The training and professional expectations of medical students in Angola, Guinea-Bissau and Mozambique

Paulo Ferrinho,Inês Fronteira,Florinda Da Silva,Mário Jorge Fresta,Hugo Mercer,Amabélia Rodrigues,Jorge Cabral,Mohsin Sidat,Gilles Dussault

doi:10.1186/1478-4491-9-9

Abstract

BackgroundThe purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future.MethodsData were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year.ResultsStudents decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor.The degree of feminization of the student population differs among the different countries.Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education.Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation.Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries.Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad.ConclusionsMedical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given to the socialization of students and the role model status of their teachers.In countries with scarce medical resources, the hospital orientation of students' expectations is understandable, although it should be associated with the development of skills to coordinate hospital work with the network of peripheral facilities. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country.

Highlights

The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future
In Mozambique, three new medical schools have been established outside Maputo: the private Catholic University established a medical college in Beira, in 2001; the Universidade do Lúrio established a medical college in Nampula, in 2007; and, more recently, another public medical school has been established in Tete
It is indicative of the need to focus on primary and secondary school education to allow for the recruitment of medical students that received their education in environments where they will be most needed as doctors later on

Summary

Introduction

The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future. Until the mid-1990s, their political systems were one-party systems, which gradually changed to multi-party systems. Three of these countries (Angola, Mozambique and Guinea-Bissau) went through periods of civil war. Mozambique and Angola have had a medical faculty since colonial times Since independence, these have produced doctors to partially meet the needs of an exclusively public sector ‘socialist health care system’, free of charge at the point of delivery. In Mozambique, three new medical schools have been established outside Maputo: the private Catholic University established a medical college in Beira (central region), in 2001; the Universidade do Lúrio established a medical college in Nampula (northern region), in 2007; and, more recently, another public medical school has been established in Tete (eastern region). In 2009, in Angola, six new medical schools were established outside Luanda, where there is a private medical school

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