Letter: Medical Doctors messing up Districts

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Kalomo hospitalGreetings to all!!!
Thank you editor for the work you are doing…
I wish to put across views on the scarcity of the Medical Doctors in this country. I will put into perspective my own understanding of the staffing challenges in the country.
Zambia has in the recent past experienced a shortage of key personnel in the health sector. My focus is on Medical Doctors, a field I hail from. This shortage can be largely attributed to many reasons and or factors. Some of these factors range from the famous brain drain to the few existing training institutions expected to produce these personnel to fill up the gap. However, through my traversing of the country of official duties, I noticed one reason that a lot of people at Ministry of Health have deliberately ignored. This is the filling up of Medical Doctors trained to manage patients at all levels of care in Health Management Offices in each district in the country.
As of 2013, Zambia had a total of about 103 districts. This was the increase seen from the 72 that were in place before the Patriotic Front government came into office. Each of these districts has a District Medical Office, tasked to manage the health system as a functionary of the Ministry of Health. At the apex of the management system in these set ups, there is a Medical Doctor, trained at either Ridgeway Campus or abroad managing the affairs of the district. Given the scenario I gave earlier on the districts, currently, we have about 103 Medical Doctors in managerial positions. As a trained Medical Doctor, I wish to bring to the attention of the nation that we do not have any management course in the syllabus during our 7 years course we attend. The same goes for provincial health management which is gripped by the lack of competent personnel. Imagine having about 150 medical doctors seeing patients daily in the health institutions in this country. These would go a long way and suffice on the missing personnel in hospitals.
Therefore, I seek to ask the following questions to my colleagues in these offices: How are they managers without the competence in management? How are they managing the health systems when the only training we acquire is patient care management? Are they comfortable not serving Zambians they swore to save after their training? How do they manage real trained managers like economists, business and public administrators without them using their egos? How are the real managers looking at them and their folly lack of competencies in management? How do they feel when there is a mention of deaths due to staff shortages, when they spend their time fully in the offices signing paperwork which they have not training for?
My personal view is that the management of the health system in this country is not up to the required standards. Poor management and incompetence has gripped the health system for many years hence our failure to make positive strides towards health service delivery. Medical doctors in these positions use favoritism, oppressive and the divide and rule approach towards management. As a country we need to attach the management science in dealing with complex systems in health. If right competences that understand health systems, management science and application of governance tenets are put in place, we can thrive as a country and produce the best health services.
May I conclude by making the following submissions: Allow competent and qualified managers to deal with the day to day running of health management institutions. Send all Medical Doctors to the hospitals to do what they are qualified to do. Remunerate all the health managing staff equally so that they perform to the required standards and see the much needed results of health service delivery. Treat all personnel as equal based on qualifications. Allow these health management offices in districts and provinces to be managed by qualified administrators; Business and Public Administrators.
May God Bless Zambia.
Ron Kunda (MBCHB)
Feedback can be sent to:ronald_kunda@yahoo.com
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40 Responses to Letter: Medical Doctors messing up Districts

  1. I was your classmate Dr. Kunda after graduating I worked as a medical doctor practicing clinical medicine for 3years. Then I did graduate training in Health policy and management. I have worked as a health care manager since then with little clinical practice. Where do you think my strength lies? I know some of our colleagues who specialized in clinical fields and super specialized in clinical areas. After 2-4 years post superspecialization they took up positions at Ndeke house or provincial medical office. What is your take on these? You are correct but not entirely correct.

    Dokota
    September 29, 2016 at 10:21 pm
    Reply

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  3. Who runs the district education board? Who runs a police station? Which one is easier? To teach an administrator medicine or to teach a medical doctor administration? If you are concerned with staff shortages then just recommend that government trains more doctors. After all, we do not have enough teachers or policemen but we these cares in administration. Kindly present your argument with evidence becausemail overall, health indicators are improving and managing a bank is not the same as managing a dhmt

    DI EMU OH
    September 30, 2016 at 10:20 am
    Reply

  4. DI EMU OH u shud b honest wit urself,u dnt nid a dr to run a district medical office,thats y thy r trained managers like the author has put it across.mst of these new districts thy r putin fresh interns to run thm.thy r making very serious administrative mistakes.let thz pipo get to the wards wr thy belong, so tht we stop having this artificial shortage in hospitals.moh has now started employing advanced clinical officers from congo as doctors who dnt evn know wat thy r doin at our expense. #getbacktothewards.

    pipi24
    September 30, 2016 at 10:48 am
    Reply

  5. Ba doctor, you seem to be ignorant on the profesion you claim to belong to. Health management is a speciality of the profesion. Please update yourself before you cause further harm and embarrassment to the profesion

    Story teller
    September 30, 2016 at 11:09 am
    Reply

  6. Dokota, I appreciate you remembering me. Trust me am entirely correct. We trained as medical doctors, why are our colleagues still wanting to be in management? They should have done Public or Business Administration from the onset. It’s utter selfishness and being irresponsible to your carriers. DMOs are now the little kids who just leave internship and are in these districts for less than 6 months, they are given these positions. No experience at all, just an ego and rudeness work for them. A few months ago I visited Central Province, many districts are manned by young boys who do not even have management training and or more than a year experience as a resident doctor. I wish Dr chitalu chilufya will helped change this selfishness

    ron
    September 30, 2016 at 1:24 pm
    Reply

    • The solutions to your perceived problems are wrong. if they do not have management skills then the solution is to train them in management and not to remove them. If they do not have experience then the solution is to give them more exposure. I suspect that you have been dislodged from a job in health management and now you are bitter

      umwaume
      October 2, 2016 at 3:21 am
      Reply

  7. I doubt if the author is even a medical doctor. This article is too simplistic and lack facts.
    Empirical evidence unfortunately for u ron is in favour of medical doctors to continue driving the health sector. All the health indicators have been positive.
    Moreover this is even the trend world over.
    Your enzy and jealous towards doctors will choke u.
    Just go and enroll at cavendish or mulubgushi … its never too late!

    joe
    September 30, 2016 at 1:52 pm
    Reply

  8. The truth pains .

    kafwimbi
    September 30, 2016 at 2:22 pm
    Reply

  9. @Kafwimbi, , indeed the truth pains. Even in the UK they realised this mistake and changed. Hospitals are run by trained administrators . Not all but most doctors have an attitude. Why train a medical officer who will sit in an office two years after graduating? Our masses are suffering because of this very grave anomaly. That’s why clinical officers and AMO’
    s pose as doctors. In the final analysis the poor nurses have borne the brunt cos they are the ones with patients 24 hrs.

    nainendimuntu
    September 30, 2016 at 3:37 pm
    Reply

    • You may not be 100% correct in your arguments. Firstly, you need to understand that the health system in Zambia is different from that of the UK. In the UK, there is a widespread integration of the health and social care services….making it very practical to have a mix of managers from all walks of professions. Secondly, the system is run by Boards (Board of Directors) which we do not have in Zambia. The health Boards will have members who are directors of the different areas of health systems management…..Finance, Nursing, Clinical/Medical, Human Resource etc. This system provides a platform where even if you had put someone to have a ceremonial role of chief executive, all the clinical areas would still be planned and managed by people with the technical knowhow of that area….as above…Nursing by a Nurse, Clinical by a clinician, finance by an accountant and so on. Do more research about the UK you are referring to and you will discover that Medical doctors have not been pushed out of the management system into the hospitals.They have actually remained as vital to the running of health services. Their system allows for appointment of non-medics as Chief Executives, but the actual management of the different areas of health services are managed by technocrats in those areas(e.g. have a look at the national structure for the NHS England here https://www.england.nhs.uk/wp-content/uploads/2016/01/nhse-senior-mngmnt-strcture-2016.pdf). This is replicated at the lower levels also. Therefore, advocating for the pushing of doctors out of management and taking them into the wards is very retrogressive, it doesn’t happen anywhere. Developed countries still have a great influence of doctors in management.Go into every developed country and you will still find a whole lot of doctors running health systems management.

      The Zambian system requires a lot of transformation to bring it to a level where you can entrust the running of health services into the hands of a non-medic. You also need to know that being a DMO is being an overseer, each office has Planners, Accountants, Procurement officers etc who should do their work in terms of other administrative roles. It is not about doing a DMO a favour by helping him no no no….thats a very bad mentality. It is about each one doing what they are employed to do efficiently. And if each of these did their work very well, these offices can be successful. Same applies with Hospitals; you have Hospital Administrators whose duty is to ensure all no-clinical administrative issues are running very well. If these fold their hands and not work, the whole system fails…..all attitude issue sometimes.

      UKview
      October 1, 2016 at 1:07 am
      Reply

    • You need to read the literature on what problems have been created by appointing non-medical managers in the UK. There are so many publications and lessons learned on this but the problem is the poor reading culture pa zed. You do not read!!

      umwaume
      October 2, 2016 at 3:24 am
      Reply

  10. The DMO has an in depth understanding of the sector. He should be the boss. Of course assisted by planning manager (economist), info manager (basis, DS,PA,BA) and others. I am a miner and mine managers r usually geologists, mining engineers or metallurgists.

    harry
    September 30, 2016 at 6:24 pm
    Reply

    • The DMO does not have an in-depth understanding. All the way from ridgeway to apply scientific management which you don’t have? Stop the rot and selfishness. I work in the UK and this was abolished. Thereafter, results have been positive. You pay planning Managers and Information officers about K6000 per month, whereas their fellow first degree holder in medicine get about K20,000….How do you expect them to perform to assist this non manager? I wouldn’t put in my best too.. You have put so much respect on these good for nothing limited career medical officers. All of the zambian doctors are in offices while the Congolese Clinical Officers are busy patronising hospitals as doctors. What a damage to our system…

      Micheal
      September 30, 2016 at 8:00 pm
      Reply

      • You can’t compare mbchb to any other degree and besides every doctor has two degrees by the time they graduate. Go and study medicine if it’s the money you are interested in.

        DI EMU OH
        October 1, 2016 at 12:00 pm
        Reply

  11. Thanks Michael. Indeed this rot must be stopped at all costs. The doctors have a know all attitude which is so irritating and they tend to look down upon other health professionals. We need to work as a team and learn to respect others cos we all can’t be doctors.

    nainendimuntu
    September 30, 2016 at 9:44 pm
    Reply

    • Do not generalise. Every profession has professionals with attitudes.

      DI EMU OH
      October 1, 2016 at 12:17 pm
      Reply

  12. Ron, I am sorry that there are some people who have chosen to attack you unnecessarily. But that’s a Zambian for you. Even though some try to be more learned by claiming that your article falls short and does not address all the facets to this issue to me is a moot point.
    This is a debate which is long overdue and hats off to you for beginning to bring it to the fore
    There is nothing wrong in having a medical doctor being at the head of the management team, be it hospital superintendent, DMO, SMO,PMO or what have you. But this does not mean that these people should abandon their their primary clinical care duties. In parts of the world where I have worked, these leads are on the roster much as everyone else, in some instances putting themselves up to take more calls than the other doctors when there is a shortage of doctors. This I believe helps to make them good field managers, pushing for recruitment and improving the work environment. There is such a strong commitment to teamwork and everyone considers the other as an equal and expertise is multi-dimensional process between doctors, nurses, clinical officers, physiotherapists etc and everyone is on first name basis.
    In Zambia wonder what would happen if a nurse calls a doctor by his first name?

    webman
    October 1, 2016 at 4:02 am
    Reply

  13. You are proposing that a doctor be reporting to a non medic or a nurse or clinical on medical matters?
    Your brain needs to checked.
    Go to ministry of livestock and fisheries, ministry of health, ministry of defense, check out the judiciary too! Go to RDA … The CEO is zesco is an electrical engineer!!
    Go back to school… become a doctor and the DMO position will be waiting for you!!

    joe
    October 1, 2016 at 7:00 am
    Reply

  14. Joe, pettiness and arrogance won’t help this country. It’s not about who a medical doctor Will report to, but about work to be done in a better system. Imagine if these non medics who are professional managers also say we will not report to a non manager? They are both first degree holders after all. A good precedence has been set at Ministry of Justice for example, where the legal minds in the govt will report to a non legal mind in the name of Given Lubinda. Pomp and utter rudeness has gripped the medical doctors in this country and this has placed our health system in a bad situation. The outlook on indicators countrywide is very bad and these non managers in most cases have limited knowledge and skill to apply towards sorting out this negative.
    The author simply advocates for medical doctors to go and manage patients while real certified managers look into administration issues

    Micheal
    October 1, 2016 at 7:22 am
    Reply

    • Your narrow sightedness is worrying to say the least. If you had issues with doctors being managers, then why not advocate they undergo management training? This is not about shortage of doctors because dmo do clinical work other than just management. We have a lot of issues in this country that we should be talking about.

      DI EMU OH
      October 1, 2016 at 12:13 pm
      Reply

    • So are you telling us that Given Lubinda has done a management course for him to run the entire justice system? You seem to be contradicting yourself.

      DI EMU OH
      October 1, 2016 at 12:46 pm
      Reply

  15. Next thing will be teachers are not qualified to be head masters of schools. Police officers should not be incharges of police stations. Road development agency should not be run by civil engineers! High court boss should not be a lawyer!!
    Are u normal you people?

    joe
    October 1, 2016 at 7:55 am
    Reply

  16. Prison service officers are messing up or prisons.. lets have someone with management skills run our prisons and not commissioner chato!
    Police IG should be a pastor because these police officers are messing up the police service!!!
    To matters pertaining to a patient.. lets have a chap with business admistration make decisions!!
    disctrict agricultural office should be headed by a pastor!

    joe
    October 1, 2016 at 8:02 am
    Reply

    • I have not heard any qualms about those professionals you have mentioned starting with teachers, engineers and ending with police (security), to manage the affairs of the institutions they head anywhere in the world. Your argument shows that you lack basic skills in taught management (management as a discipline). Did you know that the father of management as a course of study was an engineer by the name of Henry Fayol? I’m yet to come across a medical doctor contributing to knowledge in the field of management.

      However, studies shows that one does not have to study management to be a good manager but by attending “the school of hard knocks” (experience). Trained managers (economists, business and public administrators) have an advantage in that through their studies they know what works and what doesn’t and need a little bit of experience to polish up their management skills. Conversely an administrator who hasn’t done any managerial studies, may have to run an institution through trial and error thereby gain experience in the long run. But remember that some errors may be too costly.

      Also I tend to think that if someone loves and chose to study in a certain field, they should be more full filled to do what they were trained. The point is attending to patients, is very far apart with sitting in an Office worrying about an incomplete construction of a clinic project, buying of Office stationery, how to share the limited grant on limitless demands. Clearly this is too much and completely off for someone who spent 7 years studying the human anatomy and providing treatment to a sick person.

      Lastly even fellow medical doctors like the author of the article above and the late renowned Dr Francis Manda criticize their colleagues who take up management positions, a clear testimony that practicing medicine and sitting in an Office thinking of sharing limited resources (grant) to limitless needs are two very different things. In countries where health services are comparatively better managed such as UK and Kenya, medical doctors do what they were trained to do (attending to patients) while management professionals are in charge of managing health systems.

      Lumbala
      October 1, 2016 at 11:59 am
      Reply

      • The author of this publication does not appear anywhere in the register for doctors. The’ve been many like him pretending to medical doctors while writing a publication.

        DI EMU OH
        October 1, 2016 at 12:28 pm
        Reply

        • Ba DI EMU OH (DMO), What would you say about the late renowned medical doctor Francis Manda who on several occasions would publicly criticize the status quo?

          Lumbala
          October 1, 2016 at 1:05 pm
          Reply

          • It was his opinion and not a collective view of the entire medical fraternity. I agree that medical officers do need management training and it’s something the profession has noted. He had a lot of opinions on a number of things but those were mostly his opinions. Most of the publications on online media are from people who’ve got hidden motives and I can tell that the author is probably not happy with doctors from central province..

            DI EMU OH
            October 1, 2016 at 3:12 pm

      • Lumbala you are ignorant. Are you aware that even the current head of the World Bank is a medical doctor? read his profile!!!!

        umwaume
        October 2, 2016 at 3:28 am
        Reply

        • Dear umwaume, Dr. Kim the world bank president born in 1959, graduated with a B.A degree from Brown University in 1982, earned an M.D (Medical Doctor) nine years later in 1991 at Harvard and a Ph.D in anthropology at Harvard in 1993. Clearly this is one person with 3 distinct skills in terms of academic qualifications. By the way, are you aware that B.A degrees are generally management degrees? Also are you aware of his achievements as president of Dartmouth (this in my opinion could have been one of the major contribution to him being appointed the world bank president)? I would not have any qualms with a person of Dr Kim managing my trust or portfolios.

          I can’t describe you as being ignorant but perhaps you needed to do a bit more research or you deliberately ignored facts about Dr Kim.

          Lumbala
          October 2, 2016 at 9:51 am
          Reply

          • @lumbala, you are an ignorant element. Do you know that there a lot of of Zambian doctors with MBAs and other management degrees?? Kim has proved that medical doctors can do it. By the way, WHO and UNFPA are also run by doctors….go and read

            Umwaume
            October 2, 2016 at 5:00 pm

  17. Choking with jealous for MOs!!
    Go and hung if u dont want to do medicine.
    Oh wait a minute…. is it too difficult for you?

    joe
    October 1, 2016 at 2:39 pm
    Reply

    • My dear joe, not every critique should be perceived as a case of jealousy and bitterness. I tend to think as bloggers this is one way we could contribute to national development because not everyone will have the privilege to be a politician or be at the helm of power. It is possible that someone influential in society (policy maker, technocrat or politician, it might as well be you ba joe) could learn one or two things from discussions on a fora like this one. You see, contributing to national development is a battle of wits and there is absolutely no need of being emotional about it. But rather you support your views with evidence or facts. And if one is outwitted, s/he should be encouraged to read (research) more.

      In my view there is no such a thing as a difficult course of study,not even rocket science which is generally perceived to be very difficult, this is something that is relative to an individual. Why do I say this? Well during my time as a student at UNZA I closely interacted with students that can qualify to be called geniuses, I mean they graduated with distinction. Among these was my room mate who is now an MO. Common views that they would confide with me, is that contrary to popular views that their field of study is very difficult they would not find anything difficult. Off course in public they would claim that what they study is difficult lest they are accused of not being humble. Some common traits of these geniuses I closely interacted with was that they were highly enthusiastic about what they were studying, their discipline levels towards their studies were admirable and were generally hard working. With this I concluded that anyone can be a student of distinction.

      During my studies for masters degree, I applied the same behaviuor as my genius friends would confide with me, I replicated similar grades as they got at undergraduate. With that, I find it extremely hard to believe that there is such a thing as difficult field of study. All that is needed is to have interest (not the kind of interest motivated by future remuneration and accolades, but rather loving the chosen field of study), being disciplined and working hard.

      Lumbala
      October 2, 2016 at 11:11 am
      Reply

  18. Bad eggs will always be there including in the so called trained managers

    DI EMU OH
    October 1, 2016 at 3:13 pm
    Reply

  19. I am reposting this just to ensure some of the wrong information being discussed here are made straight

    Firstly, you need to understand that the health system in Zambia is different from that of the UK. In the UK, there is a widespread integration of the health and social care services….making it very practical to have a mix of managers from all walks of professions. Secondly, the system is run by Boards (Board of Directors) which we do not have in Zambia. The health Boards will have members who are directors of the different areas of health systems management…..Finance, Nursing, Clinical/Medical, Human Resource etc. This system provides a platform where even if you had put someone to have a ceremonial role of chief executive, all the clinical areas would still be planned and managed by people with the technical knowhow of that area….as above…Nursing by a Nurse, Clinical by a clinician, finance by an accountant and so on. Do more research about the UK you are referring to and you will discover that Medical doctors have not been pushed out of the management system into the hospitals.They have actually remained as vital to the running of health services. Their system allows for appointment of non-medics as Chief Executives, but the actual management of the different areas of health services are managed by technocrats in those areas(e.g. have a look at the national structure for the NHS England here https://www.england.nhs.uk/wp-content/uploads/2016/01/nhse-senior-mngmnt-strcture-2016.pdf). This is replicated at the lower levels also. Therefore, advocating for the pushing of doctors out of management and taking them into the wards is very retrogressive, it doesn’t happen anywhere. Developed countries still have a great influence of doctors in management.Go into every developed country and you will still find a whole lot of doctors running health systems management.

    The Zambian system requires a lot of transformation to bring it to a level where you can entrust the running of health services into the hands of a non-medic. You also need to know that being a DMO is being an overseer, each office has Planners, Accountants, Procurement officers etc who should do their work in terms of other administrative roles. It is not about doing a DMO a favour by helping him no no no….thats a very bad mentality. It is about each one doing what they are employed to do efficiently. And if each of these did their work very well, these offices can be successful. Same applies with Hospitals; you have Hospital Administrators whose duty is to ensure all no-clinical administrative issues are running very well. If these fold their hands and not work, the whole system fails…..all attitude issue sometimes.

    Do not be lied to by people who are pretending to have worked in other countries where managers do both management and clinical work. Those are pure lies…..Everywhere in the world, medical doctors who handle busy administrative work do not do clinical work. mwilatubepa notuma experience twabufi. Go and ask countries in the UK, Asia, America……doctors in management do management work only unless they have personal passion to stretch themselves by doing both clinical and management. On the other hand, most of those DMOs you are talking about in Zambia actually do both clinical and administrative work. You may not hear much said about other areas in the country because they may not be as sensitive and accessible as the health system.

    UKview
    October 1, 2016 at 9:51 pm
    Reply

  20. the zambia daily mail of 29th September 2016, published the names of registered health practitioners. This author is not on that list, therefore he is fake!!!! Why even publish an article from this fraud??

    umuntu
    October 2, 2016 at 7:36 am
    Reply

  21. Ba Umwaume, there is absolutely no need of being emotional about this issue under consideration, simply state your views and support it with tangible facts. As a result of being emotional, your thought pattern is being clouded out and you are deviating from the topic being discussed. ‘Ignorant’ must be the only word you best know in the English vocabulary.

    I have no problem with personnel from any profession taking up management positions, as a matter of fact, am in total agreement with research done that shows if one is good in management in one field/ area, s/he can excel in management in another field. Medical Doctors and particularly Zambian MDs are no exception to this. You would be very shocked at how much information I have about Zambian M.Ds and the kind of qualifications they possess. Of the over 100 MDs running district health, less than 50% meet the minimum acceptable qualification of having a masters. Of course they have a medical degree, but it is just that. It is in the recent past that some are upgrading.

    My appeal to policy makers is that they should also consider other cadres like Public Health Officers and Social Scientists with experience in health matters to be at the helm of district health management. As a matter of fact this is already taking place through decentralization, the district health will be under the council presided by the Town Clerk/ Council Secretary who in most cases have a social science background. However, the pace at which the district health Offices are being realigned to the councils is very slow.

    Lumbala
    October 2, 2016 at 7:24 pm
    Reply

  22. I agree with the contents of this article in totality. The management of the health care system in Zambia, administratively has gone from bad to worse. Most Doctors have no management and leadership skill, let alone the knowledge.It is trial and error.If u come out to tell them the truth, u become their enemy, hence most people under them , would just keep quiet pretending all is well.
    But i can tell u that most of them (90%) have leadership and management incompetencies. No wonder district performances are poor now as compared to the time wen we used to have DDHs wen even a clinical officer or Health inspector or indeed a nurse could manage the district.
    These days, awe mwandii… vyakulolavye.

    David Silukolwe
    October 4, 2016 at 7:20 am
    Reply

  23. I’m just wondering how one could spend seven long years of study in Medicine just to end up signing on documents in an Office. Surely how do you feel spending all those years just to start your career as a manager? Why didn’t you then pursue a career that would automatically make you a manager? My concern is not so much that DMOs are Doctors rather it is that Most DMOs are straight from University. This does not help them in the careers in which they invested so much. Some of you have made comparisons with many organisations including the Police. I beg to differ. If you went in a Police station, what you would generally notice is that staff rise through ranks. By the time they come to manage a station, they will have gained enough experience. You will also notice that the job of those managers in the other institutions is closely related to what they were trained to do. eg signing detention orders, Police bonds, detailing officers on their beats, deciding on when to take detainees to court. Managing dockets etc. I believe the way forward is to let Doctors serve in their area of training for sometime and allow those who want to specialize in Management go ahead and do so. Those who specialise in other Medical Fields let them continue working and progressing in those areas. Our biggest Challenge is that equity is not usually practiced. Those in Management areas are remunerated better than specialists in other fields. They have more privileges even in career progression which causes consternation in other workers. People should be remunerated accordingly in whichever field so that they feel proud to stay where they are required. I certainly wouldnt feel proud to spend so many years in training as a Doctor only to end up as an admin manager on my first appointment. It happened to me that when I graduated as an animal Scientist, I was posted to run a farm Institute. I quit after one year and I have never regretted. That was some good 23 years ago.

    Blackbird
    October 7, 2016 at 10:58 am
    Reply

  24. This same guy from Central Province, Chitambo has issues with the District Medical Office. He is a disgruntled fellow, not a medical doctor. Management training does not guarantee a good manager either dear friend. So you’re fighting a losing battle and its getting frustratingly boring. Just give up, quit your job, or soon get charged for your continued impersonation.

    SpookedbyYOU
    October 11, 2016 at 8:06 pm
    Reply

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