Development of a family medicine specialty training program (FMSTP) in Lesotho

Abstract

www.thelancet.com/lancetgh 13 Published Online April 8, 2016 Boston University , Boston, MA, USA (B Jack MD, J Markuns MD, B Penti MD, K Shaw MPH, E Nkholongo MPH); Lesotho Ministry of Health, Lesotho, (S Malope MD); Motebang Hospital, Leribe, Lesotho (R Schumacher MD) Correspondence to: Kristin Shaw, Family Medicine Global Health Collaborative, Boston University Medical Center, Fuller Building,, Suite 1020, 85 East Newton Street, Boston, MA 02118, USA keshaw@bu.edu Development of a family medicine specialty training programme in Lesotho Sebaka Malope, Elizabeth Nkholongo, Kristin Shaw, Brian Penti, Rudolf Schumacher, Jeff rey Markuns, Brian Jack Abstract Background Lesotho has a severe shortage of human resources for health. Many young and talented Basotho leave the country each year to attend medical school, but usually they do not return, in part because of the lack of opportunity for continuing education and specialty training in Lesotho. Here, we describe a family medicine specialty training programme (FMSTP), which aims not only to recruit Basotho physicians back to Lesotho but also increase the number of well trained physicians in Lesotho who have the knowledge, skills and commitment to meet the health needs of the people of Lesotho, especially in district hospitals.Background Lesotho has a severe shortage of human resources for health. Many young and talented Basotho leave the country each year to attend medical school, but usually they do not return, in part because of the lack of opportunity for continuing education and specialty training in Lesotho. Here, we describe a family medicine specialty training programme (FMSTP), which aims not only to recruit Basotho physicians back to Lesotho but also increase the number of well trained physicians in Lesotho who have the knowledge, skills and commitment to meet the health needs of the people of Lesotho, especially in district hospitals. Methods The FMSTP accepts Basotho doctors after they have completed medical school and at least 1 year of internship. The fi rst 2 years of the 4 year programme are focused most intensely on clinical training, with registrars working very closely with faculty trainers at their district hospital, and close supervision by the FMSTP faculty and clinical supervisors. Monthly, week-long contact sessions are held at the FMSTP academic centre in Motebang Hospital and students use e-learning in the weeks between contact sessions. The fi nal 2 years of the programme focus on specialty and community-based rotations coupled with a research project chosen by the registrar. Throughout the 4 years, clinical training is integrated with management and public health training to ensure the graduates are equipped to be leaders at a district level. Findings The FMSTP commenced in January, 2008, and was the only higher education programme in Lesotho to receive full accreditation from the Council on Higher Education in 2015. By 2016, two locally trained family medicine physicians have graduated from the programme and the fi rst graduate is now the FMSTP Deputy Director. Graduates of the programme are recognised and compensated as specialist physicians by the Lesotho Ministry of Health. The Boston University School of Medicine certifi es that graduates successfully complete the programme, as outlined in the detailed curriculum documents approved by the Council on Higher Education. Interpretation Our programme currently has six students enrolled in the programme and an additional three to four students will begin in March, 2016. We are also working with the Ministry of Health to expand our programme to the southern provinces of Lesotho and partnering with medical schools throughout southern Africa to promote Family Medicine training in the region. As the programme continues to expand, success will be measured by the proportion of Basotho medical students returning to Lesotho, retention rates of district physicians, and quality and comprehensiveness of health care provided at district hospitals. Funding Kellogg Foundation, PEPFAR, and the Global Fund. Copyright © Malope et al. Open Access article distributed under the terms of CC BY. Declaration of interests We declare no competing interests.