Scaling up specialist training in developing countries: lessons learned from the first 12 years of regional postgraduate training in Fiji - a case study.

Background: In 1997, regional specialist training was established in Fiji, consisting of one-year Postgraduate Diplomas followed by three-year master's degree programs in anesthesia, internal medicine, obstetrics/gynecology, pediatrics and surgery. The evolution of these programs during the first 12 years is presented.

Case Description: A case study utilizing mixed methods was carried out, including a prospective collection of enrolment and employment data, supplemented by semi-structured interviews.

Challenges in the microbiological diagnosis and management of hVISA infections.

Aims: To highlight the challenges involved in diagnosing and managing complicated heterogeneous vancomycin intermediate Staphylococcus aureus (hVISA) infections and to improve clinical recognition of such infections.

Methods: A retrospective review of patients with proven hVISA infections was undertaken in two major referral centres of North Queensland from 2006 to 2010. All isolates had population analysis profiling (PAP) done along with hVISA screening performed by the macro-Etest (MET).

Professional satisfaction and dissatisfaction among Fiji specialist trainees: what are the implications for preventing migration?

The migration of doctors from developing countries threatens the health status of the populations left behind. This qualitative study was conducted to explore why an unexpected number of Fiji specialist trainees left the public sector, often to migrate, using a lens of professional satisfaction. Forty seven Fiji doctors, including 36 of 66 who undertook specialist training in Fiji, were interviewed about the factors that led to their own professional satisfaction and dissatisfaction.

Lack of coordination between health policy and medical education: a contributing factor to the resignation of specialist trainees in Fiji?

Aim: Specialist training was established in Fiji in 1998. This study explored whether health policy, and in particular mismatches between existing policy and the new realities of local specialist training, contributed to decisions by many trainees to ultimately leave the public sectors, often to migrate.

Method: Data was collected on the whereabouts of all specialist trainees.

Specialist training in Fiji: why do graduates migrate, and why do they remain? A qualitative study.

Background: Specialist training was established in the late 1990s at the Fiji School of Medicine. Losses of graduates to overseas migration and to the local private sector prompted us to explore the reasons for these losses from the Fiji public workforce.

Methods: Data were collected on the whereabouts and highest educational attainments of the 66 Fiji doctors who had undertaken specialist training to at least the diploma level between 1997 and 2004.

Clinical presentation of melioidosis in Queensland, Australia.

A retrospective study was performed on culture-positive patients (n = 57) with melioidosis presenting to the Townsville Hospital to define the epidemiology of the disease in Queensland, Australia. Mortality was 25% (n = 14) with a 9% (n = 5) relapse rate. At presentation, primary organs involved included the lungs (58%; n = 33), genitourinary system (11%; n = 6), skin and soft tissue (9%; n = 5), bone and joints (4%; n = 2), central nervous system (4%; n = 2), mycotic aneurysm (2%; n = 1) and peritonitis (2%; n = 1).

The tropical triangle: a health education alliance for the Southwest Pacific.

Introduction: Few collaborations between universities in developed countries and medical schools in developing countries have been described in detail in the medical literature. We describe a collaboration between three medical schools, one in a developed country and two in developing countries based on shared challenges and missions.

The Alliance: James Cook University School of Medicine (JCU), Fiji School of Medicine (FSM) and University of Papua New Guinea School of Medicine (UPNG) are all located within the tropical regions of the Southwest Pacific.