This is a longstanding issue and I applaud our undersecretary in informing the Public about this. While some my blame poor management, it all boils down to a lot of interrelated factors. Individuals have very different reasons to leave or remain in the country. For those who left the country, it is a probably a moral failure and lack of sense of obligation towards our nation.

For those Doctors who remain, the nation will duly recognize your deeds if not then for believers it is an act of love. For the most part 90% of those who leave are for economic opportunities and this is accelerated by how the Ministry and its leadership relate and understand each Doctors dilemma including a clear career prospect and outline for each individual. Outlining a career path is a very fine line to draw and any mismatch in expectations can have very severe repercussions.

This should be done very early preferably after graduating from medical school. For example, what are the career prospects for Doctors who opt to base in Provincial Hospitals? Do we train them in certain clinical career path with the aim of delivering most of the curative services at that center or do we just leave them alone to slowly decay and get medical dementia?

The worst dementia any Doctor can suffer from in the 21st century especially with the very rapid changes in the medical field! Once a Dr is posted to the Provincial centers what incentives are there in terms of Continuous Medical Education and other privileges offered compared to their colleagues that prefer to remain in Honiara? Don't just dump these young Drs in Temotu or other provincial centers and expect them to deliver a quality service. While some may argue that Drs are meant to save lives and work tirelessly, it is a very dangerous argument to pursue because how can sanity be guaranteed therefore quality service maintained under these circumstances?

Fine tuning of individual careers is not a difficult task to do; however accommodating these career paths to meet the general aims and objectives of the Ministry of Health in providing this much needed service to the General Population is perhaps the most difficult task anyone in the Management positions will find themselves in. Furthermore having specialists in the Provincial centers will also require upgrading the hospitals to meet certain standard requirements. Whether the government has the ability to do so is another issue.