International Medical Education Outreach: Benefits for US Medical Education and Practice

Abstract

Much of the focus in Sub-Saharan Africa has been on aid that mitigates the burden of major infectious diseases such as human immunodeficiency virus (HIV), malaria, and tuberculosis. There also is increasing support for the scientific community to generate discoveries that better address these epidemics. Concurrently, there is a growing understanding of the need to invest in mechanisms and policies to establish a health care work force, which is currently quite scarce throughout the developing world. A wide variety of health care workers are required; physicians hold a particularly important leadership role on the health care team. There is a profound shortage of medical schools, and their current enrollment is insufficient to address the needs of the region. These shortfalls are further compounded by emigration of graduates out of the region, most often to pursue postgraduate training in residencies and fellowships that are not available in their own countries. One of the consequences of this training is that these physicians no longer ‘‘fit in’’ back home and many do not return. Rather than focus on the mechanisms that cause physicians to leave Africa, there is a growing realization of the need to import education and training programs into the region. These opportunities have also attracted the attention of schools and organizations in the United States, along with funders interested in the improvement of health care in SubSaharan Africa. Instead of exporting systems and curricula that seem to work in the United States, there is a need to develop programs and pathways in these countries that directly link education to desired local health care outcomes. For example, increasing the emphasis on management of obstructed labor or the performance of adult circumcision (which has recently shown to have a dramatic impact on HIV transmission) will have a substantial impact on health outcomes.