NEWSLETTER | WOMEN IN MOTION
Medical Skills: How do We Compare?
Medical education in sub-Saharan Africa has a long and varied history. The first sub-Saharan
African institution to train medical doctors was the University of Cape Town in 1919.
Only a handful of new medical schools were established before 1950, but the independence of many nations in the middle of the 20th century led to booming growth in the number of African medical schools in the 1960s and 1970s. The 1990s and the 2000s saw a renewed vigour in the establishment of medical schools, with a variety of innovative models beginning to diversify the field
of medical education. Now, schools vary greatly in terms of size, curriculum, approach to education, and types of funding and governance. All medical schools, however, share the mission of training the physicians who will help to tackle the world’s health problems.
by Alex Rose-Innes
One has to ask how Africa’s medical training compares with the rest of the world, and especially First World countries. The answer is worrying, as medical academics in Nigeria continue to express concern regarding the falling standards in the training of doctors.
Complaints regarding ineffective admission policies, inadequate facilities, low remuneration, and the brain drain, among other ills, as well as recommendations to tackle problems at the continent’s 33 medical schools and produce quality medical
graduates, are regularly highlighted in the overseas press. One of the major problems is lack of a coherent admissions policy.
Uncoordinated admission has damaging domino effects up the entire medical-training system.
To address the shortage of health-care workers in the country (not doctors, however), Kenya has employed various strategies,
two of which have included an Emergency Hire Plan and a computer-based distance education programme. The Emergency
Hire Plan has facilitated the rapid recruitment and deployment of health workers. Data from various publications indicates that
the Plan has accounted for the hiring of almost 2 000 nurses and has increased the public-sector nursing workforce by 12%. The question however remains: How good is such training?
Isaac D Gukas of the University of East Anglia, Norwich, in the United Kingdom published a study on the global paradigm
shift in medical education. In it, he highlighted the issues of concern for the African continent.
When medical education became established in Africa, Western curricula were adopted, but, over the last 50 years, major global pedagogical shifts have occurred in medical education without Africa keeping pace. In his paper, Gukas identifies some of the issues needing to be addressed in Africa.
Socioeconomic and political instability, failure to rapidly overcome the inertia for change by substituting the old curriculum
with a more problem-, system- and student-based one, and redefining the goals of medical education are, in his opinion, some of the issues of concern for Africa and its ability to keep up in the dynamic world of medical education. In his study, he found that there are only a few faculty and school managers with sufficient medical education background to initiate, evaluate and sustain these changes.
If one looks at the report, there is no doubt that African medical academics, national governments and the international
community need to come together to assist Africa to rise to these challenges and ensure attainment and sustenance of global standards in medical training. Africa cannot succeed alone; it needs the international community to rise to, and support, the challenge.
Although African medical education started on the same level as that of the rest of the world, owing to poverty, war, and mismanagement of resources, the standards have slipped to a dangerous low. This has created a theoretical gulf between medical schools in Africa and those in the West. It is important to note, though, that most African medical schools have attempted to maximise certain benefits of traditional training.
Use of educational technologies such as computers, the Internet and virtual-learning environments has facilitated the process of learning, especially learner-centred methods of education, but, in rural Africa where supply of electricity alone is an urgent need, this is sadly lacking. Medical facilities in the West have access to the latest electronic diagnostic tools and data retrieval is optimum.
What is the solution? How can Africa overcome this hurdle in its quest to provide proper health care for its growing population?
Experts agree that Africa’s use of the old precolonial education system should be renewed. The continent should, as South Africa did after the apartheid era, define its most prevailing health needs and clearly identify the care needed to address those needs in order to become relevant in the changing medical world.