Abstract
Background:The shortage of medical doctors in sub-Saharan Africa (SSA) has resulted in increased enrolment in medical schools, which has not been matched with increased faculty size or physical infrastructure. This process has led to overcrowding and possibly reduced quality of training. To reduce overcrowding at its teaching hospital, the Kilimanjaro Christian Medical University College introduced eight-week peripheral clerkship rotations in 2012. We explore students’ perceptions and attitudes towards peripheral hospital placements.Method:The clerkship rotations were conducted in eight hospitals operating in the northern Tanzania, after evaluating each hospitals’ capabilities and establishing the optimum number of students per hospital. Paper-based surveys were conducted after student rotations from 2014 to 2016.Results:Overall student satisfaction was moderate (strength of consensus measure (sCns), 77%). The three cohorts exhibited improving trends over three years with respect to satisfaction with clinical skills and attitude towards placements. student-preceptor interaction was rated highly (sCns 81–84%). The first cohort students expressed concerns about limited laboratory support, and poor access to Internet and learning resources. Specific interventions were undertaken to address these concerns.Conclusions:Student experiences in peripheral rotations were positive with adequate satisfaction levels. Opportunities exist for medical schools in SSA to enhance clinical training and relieve overcrowding through peripheral clerkship rotations.
Highlights
The shortage of medical doctors in sub-Saharan Africa (SSA) has resulted in increased enrolment in medical schools, which has not been matched with increased faculty size or physical infrastructure
Analysis of different domains probed for satisfaction indicated that, satisfaction with clinical practice competencies/skills acquired increased in consecutive cohorts indicating strong agreement
Overall student experiences in peripheral clerkship rotations were positive with high level of student satisfaction
Summary
The shortage of medical doctors in sub-Saharan Africa (SSA) has resulted in increased enrolment in medical schools, which has not been matched with increased faculty size or physical infrastructure. This process has led to overcrowding and possibly reduced quality of training. Within a 12-year period (1997 to 2009), Tanzania expanded the enrolment of medical students by five-fold in eight public and private health training institutions [5] This expansion in enrolment has not been accompanied by adequate increases in faculty size or physical infrastructure. These teaching hospitals have limited clinical practice areas and mostly concentrate on curative care [6]
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