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Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative

Many African countries have extremely low ratios of physicians to population, and there are very, very few specialists. This leaves most patients without access to specialised care, and importantly also leaves many countries with insufficient expertise to properly evaluate the burden of illness and...

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Autores principales: Schluger, Neil W, Sherman, Charles B, Binegdie, Amsalu, Gebremariam, Tewedros, Kebede, Dawit, Worku, Aschalew, Carter, E Jane, Brändli, Otto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144898/
https://www.ncbi.nlm.nih.gov/pubmed/30245867
http://dx.doi.org/10.1136/bmjgh-2018-001041
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author Schluger, Neil W
Sherman, Charles B
Binegdie, Amsalu
Gebremariam, Tewedros
Kebede, Dawit
Worku, Aschalew
Carter, E Jane
Brändli, Otto
author_facet Schluger, Neil W
Sherman, Charles B
Binegdie, Amsalu
Gebremariam, Tewedros
Kebede, Dawit
Worku, Aschalew
Carter, E Jane
Brändli, Otto
author_sort Schluger, Neil W
collection PubMed
description Many African countries have extremely low ratios of physicians to population, and there are very, very few specialists. This leaves most patients without access to specialised care, and importantly also leaves many countries with insufficient expertise to properly evaluate the burden of illness and the needs of the population overall. The challenges to training a specialised physician workforce in resource-limited settings are many, and they go far beyond the (relatively simple) task of transmission of clinical skills. We initiated a capacity-building programme to train pulmonary physicians in Ethiopia, a country of 105 million persons with a high burden of lung disease that had no prior existing training programme in pulmonary medicine. Using volunteer faculty from the USA and Europe, we have provided high-quality training and established a cohort of pulmonary specialists there. We have identified several components of training that go beyond clinical skills development but which we feel are crucial to sustainability. These components include the delineation of viable career pathways that allow professional growth for subspecialist physicians and that support the permanent establishment of a local faculty; the development of important non-clinical skills, including leadership and pedagogical techniques; training in clinical research methodologies; and the development of mechanisms to amplify the impact of a still relatively small number of specialised physicians to address the needs of the population generally. Our programme, the East African Training Initiative, has successfully addressed many of these challenges and we hope that it can be replicated elsewhere.
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spelling pubmed-61448982018-09-21 Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative Schluger, Neil W Sherman, Charles B Binegdie, Amsalu Gebremariam, Tewedros Kebede, Dawit Worku, Aschalew Carter, E Jane Brändli, Otto BMJ Glob Health Practice Many African countries have extremely low ratios of physicians to population, and there are very, very few specialists. This leaves most patients without access to specialised care, and importantly also leaves many countries with insufficient expertise to properly evaluate the burden of illness and the needs of the population overall. The challenges to training a specialised physician workforce in resource-limited settings are many, and they go far beyond the (relatively simple) task of transmission of clinical skills. We initiated a capacity-building programme to train pulmonary physicians in Ethiopia, a country of 105 million persons with a high burden of lung disease that had no prior existing training programme in pulmonary medicine. Using volunteer faculty from the USA and Europe, we have provided high-quality training and established a cohort of pulmonary specialists there. We have identified several components of training that go beyond clinical skills development but which we feel are crucial to sustainability. These components include the delineation of viable career pathways that allow professional growth for subspecialist physicians and that support the permanent establishment of a local faculty; the development of important non-clinical skills, including leadership and pedagogical techniques; training in clinical research methodologies; and the development of mechanisms to amplify the impact of a still relatively small number of specialised physicians to address the needs of the population generally. Our programme, the East African Training Initiative, has successfully addressed many of these challenges and we hope that it can be replicated elsewhere. BMJ Publishing Group 2018-09-17 /pmc/articles/PMC6144898/ /pubmed/30245867 http://dx.doi.org/10.1136/bmjgh-2018-001041 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Practice
Schluger, Neil W
Sherman, Charles B
Binegdie, Amsalu
Gebremariam, Tewedros
Kebede, Dawit
Worku, Aschalew
Carter, E Jane
Brändli, Otto
Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title_full Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title_fullStr Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title_full_unstemmed Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title_short Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative
title_sort creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the east african training initiative
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144898/
https://www.ncbi.nlm.nih.gov/pubmed/30245867
http://dx.doi.org/10.1136/bmjgh-2018-001041
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