SAMSS Newsletter, December 3, 2010
The SAMSS report “The Sub-Saharan African Medical School Study: Data, Observation, and Opportunity” has recently been released. A concise version of the SAMSS report brief is available here. The report outlines the site visit findings gathered from visits to ten medical schools and a survey distributed to 146 medical schools in the region. Some general findings include (1) many countries are prioritizing the scale of medical education as part of overall health sector, (2) physician “brain drain” is a special problem for medical education, and (3) accreditation and quality measurement are important developments for standardizing medical education and physician capabilities. The report discusses some challenges including the mismatch between the number of medical students trained and the number of physicians the government can employ, the lack of coordination among ministries of health and ministries of education, the severe shortage of medical school faculty, the inadequate infrastructure, and the variability in secondarily school education quality. The report also outlines the different levels of innovations observed in the medical schools. Many of the medical schools emphasized “community oriented,” “relevant,” or “nationally focused” medical education to meet local needs. The Study reveals that medical schools in Africa have developed partnerships with medical schools in other countries to support teaching, service and research activities.
SAMSS documented the existence of a total of 169 medical schools in Sub-Saharan Africa; a significant increase from the 103 previously identified medical schools. The quantitative and qualitative survey was distributed to 146 medical schools in Sub-Saharan Africa and 105 completed it, a response rate of 72%. Of these 105 medical schools, 73% reported expanding their first year enrollment in the past five years while 45% plan to increase their intake over the next five years. The responding medical schools reported a total of 7,861 graduates in 2008 and the SAMSS team estimates that Sub-Saharan Africa’s medical schools currently produce about 10,000-11,000 graduates per year cumulatively. The survey asked about where doctors are practicing five years after graduation; the average dean estimated that 22% of graduates from his/her school had left Africa. Survey respondents identified faculty-related issues as their largest barrier to improving the quality of their graduates, and they reported infrastructure-related issues as their largest obstacle to increasing the quantity of doctors trained.
The findings of the Study were also published online on November 11th, in The Lancet. Both the article, called Medical schools in Sub-Saharan Africa, and the report propose the following recommendations to strengthen medical education in Sub-Saharan Africa: (1) launch campaigns to develop the capacity of medical school faculties; including recruitment, training, and retention; (2) increase investment in medical education infrastructure; (3) build structures to promote inter-ministerial collaboration for medical education; (4) fund research and research training at medical schools; (5) promote community orientated education based on principles of primary health care; (6) establish national and regional postgraduate medical education programs to promote training, excellence and retention; (7) establish national or regional bodies that are responsible for accreditation and quality assurance of medical education; (8) increase donor investment in medical education aligned with national health needs; (9) recognize and review the growing role of private institutions in medical education; and (10) revitalize the African Medical Schools Association.
The Site Visit Reports are also available, from the College of Medicine, University of Ibadan (Nigeria); College of Medicine, University of Malawi; Hubert Kairuki Memorial University (Tanzania); University of Gezira Faculty of Medicine (Sudan); Walter Sisulu University School of Medicine (South Africa); the Catholic University of Mozambique; Makerere University College of Health Sciences (Uganda); Cocody University (Cote d’Ivoire); Jimma University School of Medicine (Ethiopia); and University of Mali Faculty of Medicine.
We hope that these recommendations and the findings of this study will provide useful information to medical educators, policymakers, and international donors as they work to promote and improve medical education in Sub-Saharan Africa.
Francis Omaswa, MBCHB, MMed, FRCS, FCS
Executive Director, African Centre for Global Health and Social Transformation
Co-Chair, SAMSS Advisory Committee
Fitzhugh Mullan, MD
The George Washington University
Principal Investigator, SAMSS
Seble Frehywot, MD, MHSA
The George Washington University
Co-Principal Investigator, SAMSS
On behalf of the SAMSS Advisory Committee
Medical journals at Cocody University (Cote d’Ivoire)
SAMSS Advisory Committee
Magdalena Awases PhD, MA, HMPP, RN
Charles Boelen MD, MPH, MSc
Mohenou Isidore Jean-Marie Diomande MD
Dela Dovlo MB Ch.B, MPH, MWACP
Diaa Eldin Elgaili Abubakr MD
Josefo João Ferro MD
Abraham Haileamlak MD
Jehu Iputo MBChB, PhD
Marian Jacobs MBChB
Abdel Karim Koumaré MD, MPH
Mwapatsa Mipando MSc, PhD
Gottlieb Monekosso MD, DSc, FRCP, FWACP, DTMEH
Emiola Oluwabunmi Olapade-Olaopa MD,. FRCS, FWACS
Francis Omaswa MBCHB, MMed, FRCS, FCS
Paschalis Rugarabamu DDS, MDent
Nelson K. Sewankambo MBChB, M.Sc, M.Med, FRCP
SAMSS site visit team at the University of Gezira Faculty of Medicine (Sudan)