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Published in: Human Resources for Health 1/2014

Open Access 01-12-2014 | Research

The rise of medical training in Portuguese speaking African countries

Authors: Inês Fronteira, Mohsin Sidat, Mário Fresta, Maria do Rosário Sambo, Celso Belo, Cezaltina Kahuli, Maria Alexandra Rodrigues, Paulo Ferrinho

Published in: Human Resources for Health | Issue 1/2014

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Abstract

Background

Medical training has shown to be strategic for strengthening health systems, especially in those countries identified to have critical shortage of human resources for health. In the past few years, several studies have been conducted to characterize and identify major challenges faced by medical schools worldwide, and particularly in Africa. Nevertheless, none has previously addressed medical training issues in Portuguese Speaking African Countries (PSAC). The aim of this study was to establish baseline knowledge of the PSAC’s medical schools in terms of creation and ownership, programmes offered, applicants and registered students, barriers to increased intake of students, teaching workforce and available resources.

Methods

A quantitative, observational, multicentric, cross-sectional study of all medical schools active in 2012 in the PSAC. An adapted version of the questionnaires developed by Chen et al. (2012) was sent to all medical schools electronically. Data were analyzed using descriptive statistics.

Results

A total of nine medical schools answered the questionnaire (three from Angola, two from Guinea Bissau and four from Mozambique). Since 2006 an effort has been made to increase the number of medical trainees. Besides the medical degree offered by all schools, some offered other undergraduate and postgraduate training programmes. The number of applicants to medical schools largely outnumbers the available vacancies in all countries but insufficient infrastructures and lack of teaching personnel are important constraints to increase vacancies. The teaching personnel are mainly trained abroad, employed part-time by the medical school and do not have a PhD qualification.

Conclusion

Governments in the PSAC have significantly invested in training to address medical shortages. However, medical schools are still struggling to give an adequate and effective response. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country and develop local faculty capacity.
Literature
1.
go back to reference Chen C, Buch E, Wassermann T, Frehywot S, Mullan F, Omaswa F, Greysen SR, Kolars JC, Dovlo D, El Gali Abu Bakr DE, Haileamlak A, Koumare AK: Olapade-Olaopa EO: A survey of Sub-Saharan African medical schools. Hum Resour Health. 2012, 10: 4-10.1186/1478-4491-10-4.CrossRefPubMedPubMedCentral Chen C, Buch E, Wassermann T, Frehywot S, Mullan F, Omaswa F, Greysen SR, Kolars JC, Dovlo D, El Gali Abu Bakr DE, Haileamlak A, Koumare AK: Olapade-Olaopa EO: A survey of Sub-Saharan African medical schools. Hum Resour Health. 2012, 10: 4-10.1186/1478-4491-10-4.CrossRefPubMedPubMedCentral
2.
go back to reference Mullan F, Frehywot S, Omaswa F, Buch E, Chen C, Greysen SR, Wassermann T, ElDin ElGaili Abubakr D, Awases M, Boelen C, Diomande M, Dovlo D, Ferro J, Haileamlak A, Iputo J, Jacobs M, Koumaré A, Mipando M, Monekosso G, Olapade-Olaopa E, Rugarabamu P, Sewankambo N, Ross H, Ayas H, Chale S, Cyprien S, Cohen J, Haile-Mariam T, Hamburger E, Jolley L: Medical schools in sub-Saharan Africa. Lancet. 2011, 377: 1113-1121. 10.1016/S0140-6736(10)61961-7.CrossRefPubMed Mullan F, Frehywot S, Omaswa F, Buch E, Chen C, Greysen SR, Wassermann T, ElDin ElGaili Abubakr D, Awases M, Boelen C, Diomande M, Dovlo D, Ferro J, Haileamlak A, Iputo J, Jacobs M, Koumaré A, Mipando M, Monekosso G, Olapade-Olaopa E, Rugarabamu P, Sewankambo N, Ross H, Ayas H, Chale S, Cyprien S, Cohen J, Haile-Mariam T, Hamburger E, Jolley L: Medical schools in sub-Saharan Africa. Lancet. 2011, 377: 1113-1121. 10.1016/S0140-6736(10)61961-7.CrossRefPubMed
3.
go back to reference António Pedro D: National Director for Health. December 2013, Cape Verde: personal communication António Pedro D: National Director for Health. December 2013, Cape Verde: personal communication
4.
go back to reference Mullan F, Frehywot S, Omaswa F, Sewankambo N, Talib Z, Chen C, Kiarie J, Kiguli-Malwadde E: The Medical Education Partnership Initiative: PEPFAR’s effort to boost health worker education to strengthen health systems. Health Aff (Millwood). 2012, 31: 1561-1572. 10.1377/hlthaff.2012.0219.CrossRef Mullan F, Frehywot S, Omaswa F, Sewankambo N, Talib Z, Chen C, Kiarie J, Kiguli-Malwadde E: The Medical Education Partnership Initiative: PEPFAR’s effort to boost health worker education to strengthen health systems. Health Aff (Millwood). 2012, 31: 1561-1572. 10.1377/hlthaff.2012.0219.CrossRef
7.
go back to reference Touré B, Avocksonma D, Nyoni J, Ahmal A: Road map for sclaing up human resources for health for improved health service delivery in the African Region 2012-2025. African health Monitor. 2013, 18: 20-26. Touré B, Avocksonma D, Nyoni J, Ahmal A: Road map for sclaing up human resources for health for improved health service delivery in the African Region 2012-2025. African health Monitor. 2013, 18: 20-26.
8.
go back to reference Cometto G, Tulenko K, Muula AS, Krech R: Health workforce brain drain: from denouncing the challenge to solving the problem. PLoS Med. 2013, 10: e1001514-10.1371/journal.pmed.1001514.CrossRefPubMedPubMedCentral Cometto G, Tulenko K, Muula AS, Krech R: Health workforce brain drain: from denouncing the challenge to solving the problem. PLoS Med. 2013, 10: e1001514-10.1371/journal.pmed.1001514.CrossRefPubMedPubMedCentral
9.
go back to reference Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG: The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health. 2004, 2: 17-10.1186/1478-4491-2-17.CrossRefPubMedPubMedCentral Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG: The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health. 2004, 2: 17-10.1186/1478-4491-2-17.CrossRefPubMedPubMedCentral
10.
go back to reference Kasper J, Bajunirwe F: Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres. Arch Dis Child. 2012, 97: 973-979. 10.1136/archdischild-2012-301900.CrossRefPubMed Kasper J, Bajunirwe F: Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres. Arch Dis Child. 2012, 97: 973-979. 10.1136/archdischild-2012-301900.CrossRefPubMed
11.
go back to reference Kollar E, Buyx A: Ethics and policy of medical brain drain: a review. Swiss Med Wkly. 2013, 143: w13845-PubMed Kollar E, Buyx A: Ethics and policy of medical brain drain: a review. Swiss Med Wkly. 2013, 143: w13845-PubMed
12.
go back to reference Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S: Human resources for health: overcoming the crisis. Lancet. 2004, 364: 1984-1990. 10.1016/S0140-6736(04)17482-5.CrossRefPubMed Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S: Human resources for health: overcoming the crisis. Lancet. 2004, 364: 1984-1990. 10.1016/S0140-6736(04)17482-5.CrossRefPubMed
14.
go back to reference Fresta M, Venturelli J, Ferreira A: Reforma do curso de medicina. Conclusões e recomendações do seminário inicial. Revista Angolana de Educação Médica. 2004, 2: 15-23. Fresta M, Venturelli J, Ferreira A: Reforma do curso de medicina. Conclusões e recomendações do seminário inicial. Revista Angolana de Educação Médica. 2004, 2: 15-23.
15.
go back to reference Bettencourt Mateus M: (Reforma do Sistema Nacional de Saúde - Perspectivas na Óptica dos parceiros). Presentation to the National Forum to Debate the National Health Strategy. 18 March 2013, Benguela, Angola Bettencourt Mateus M: (Reforma do Sistema Nacional de Saúde - Perspectivas na Óptica dos parceiros). Presentation to the National Forum to Debate the National Health Strategy. 18 March 2013, Benguela, Angola
16.
go back to reference Pinto MS, Cecchini MA, Malaquias IM, Moreira-Nordemann LM, Pita JR: O medico brasileiro Jose Pinto de Azeredo (1766?-1810) e o exame quimico da atmosfera do Rio de Janeiro. Historia, Ciencias, Saude-Manguinhos. 2005, 12: 617-673. 10.1590/S0104-59702005000300002.CrossRefPubMed Pinto MS, Cecchini MA, Malaquias IM, Moreira-Nordemann LM, Pita JR: O medico brasileiro Jose Pinto de Azeredo (1766?-1810) e o exame quimico da atmosfera do Rio de Janeiro. Historia, Ciencias, Saude-Manguinhos. 2005, 12: 617-673. 10.1590/S0104-59702005000300002.CrossRefPubMed
17.
go back to reference Cambournac F: A acção dos portugueses no campo da medicina tropical. O Médico. 1982, 102: 1-50. Cambournac F: A acção dos portugueses no campo da medicina tropical. O Médico. 1982, 102: 1-50.
22.
go back to reference Oliveira M: Processo de Descentralização do Serviço Nacional de Saúde de Angola. PhD Thesis. 2010, Rio de Janeiro, Brazil: FIOCRUZ Rio de Janeiro Oliveira M: Processo de Descentralização do Serviço Nacional de Saúde de Angola. PhD Thesis. 2010, Rio de Janeiro, Brazil: FIOCRUZ Rio de Janeiro
23.
go back to reference Tyrrell A, Russo G, Dussault G, Ferrinho P: Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea-Bissau. Hum Resour Health. 2010, 8: 1-10. 10.1186/1478-4491-8-1.CrossRef Tyrrell A, Russo G, Dussault G, Ferrinho P: Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea-Bissau. Hum Resour Health. 2010, 8: 1-10. 10.1186/1478-4491-8-1.CrossRef
24.
go back to reference Cabral J, Dussault G, Buchan J, Ferrinho P: Scaling-up the medical workforce in Timor-Leste: challenges of a great leap forward. Soc Sci Med. 2013, 96: 285-289.CrossRefPubMed Cabral J, Dussault G, Buchan J, Ferrinho P: Scaling-up the medical workforce in Timor-Leste: challenges of a great leap forward. Soc Sci Med. 2013, 96: 285-289.CrossRefPubMed
25.
go back to reference Simões C: Evolução do ‘numerus clausus’ na faculdade de medicina da universidade Agostinho Neto. Revista Angolana de Educação Médica. 2004, 2: 7-13. Simões C: Evolução do ‘numerus clausus’ na faculdade de medicina da universidade Agostinho Neto. Revista Angolana de Educação Médica. 2004, 2: 7-13.
26.
go back to reference Ferrinho P, Sidat M, Fresta MJ, Rodrigues A, Fronteira I, da Silva F, Mercer H, Cabral J, Dussault G: The training and professional expectations of medical students in Angola. Guinea-Bissau and Mozambique. Hum Resour Health. 2011, 9: 9-10.1186/1478-4491-9-9.CrossRefPubMed Ferrinho P, Sidat M, Fresta MJ, Rodrigues A, Fronteira I, da Silva F, Mercer H, Cabral J, Dussault G: The training and professional expectations of medical students in Angola. Guinea-Bissau and Mozambique. Hum Resour Health. 2011, 9: 9-10.1186/1478-4491-9-9.CrossRefPubMed
28.
go back to reference Gilchrist KL, Rector C: Can you keep them? Strategies to attract and retain nursing students from diverse populations: best practices in nursing education. J Transcult Nurs. 2007, 18: 277-285. 10.1177/1043659607301305.CrossRefPubMed Gilchrist KL, Rector C: Can you keep them? Strategies to attract and retain nursing students from diverse populations: best practices in nursing education. J Transcult Nurs. 2007, 18: 277-285. 10.1177/1043659607301305.CrossRefPubMed
29.
go back to reference Buerhaus PI, Donelan K, Norman L, Dittus R: Nursing students’ perceptions of a career in nursing and impact of a national campaign designed to attract people into the nursing profession [abstract]. J Prof Nurs. 2005, 21: 75-10.1016/j.profnurs.2005.02.001.CrossRefPubMed Buerhaus PI, Donelan K, Norman L, Dittus R: Nursing students’ perceptions of a career in nursing and impact of a national campaign designed to attract people into the nursing profession [abstract]. J Prof Nurs. 2005, 21: 75-10.1016/j.profnurs.2005.02.001.CrossRefPubMed
30.
go back to reference Wieck KL: Faculty for the millennium: changes needed to attract the emerging workforce into nursing. J Nurs Educ. 2003, 42: 151-158.PubMed Wieck KL: Faculty for the millennium: changes needed to attract the emerging workforce into nursing. J Nurs Educ. 2003, 42: 151-158.PubMed
31.
go back to reference Cooke M, Irby DM, Sullivan W, Ludmerer KM: American medical education 100 years after the Flexner report. N Engl J Med. 2006, 355: 1339-1344. 10.1056/NEJMra055445.CrossRefPubMed Cooke M, Irby DM, Sullivan W, Ludmerer KM: American medical education 100 years after the Flexner report. N Engl J Med. 2006, 355: 1339-1344. 10.1056/NEJMra055445.CrossRefPubMed
32.
go back to reference Ferrinho P, Fronteira I, Sidat M, da Sousa F, Jr DG: Profile and professional expectations of medical students in Mozambique: a longitudinal study. Hum Resour Health. 2010, 8: 21-10.1186/1478-4491-8-21.CrossRefPubMedPubMedCentral Ferrinho P, Fronteira I, Sidat M, da Sousa F, Jr DG: Profile and professional expectations of medical students in Mozambique: a longitudinal study. Hum Resour Health. 2010, 8: 21-10.1186/1478-4491-8-21.CrossRefPubMedPubMedCentral
33.
go back to reference Fronteira I, Rodrigues A, Pereira C, Silva AP, Mercer H, Dussault G, Ferrinho P: Realities and professional expectations of medical students attending Guinea Bissau’s medical school in 2007 school year. Acta Med Port. 2011, 24: 265-270.PubMed Fronteira I, Rodrigues A, Pereira C, Silva AP, Mercer H, Dussault G, Ferrinho P: Realities and professional expectations of medical students attending Guinea Bissau’s medical school in 2007 school year. Acta Med Port. 2011, 24: 265-270.PubMed
34.
go back to reference Rothstein W: American Medical School and the Practice of Medicine: a History. 1987, New York: Oxford University Press Rothstein W: American Medical School and the Practice of Medicine: a History. 1987, New York: Oxford University Press
36.
go back to reference McAleer E, Parker R, Griffiths OR: Medical schools should develop medical educators, not just doctors. Med Teach. 2013, 35: 698-CrossRefPubMed McAleer E, Parker R, Griffiths OR: Medical schools should develop medical educators, not just doctors. Med Teach. 2013, 35: 698-CrossRefPubMed
37.
go back to reference Diaz G, Sousa D, Pascoal M, Agostinho G, Antonio C: O desafio da formação de futuros docentes na FMUKB. IV Jornadas Científicas da Faculdade de Medicina da Universidade de Katyavala Bwila, Benguela. 16 October 2013, Benguela: Faculdade de Medicina da Universidade de Katyavala Bwila, 26- Diaz G, Sousa D, Pascoal M, Agostinho G, Antonio C: O desafio da formação de futuros docentes na FMUKB. IV Jornadas Científicas da Faculdade de Medicina da Universidade de Katyavala Bwila, Benguela. 16 October 2013, Benguela: Faculdade de Medicina da Universidade de Katyavala Bwila, 26-
38.
go back to reference Silva M, Johnson G, Arce A: Cooperação e soft power na política externa cubana: a emergência da diplomacia social. Conjuntura Austral. 2014, 5: 101-121. Silva M, Johnson G, Arce A: Cooperação e soft power na política externa cubana: a emergência da diplomacia social. Conjuntura Austral. 2014, 5: 101-121.
40.
go back to reference Feinsilver J: Healing the Masses: Cuban Health Politics at Home and Abroad. 1993, Berkeley: University of California Press Feinsilver J: Healing the Masses: Cuban Health Politics at Home and Abroad. 1993, Berkeley: University of California Press
41.
go back to reference De Vos P, De Ceukelaire W, Van der Stuyft P: Cuba’s international cooperation in health: an overview. Int J Health Serv. 2007, 37: 761-776. 10.2190/HS.37.4.k.CrossRefPubMed De Vos P, De Ceukelaire W, Van der Stuyft P: Cuba’s international cooperation in health: an overview. Int J Health Serv. 2007, 37: 761-776. 10.2190/HS.37.4.k.CrossRefPubMed
42.
go back to reference Sousa F, Schwalbach J, Adam Y, Goncalves L, Ferrinho P: The training and expectations of medical students in Mozambique. Hum Resour Health. 2007, 5: 11-10.1186/1478-4491-5-11.CrossRefPubMedPubMedCentral Sousa F, Schwalbach J, Adam Y, Goncalves L, Ferrinho P: The training and expectations of medical students in Mozambique. Hum Resour Health. 2007, 5: 11-10.1186/1478-4491-5-11.CrossRefPubMedPubMedCentral
44.
go back to reference Castelo M: Exame de acesso à faculdade de medicina da UAN no ano 2004/2005 - relatório final da vice-direcção para os assuntos académicos. Revista Angolana de Educação Médica. 2004, 2: 25-29. Castelo M: Exame de acesso à faculdade de medicina da UAN no ano 2004/2005 - relatório final da vice-direcção para os assuntos académicos. Revista Angolana de Educação Médica. 2004, 2: 25-29.
45.
go back to reference Phillips SP, Austin EB: The feminization of medicine and population health. JAMA. 2009, 301: 863-864. 10.1001/jama.2009.155.CrossRefPubMed Phillips SP, Austin EB: The feminization of medicine and population health. JAMA. 2009, 301: 863-864. 10.1001/jama.2009.155.CrossRefPubMed
46.
go back to reference Gjerberg E: Gender similarities in doctors’ preferences - and gender differences in final specialisation. Soc Sci Med. 2002, 54: 591-605. 10.1016/S0277-9536(01)00054-5.CrossRefPubMed Gjerberg E: Gender similarities in doctors’ preferences - and gender differences in final specialisation. Soc Sci Med. 2002, 54: 591-605. 10.1016/S0277-9536(01)00054-5.CrossRefPubMed
47.
go back to reference Fukuda Y, Harada T: Gender differences in specialty preference and mismatch with real needs in Japanese medical students. BMC Med Educ. 2010, 10: 15-10.1186/1472-6920-10-15.CrossRefPubMedPubMedCentral Fukuda Y, Harada T: Gender differences in specialty preference and mismatch with real needs in Japanese medical students. BMC Med Educ. 2010, 10: 15-10.1186/1472-6920-10-15.CrossRefPubMedPubMedCentral
48.
go back to reference Lambert EM, Holmboe ES: The relationship between specialty choice and gender of U.S. medical students, 1990–2003. Acad Med. 2005, 80: 797-802. 10.1097/00001888-200509000-00003.CrossRefPubMed Lambert EM, Holmboe ES: The relationship between specialty choice and gender of U.S. medical students, 1990–2003. Acad Med. 2005, 80: 797-802. 10.1097/00001888-200509000-00003.CrossRefPubMed
49.
go back to reference Dorsey ER, Jarjoura D, Rutecki GW: The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996–2003. Acad Med. 2005, 80: 791-796. 10.1097/00001888-200509000-00002.CrossRefPubMed Dorsey ER, Jarjoura D, Rutecki GW: The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996–2003. Acad Med. 2005, 80: 791-796. 10.1097/00001888-200509000-00002.CrossRefPubMed
50.
go back to reference Buddeberg-Fischer B, Klaghofer R, Abel T, Buddeberg C: The influence of gender and personality traits on the career planning of Swiss medical students. Swiss Med Wkly. 2003, 133: 535-540.PubMed Buddeberg-Fischer B, Klaghofer R, Abel T, Buddeberg C: The influence of gender and personality traits on the career planning of Swiss medical students. Swiss Med Wkly. 2003, 133: 535-540.PubMed
51.
go back to reference Schwartz RW, Jarecky RK, Strodel WE, Haley JV, Young B, Griffen WO: Controllable lifestyle: a new factor in career choice by medical students. Acad Med. 1989, 64: 606-609. 10.1097/00001888-198910000-00012.CrossRefPubMed Schwartz RW, Jarecky RK, Strodel WE, Haley JV, Young B, Griffen WO: Controllable lifestyle: a new factor in career choice by medical students. Acad Med. 1989, 64: 606-609. 10.1097/00001888-198910000-00012.CrossRefPubMed
Metadata
Title
The rise of medical training in Portuguese speaking African countries
Authors
Inês Fronteira
Mohsin Sidat
Mário Fresta
Maria do Rosário Sambo
Celso Belo
Cezaltina Kahuli
Maria Alexandra Rodrigues
Paulo Ferrinho
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2014
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/1478-4491-12-63

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