Global Health MD

Entries from May 2009

Using western standards for residency curricula abroad

May 15, 2009 · Leave a Comment

Recently, I had a dicussion on how we can apply the standards and culture of our medical education system in the US to build and improve the residency curricula in East Africa. While it’s important to always take into account local culture, resources and epidemiolo in building a curriculum – I do think there is some merit in thinking about the western system and how we can apply it.

One of the deficits in Africa, in terms of medical education, is the lack of an accreditation body like the ACGME and/or RRC that set standards which are then enforced. Programs in Africa are not held to any outside standards and as a result the quality of care provided by physicians trained regionally is not predictable. However, in building a curriculum for a residency program in East Africa, it would be helpful to try to use the ACGME Core Competencies as a guide.

As a reminder, these core competencies are:

  1. Medical Knowledge
  2. Patient Care
  3. Practice-based learning and improvement
  4. System-based learning
  5. Interpersonal skills and Communication
  6. Professionalism

Based on what I have seen and heard, I think the areas that need the most attention are Patient Care (including here current evidence-based practices) and Interpersonal Skills and Communication (especially in areas such as end-of-life care, palliative care etc). The institutions need to put in place Quality Improvement projects/programs so that PBL can occur – without any practice data, it’s difficult to reflect.

Categories: Uncategorized

Healthcare Challenges in Africa

May 15, 2009 · Leave a Comment

A team of doctors were debriefing from a recent trip to visit hospitals in Kisumu and Mombasa . Their anecdotes were interesting. They commented on the fact that providers sometimes lack knowledge of current evidence-based practices. I wonder if this is because they don’t have access to current literature (i.e. no or poor internet connection?) or because they lack intellectual curiosity to keep up with new information.  With fewer professionals working in the smaller hospitals and with slow internet access, it limits their ability and interest in reading current journals and keeping abreast of the latest developments.  The local educational culture is therefore often stagnant.  I’ve definitely encountered this issue before in the medical education system and feel that it is a bit of both.

The other very simple problem that can be easily addressed to have a great impact, is infection control, even as simple as hand-washing. I would have expected that these simple interventions would already be commonplace, however, it appears even these simple issues still exist – which is both reassuring (because it means that we will be able to improve the situation even with little investment of time or money) and at the same time concerning ( that such commone-sense practices are not yet being enforced)

Categories: East Africa · infant mortality