Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

Brittney S Mengistu,Damen Haile Mariam,Miliard Derbew,Holly Vins,Henry M Blumberg,Carlos Del Rio,Jennifer O Spicer,Caitrin M Kelly,Dawn L Comeau,Daphne R Mcgee,Abebe Bekele

doi:10.1186/s12909-016-0849-0

Brittney S Mengistu, Damen Haile Mariam + Show 9 more

Open Access

https://doi.org/10.1186/s12909-016-0849-0

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Abstract

BackgroundEthiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Recently, the Ethiopian government implemented a “flood and retain” initiative to rapidly increase the quantity of physicians in Ethiopia. Consequently, medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300–400 students per class. This study evaluated the impact of the rapid scale-up in the number of medical students on the quality of medical education at AAU and the impact of the U.S. government-funded Medical Education Partnership Initiative (MEPI) grant awarded to AAU to provide resources to strengthen the quality of medical education at AAU.MethodsQualitative, semi-structured, in-depth interviews were conducted with 22 key informants including faculty members, administrators and medical students at AAU. The audio recordings were transcribed verbatim and interview data were analyzed with thematic analysis.ResultsFour key themes emerged from the data. Overall, participants perceived a decrease in the quality of medical education at AAU due to challenges created by the rapid scale-up in the number of medical students. Positive learning environments were described as difficult to achieve due to overcrowding in classrooms and the limited numbers of textbooks. Overall, participants stated that infrastructure improvement is needed to provide adequate medical student training. The medical education initiatives implemented and funded by MEPI have provided significant resources to support the medical student curriculum but additional resources are required to accommodate a large student body.ConclusionsThe unprecedented rapid scale-up of medical students has impacted multiple facets of medical education at AAU. It is important to consider the perspectives of students and faculty in order to focus future medical education policies, MEPI programming and the allocation of resources.

Highlights

Ethiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons
All graduates of public medical schools are required to serve in Ethiopia as a general practitioner for two to four years
This requirement was implemented by the Ministry of Health as an effort to reduce the brain drain and expand health coverage by retaining the number of physicians practicing in Ethiopia, especially in rural areas where physician shortages are most severe

Summary

Introduction

Ethiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300–400 students per class. Since the initiative’s implementation, enrollment at Addis Ababa University (AAU) School of Medicine has more than tripled, while the number of faculty, funding, and resources has not increased proportionally. All graduates of public medical schools are required to serve in Ethiopia as a general practitioner for two to four years. This requirement was implemented by the Ministry of Health as an effort to reduce the brain drain and expand health coverage by retaining the number of physicians practicing in Ethiopia, especially in rural areas where physician shortages are most severe

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