituals whose net effect has been to erode labour productivity across the board. In the VC’s telling, the DDT’s study programme makes it impossible for learners to engage in indulgence that would take their focus away from books.

“Here there is no time for leisure,” she says adding that the rigour of the College’s programme is such that some first-year students who transferred from the University of Botswana (UB) found themselves having to learn a lot of new material that they hadn’t been exposed to.

Every DDT lecturer has a master’s degree and as the VC reveals, some lecturers previously worked for UB.

The Tlhoiwes did their medical training at the St. Georges University in Grenada, an island country located northwest of Trinidad and Tobago. Founded by an American as an independent School of Medicine in 1976, St. George’s University draws students and faculty from 140 countries. Being thousands of nautical miles away to acquire education that they couldn’t find at home inspired an idea that the future married couple would attempt to create commercial opportunity for upon return. This was way before the School of Medicine (SoM) at UB was established. Once back home, the couple registered the school and applied for accreditation with the Tertiary Education Council which has been renamed the Human Resource Development Council. That effort didn’t go too far because, as the Chancellor recalls, “the requirements were just too much.” Passage of time and changed dynamics helped get them to a point where they have been able to meet such requirements.

Drawing on their own student experience, the couple modeled DDT’s study programme on St. George’s American system where students’ progress is evaluated mid-semester. Those lagging behind are counseled, “decelerate” their study programmes if they can’t cope with the workload and complete outstanding modules the next academic year. The VC says that the latter happens at no extra cost to the student.

According to her husband, most of the students are sponsored by the government through the Department of Tertiary Education Financing. The second set is privately sponsored and the third is of special-needs students who are sponsored under the College’s own Tlhoiwe and Tlhoiwe Scholarship of Excellence. He explains that the inaugural batch of the latter comprised of three beneficiaries who qualified on the basis of special financial need and sterling academic performance in the BGSCE.

Upon conviction that the US educational system is “more efficient” than the British one and on the basis of the proprietors’ own experience, DDT is more inclined towards the former. However, that raises the question of whether an American system would fit perfectly in a country with a British colonial past. Prefacing her answer by stating that whether one studies under the British or US system, “the human body is still the same”, the VC says that the British have themselves come to appreciate the efficiency of the US and are shifting towards it.

Farther down the road, DDT’s US character will become more pronounced as the College grows. Alongside plans to broaden and deepen programme offerings, the VC says that they intend to set up a prometric centre. To that end, DDT is in the throes of soliciting twinning arrangements with certain US universities through the US embassy. She adds that this twinning is designed to enhance DDT’s status in terms of quality assurance and capacity building.

Funded by the Citizen Entrepreneurial Development Agency (CEDA), DDT opened last year with an inaugural enrolment of 125 students. Currently, it is the only private TEI whose programmes begin at bachelor degree level – there are plans to introduce master degree programmes a little farther down the road. The VC says that completing a degree programme all at once makes education cheaper in that a non-continuous study programme in which one does a certificate or diploma programme then a degree afterwards is more costly. She adds that DDT’s arrangement also enables students to attain their qualifications in a shorter period of time. At this point DDT offers five programmes: Bachelor of Doctor Assistance, Bachelor of Physiotherapy, Bachelor of Pharmacy, Bachelor of Dental and Hygiene Therapy and Bachelor of Medical Laboratory Sciences.  Explaining the choice of this fare, Dr. Tumelo Tlhoiwe says that Botswana has acute shortage of manpower in those areas. Apparently there are fewer pharmacists than doctors in the country.

In her telling, DDT aims to produce the type of graduate who can pursue a master’s degree programme anywhere in the world upon completion of the College’s own degree programme. Part of internationalizing the College’s education will take the form of plugging into the United States Medical Licensing Examination (USMLE) which the VC says would enable graduates to work in the US. As a multi-part professional examination sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners (NBME), the USMLE is taken by physicians with an M.D. degree. These physicians are required to pass this examination before being permitted to practice medicine in the US. Dr. Tumelo Tlhoiwe says that DDT’s management wants the College to be an examination centre for the USMLE. St. George’s is an USMLE exam centre and in 2014, its first-time takers of the Step 1 exam registered a 96 percent pass rate. The Chancellor is not too worried about successful USMLE candidates seeking greener pastures abroad because they will acquire valuable knowledge and experience that they will bring to the country upon returning home.

The Chancellor further asserts that DDT’s aim is to not only train for Botswana but the whole of the SADC region, a feat he hopes would help brand Botswana as a go-to destination for quality education. In the next intake (which is in August this year), DDT hopes to enroll international students and has taken necessary steps to that end. Last year, the College attended a global expo in Swaziland where, by the account of both the Chancellor and VC, there was enthusiastic response from the target expo-goers. Setting up regional centres figures in the College’s plans but that will be determined by where large numbers of students come from.

In its aspiration for Ivy League-like pedigree, DDT has assembled a constellation of stars (advisors, some with Ivy League ties) who are lighting its path to excellence. Among them are Professor James Shepherd of Yale University who directed a research programme in TB and HIV for the Centers for Disease Control and Prevention (CDC) in Botswana; Professor Yohanna Mashalla of SoM which graduated its first batch of doctors last year; and Dr. Kathleen Toomey, the former CDC Country Director for Botswana. The VC says that with her knowledge and experience of healthcare in Botswana, the latter was excited about the establishment of DDT because she knew what holes it would plug. Toomey, who holds an MD and MPH from Harvard, was a member of SoM’s Medical Education Partnership Initiative Advisory Committee.

DDT is also establishing links with Indian universities. India produces some of the best doctors in the world, exporting some of its crème de la crème to the west where pastures are perpetually greener. To tap into this expertise, DDT plans to establish a working relationship with some credible Indian universities. The Chancellor says that the College plans to establish satellite link-up with those universities and institute a telemedicine programme that would allow students at the DDT campus in Gaborone to either receive lectures or watch surgical procedures being performed in real time.


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