The Libyan doctors' brain drain: an exploratory study

Background: Medical emigration from developing to developed countries is a well established phenomenon of substantial importance. Though Libya is classified as an upper-middle income country, it has been affected by this trend. This study was undertaken to identify some of the possible reasons behind the emigration of Libyan doctors and factors that might motivate them to return. Findings: Seventy-four completed questionnaires were analysed. Median age of the respondents was 43 years (33-60) and median duration of stay outside Libya was 15 years (6-29). Most of the participants were resident in Europe (66%). The desire to further their education and research was the main reason given by 88% of the respondents for leaving Libya, while 50% of them gave that as the main reason for staying abroad. One-third of the respondents (31%) cited economic factors as the main reason for not returning. None of the respondents ruled out returning to Libya, and about half of them stated that they definitely or probably will return to Libya. 58% ranked reform of the Libyan health system as the most important reason that could induce them to return to Libya. Conclusion: The study shows that reforming the health care system in Libya might induce some of the physicians who moved abroad mainly for educational and economic reasons to return to Libya to practice medicine

Scientific publication productivity of Libyan medical schools: a bibliometric study of papers listed in PubMed, 1988-2007

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Letter to the Editor: Clinical audit as a framework for the consultation on the future of Libyan Health Services

No Abstrac

Establishing a Libyan Medical Research Council is Urgently Needed

To the Editor: I read with interest the study by Bakoush et al addressing the issue of medical publication in Libya [1]. The number of published reports from Libya was compared with another three Arabic countries (Morocco, Tunisia and Yemen). I suggest to the authors the extention of their study to include all twenty-three Arabic countries. This would enhance our knowledge of the scientific productivity of the Arab world

Medical records and correspondence demand respect

To The Editor: I was amazed recently to see a patient from Libya who came to the UK for treatment based on the advice of his Libyan physicians. The patient carried with him no referral letter whatsoever. Not one physician familiar with his case bothered to write a few lines for the poor patient, although each of those doctors saw the patient at least twice and prescribed one or more treatment. The patient carried with him different medications that had been prescribed, and a few empty containers of other medicines he had used. I mention the above short tale to bring to light what I feel is a major ethical problem with the way medicine is practiced in Libya [1]. The keeping of good medical records together with clear and concise correspondence between physicians is imperative for several reasons. Not only does it avoid duplication of services and unnecessary costs, it decreases the time invested by both the patient and physician, and it fosters a collegial relationship among healthcare providers. Many times, referring physicians may not know each other. It provides a channel for them to learn from each other as well as a method for them to form professional relationships. It occurred to me that colleagues in Libya may be shy of writing referral letters or may even be phobic about disclosing their practice habits. Patient information can best be written as referral letters which summaries the patient presentation, testing, response to treatment, possible consultation, and reason for referral. The referral may be because the physician(s) initially treating the patient simply have tried all treatments known to them, or they may need to refer if they lack certain diagnostic equipment necessary to continue the care. To refer the patient to colleagues simply says “we think more can be done for this patient but we may not be able to do it here; please evaluate.” It shows respect for the patient and for the colleague. No physician knows everything there is to know or has every diagnostic tool available. I understand from speaking to doctors who practice in Libya that medical documentation is rudimentary. If it exists, it lacks clarity, continuity, confidentiality, and accountability. Doctors fail to sign and date their orders if they enter them in patients’ notes [2]. Relaying patients’ information to colleagues is mainly done verbally without much documentation [3]. People who need to go abroad for governmental paid treatment may request a medical report. These are almost always simple, short letters without clear diagnoses, treatment recommendations, or a current medication list. I recall senior surgeons who left the duty of writing the operative notes to the most junior doctor on the team. There is a lesson to be learnt here from other physicians who demand more of themselves and of their colleagues, as it helps advance practice There might be few potential reasons to explain why this malpractice is happening:1. Concern about litigation.2. Lack of basic clerical support.3. Lack of appropriate stationary or reliable postal service4. No clear guidelines from the relevant governing body 5. Lack of confidence6. Lack of a general practitioner to look after the patient’s interest With widespread communication technology, there is no excuse for doctors today to fail to document patient information. Computer software provides a simple method for documentation and allows for the swift electronic transmission of data to and from colleagues. We are more prone to litigation if we fail to record what we have done with our patients. We may forget the old adage “if it’s not documented, it was not done.” This is how attorneys approach medical documentation when retained for legal services. It is important we do not forget this simple fact. I was unable to find any clear guidelines from the medical board in Libya about keeping case notes and writing correspondence, although these guidelines are widely available internationally and need only sincere implementation [4]. As medical practice becomes more sophisticated and we find more subspecialty colleagues inside Libya, it will become even more important to have a reliable communication system. I would like to encourage physicians in Libya to be proactive rather than reactive when it comes to their medical documentation practice for it stands to benefit both the patient and physician, and it will undoubtedly help the evolution of medical practice in Libya

Parkinsonism and tremor disorders. A clinical approach

Differentiation of idiopathic Parkinson's disease from other causes of Parkinsonism, such as Multiple System Atrophy, Progressive Supranuclar Palsy and Vascular Parkinsonism can be difficult. Clinicopathological studies suggest that the clinical diagnosis of idiopathic Parkinson's disease is 76% reliable. Also, clinical differentiation of tremor prominent Parkinsonism from Essential Tremor or Drug induced Parkinsonism may be problematic, especially in the early stages of the disease. Since these disorders are obviously different in clinical progress, it is important for the clinician to address the patient's and family's concerns about prognosis from a firm diagnostic footing. In this article the clinical features of the common and important causes of Parkinsonism and tremor disorders are reviewed and a practical approach is suggested

Undergraduate medical education; how far should we go?

Medical education is a leading step in improving the quality of health services all over the world; in recent years such an important issue has changed tremendously. New concepts and theories were introduced particularly in undergraduate medical education, these may include beyond curriculum education and the concept of problem based learning (PBL). The latter was introduced by Barrows at McMaster University, Canada over three decades ago and will gain the main emphasis in this article. PBL has shown to be valuable and reflects major improvements in undergraduate medical education. Incorporation of such changes will rarely bear priority in developing countries such as Libya, where the debate about the challenges of undergraduate medical education and the importance of the problem-based learning has just started. However, every one who is involved in medical education has his own views about the process of teaching and that tends to reflect on the way he teaches.Here are my personal views about undergraduate medical education which will be discussed by answering three main questions: 1) How did I develop my views? 2) What are my views? 3) How these views affect the way I teach

Astronomical & Space Science Portal Information System Design for LCRSSS Center in Libya

The internet technologies are rapidly increasing. The aim of the study is to design and develop an astronomical & space science portal information system (WASSIS). The WASSIS is a real-time application system which provides a convenient graphics user interface (GUI) for both user and Libyan Centre for Remote Sensing and Space Science (LCRSSS) staff. It allows user to make self-registration to become as member of the system, update information, view announcement, view astronomical and space information time-to-time. It also allows administrator to manage user/staff account and view report. All of the services are possible anywhere at any time

The Libyan medical profession needs a regulatory body

Comment on:Elmahdi A. Elkhammas. Medical ethics in Libya: where to start? Libyan J Med 2007;1(2);AOP:06120