initial context for clinical education. Expansion of the capacity of the Faculty followed several steps. In addition to population growth, the exodus of medical graduates to North America, never to return, exacerbated the need to increase the output of doctors. In the 1960s, it was possible to complete the clinical clerkship element of training in Trinidad and Tobago (at the Port of Spain General Hospital) and in Barbados (at the Queen Elizabeth Hospital), as well as in Jamaica. In 1989, the medical school at the St. Augustine campus opened. However, rather than adopt the 'traditional' existing curriculum at the Mona school, it adopted a problem-based approach. Mona, which had already carried out some curricular reform due to World Health Organization recommendations to place greater emphasis on community health promotion and protection, and St. Augustine, had different medical school curricula, though the graduates took the same qualifying exams. Moreover, St. Augustine's Faculty of Medical Sciences included not just a School of Medicine, but also Schools of Dentistry, Veterinarian Medicine, Nursing and Pharmacy, which necessitated some sharing of resources. In 2008, the clerkships in Barbados were fully developed into a medical school at the Cave Hill campus. Around the same time, the UWI School of Clinical Medicine and Research was established from an existing programme allowing clerkships to be undertaken in Nassau, under the direction of the St. Augustine campus. The School offers the final two years of the five-year programme. Specialist medical training Similar to the general training, specialist training was progressively made available through the UWI. For example, anaesthesia was initially provided by untrained doctors, nurses, and pharmacists, leading to high morbidity and mortality rates. Initially, doctors were sent overseas for a year of post-graduate training. While the Faculty was established in 1948, the one-year post-graduate diploma in anaesthetics did not begin until 1966 at the Mona Campus. St. Augustine and Cave Hill added the diploma in 1976. However, Mona was already moving towards a four-year Doctor of Medicine Anaesthetics degree, first offered in 1974. Eventually, this more specialised degree (extended to include intensive care) was extended to the other two campuses in 1984 while the one-year programme was discontinued in 1994. While improvements were being made to the training of physicians as anaesthesiologists, there continued to be a shortage of trained personnel in rural areas. In Jamaica, an initiative to train nurse anaesthetists started, with nurses first sent to