Ethiopian Medical Research Articles

Patterns of Major Oral and Maxillofacial Surgery Cases in Two Ethiopian Medical Centers: A Three-Year Retrospective Study

BACKGROUND: Oral and Maxillofacial region is an area that is prone to multitude of disease conditions of developmental nature or acquired which require surgical intervention on many occasions. The aim of this study was to assess the pattern, indications, and types of major oral and maxillofacial surgical procedures carried out at Addis Ababa university Maxillofacial Surgery affiliate hospitals. METHODS: A retrospective study was conducted on all patients who had undergone oral and maxillofacial surgeries under general anesthesia at Yekatit 12 Hospital Medical College and Saint Peter Specialized Hospital in a period of 3 years from January 2017 to December 2019. Descriptive statistics such as biodata, indication and type of surgery were recorded and analyzed using the Epi info version 7 software. RESULTS: A total of 689 patients with oral and maxillofacial conditions were managed during the study period. The male to female ratio was 2.48:1, and the mean age of patients was 29.05 years with standard deviation of ±15.5. The predominant indications for surgery were traumatic conditions (50.71%, n=354), followed by neoplastic conditions (18.7%, n=129)). Open reduction and internal fixation were the most common (43.7%, n=313) surgical procedure performed. CONCLUSIONS: The field of oral and maxillofacial surgery in our climes is a relatively new one. However, it is evolving, and its relevance is growing. With the observed relatively high frequency of traumatic conditions, especially among younger populations, efforts geared at prevention and adequate preparedness for proper surgical management of such patients should be commenced.

Epidemiology and Outcomes of Critical Illness and Novel Predictors of Mortality in an Ethiopian Medical Intensive Care Unit.

Low- and middle-income countries (LMICs) bear most of the global burden of critical illness. Managing this burden requires improved understanding of epidemiology and outcomes in LMIC intensive care units (ICUs), including LMIC-specific mortality prediction scores. This study was a retrospective observational study at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, examining all consecutive medical ICU admissions from June 2014 to April 2015. The primary outcome was ICU mortality; secondary outcomes were prolonged ICU stay and prolonged mechanical ventilation. ICU mortality prediction models were created using multivariable logistic regression and compared with the Mortality Probability Model-II (MPM-II). Associations with secondary outcomes were examined with multivariable logistic regression. There were 198 admissions during the study period; mortality was 35%. Age, shock on admission, mechanical ventilation, human immunodeficiency virus, and Glasgow Coma Scale ≤8 were associated with ICU mortality. The receiver operating characteristic curve for this 5-factor model had an AUC of 0.8205 versus 0.7468 for MPM-II, favoring the simplified new model. Mechanical ventilation and lack of shock were associated with prolonged ICU stays. Mortality in an LMIC medical ICU was high. This study examines an LMIC medical ICU population, showing a simplified prediction model may predict mortality as well as complex models.

Predictors of unwillingness to receive COVID -19 vaccines among Ethiopian Medical students.

Medical students are among the potential risky population for the transmission of COVID 19 infections; their willingness to receive COVID 19 vaccine is not well studied. Thus, this study assessed Predictors of Unwillingness to receive COVID -19 vaccines among Ethiopian Medical students. From the 25th of May, 2020 to the 26th of June, 2021, an institution-based cross-sectional study was done at Mizan-Tepi University Teaching Hospital,On 313 medical students from each department and batch were chosen using a multistage sampling approach. A bivariate and multivariable logistic regression were done to identify the predictors of Unwillingness to receive COVID -19 vaccines. Figures, tables, and graphs were used to present the findings. The adjusted odds ratio and its 95% confidence interval were provided. In this study 124 (40.7%) 95% CI (35.1,46.4) medical students were not willing to receive the COVID-19 vaccine. And also increased in the age of the student[AOR 0.43, 95% CI; (.29,.63)], Knowledge status about COVID 19 infection transmission, risk factors and control behavior[AOR 1.45, 95% CI; (1.14, 1.85)], perceived susceptibility to COVID 19 infection [AOR 1.70 (1.15, 2.51)], perceived severity of COVID 19 infection[AOR 1.26 (1.01, 1.57)], perceived benefit of COVID 19 vaccine [AOR .58(.38, .88)], positive attitude towards COVID 19 vaccines [AOR .46(.35, .62)], and confidence in safety and efficacy of the vaccine and public authorities decissin in the best interest of the community [AOR 1.93(1.24, 2.99)] were predictors of non-willingness to receive COVID 19 vaccine. Non-willingness to accept the COVID 19 vaccine was predicted by student age, elements in the Health belief model such as anticipated susceptibility, severity, and benefit, and a positive attitude and trust in the vaccine.

Clinical Competence and Perception of Medical Students after Early Clinical Exposure through Pre-clerckship Education at an Ethiopian Medical School: A Cross-sectional Study.

Conventional medical curriculum is the mainstay in the long history of modern medical education. Innovative integrated medical curriculum attracted significant attention in improving conventional curriculum. In the integrated curriculum, basic sciences are incorporated horizontally with each other, and students are exposed early to clinical settings. This is expected to improve students' knowledge and skills in clinical medicine by the time they start their clerkship rotation. the study aims to make a baseline assessment on the overall knowledge and skills of medical students towards clinical medicine. An institution-based cross-sectional study was conducted from March to April of 2020 using 91 third year medical students (convenience sampling). A three-section self-administered survey instrument, short written MCQ exam, and practical (OSCE) students' examination were used for this survey. participants tend to exhibit better knowledge on basics of history taking and physical examination with an average score of 79%. Comparatively, the score for average physical examination skill was low (56.3%). Students' perception on ECE showed, over 50% of participants believe ECE increases burden on their overall workload. Even then, the majority (92.3%) still think that ECE has positive impact on their clerkship education. Taken together, it appears more hands-on interventions is needed to further improve skills of medical students in physical examination with particular emphasis on the clinical examination of breast, thyroid, musculoskeletal, and neurologic systems.

Extent of Utilization of Radiologic Images in Gross Anatomy Teaching, the Experience of Ethiopian Medical Schools

BackgroundOne of the greatest developments in modern medicine is the strides taken in radiology. Today, thanks to high-tech devices like computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound, a noninvasive glimpse into the human interior has been made possible. These recent developments have revolutionized how doctors see anatomy. To keep pace with this progress, many medical school anatomy curriculums have undergone a facelift. In these new curriculums, radiology has been presented as a practical and sufficient alternative tool for learning anatomy. This study, therefore, aimed to determine the extent of the use of radiologic images in the teaching of anatomy in Ethiopian medical schools.MethodsAn online questionnaire was used to collect, compile and analyze data from anatomy instructors in Ethiopian medical schools.ResultsThe survey showed that 55.9% of the instructors used radiologic images of one form or another in their teaching. However, it also revealed radiological images comprise <5% of the total images used in teaching. The majority (73.5%) of the instructors lacked any prior training or coursework in radiologic anatomy. Despite full-time radiology faculties existing in the schools, a relationship between the anatomy and radiology department is virtually unheard of.ConclusionThe curriculum currently in use in Ethiopian medical schools is designed in a way both vertical and horizontal integration of the traditional subjects are achieved. This way, the introduction of clinical medicine early will provide context and relevance to the learning of basic science. Despite the curriculum’s emphasis, we have observed limitations in the degree of integration of anatomy and radiology.

Narrative Analysis of Ethiopian Medical students Major Department Choice: Experience Factors, Performance and Challenge

Narrative Analysis of Ethiopian Medical students Major Department Choice: Experience Factors, Performance and Challenge

Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools.

BackgroundHuman anatomy has historically been a cornerstone in medical education and is special in that it uses human remains kept in various anatomical facilities like a morgue, gross anatomy laboratory, or museums for instruction and research. While serving knowledge advancement facilitating clinical practice and research, human cadaver handling, and usage at all levels, such as cadaver sourcing, transportation, storage, preservation, dissection, and final disposal deserves in return the utmost respect. In Ethiopia, even though there is not enough information on when, where, and by whom the first cadaver dissection was conducted, dissection is being conducted in many of its medical schools. Despite ethical necessity surrounding human body usage in every anatomical setting, there is still ethical and legal uncertainty due to several challenging barriers which is severe in developing nations including Ethiopia. The aim of this study is, therefore, to assess ethical practices of handling and usage of the human body to promote, in the near future, formulation and implementation of acceptable, respectful, and ethical guidelines for the anatomy dissection laboratories and related settings in Ethiopia.MethodsA multicentered cross-sectional study was used at selected anatomy facilities of eight Ethiopian medical schools. The collected data through structured questionnaires and checklists were cleaned, preset and entered in to SPSS version 20 for analysis. Internal consistency and reliability were measured by using Cronbach’s alpha.ResultsThe study result showed vivid human body ethical breaches that ranged from lack of power by anatomy unit to oversee the process during sourcing, transportation, embalming, caring, and dissection of cadavers in the anatomy laboratories to student’s mistreatment of cadavers.ConclusionIn addition to lack of compliance due to lack of standard ethical guidelines or policies regarding human body usage, the compliance-based professional development is also nonexistent. The ethical way of body sourcing is through body donation; however, in Ethiopia, anatomy teaching exclusively depends on unclaimed bodies. Using a body for dissection that is solely sourced unethically may generate a negative emotional sense of life for anatomy instructors, technical assistants, morticians, and medical students. We inspire better provision of moral and ethical exercise with the good practice concerning the human body through recognizing the humanity and uniqueness of the deceased person. The results of this study serve as a serious condemnation of practices in Ethiopian anatomy facilities and we urge the Anatomical Society of Ethiopia to play its part in changing the present practices related to ethical and legal uncertainty of the human body usage.

The Perception, Emotional Experiences and Cultural attachments of Ethiopian Medical Students during Human Cadaver Dissection

Human cadaver dissection has been used as an instructional methodology in Anatomy for centuries and remains time-honored and accepted method. However, initial exposure to cadaver dissection has been found to evoke emotional reactions in medical students, and has raised concern. Previous studies report that some students experience stress and even psychological trauma, with a concern about exposure to disease during dissection. The emotional experiences and coping strategies may also be affected by cultural differences between medical students. The main aim of this study is to assess and compare medical students’ perception, emotional experiences and the impact of cultural attachment on the dissection of the human cadaver. A longitudinal survey was conducted focusing on cultural identity, prior experience with cadaver dissection, emotional experiences, and coping strategies in a medical school of Addis Ababa University, Ethiopia in 2018. Data were collected at three time points a week before initial exposure to dissection (time 1), a week after the first encounter (time 2), and at the end of cadaver dissection (time 3). Findings indicate that self-rated perception of evoked emotional experiences enjoyable, stimulating, exhilarating, and interesting increased across the three time points, while scary, depressing, unbearable, and anxiety-provoking emotions significantly decreased. These results suggest that while cultural attachment appears to affect the rate of change over time in several different emotional responses, religious affiliation (Christian, Muslim) or an ethnic background (Amhara, Oromo or others) per se, do not manifest any significant differences across these emotional experiences, nor the rate at which they change for individuals in the sample.

Predictors of immunization coverage among 12\u201323\u2009month old children in Ethiopia: systematic review and meta-analysis

BackgroundImmunization is one of modern medicine’s greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12–23 months in Ethiopia.MethodElectronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I2, Funnel plot and Egger’s test was used to check for publication bias.ResultsWe identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62–3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27–3.77), residence, (OR = 2.11; 95% CI: 1.00–4.45), birth at health facility (OR = 1.86; 95% CI: 0.99–3.49), family size less than four, (OR = 1.81; 95% CI: 1.16–2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07–12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35–4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62–4.89), antennal care, (OR = 3.11; 95% CI: 1.64–5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99–7.75).ConclusionOur findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to “hard to reach areas” to improve immunization coverage for children aged 12–23 months.

Electrocardiography Interpretation Competency of Medical Interns: Experience from Two Ethiopian Medical Schools.

Background Electrocardiography (ECG) is the graphical display of electrical potential differences of an electric field originating in the heart. Interpretation of ECG is a core clinical skill in the department of emergency medicine. The main aim of this survey was to assess competency of ECG interpretation among 2018 graduating class medical students in Addis Ababa University and Haramaya University. Methodology. A cross-sectional survey was conducted on medical interns at Addis Ababa University and Haramaya University. Data had been collected from October 01, 2018, to October 30, 2018, by using structured questionnaires. Data were entered, cleaned, edited, and analyzed by using SPSS version 25.0 statistical software. Descriptive statistics, cross-tabs, chi-squared test, Mann–Whitney U test, and binary logistic regression were utilized. Results Two-hundred and two graduating medical students were involved on this survey, out of which 61.3% (95% CI 56.3–66.3%) and 32.75% (95% CI 28.25–37.25) were able to correctly interpret the primary ECG parameters and the arrest rhythm of ECG abnormalities, respectively. The ability to detect from common emergency ECG abnormalities of anterioseptal ST segment elevation myocardial infraction, atrial fibrillation, and first-degree atrioventricular block was 42.6%, 39.1%, and 32.1%, respectively. Conclusion This survey showed graduating medical students had low competency in ECG interpretations.

The Perception and Emotional Experiences of Ethiopian Medical Students during Human Cadaver Dissection

Human cadaver dissection has been used as an instructional methodology in Anatomy for centuries and remains time‐honored and accepted method. However, initial exposure to cadaver dissection has been found to evoke emotional reactions in medical students, and has raised concern. Previous studies report that some students experience stress and even psychological trauma, with a concern about exposure to disease during dissection. The emotional experiences and coping strategies may also be affected by cultural differences between medical students. The main aim of this study is to assess and compare medical students’ perception, emotional experiences and the impact of cultural attachment on the dissection of the human cadaver. A longitudinal survey was conducted focusing on cultural identity, prior experience with cadaver dissection, emotional experiences, and coping strategies in a medical school of Addis Ababa University, Ethiopia in 2018. Data were collected at three time points a week before initial exposure to dissection (time 1), a week after the first encounter (time 2), and at the end of cadaver dissection (time 3). Findings indicate that self‐rated perception of evoked emotional experiences enjoyable, stimulating, exhilarating, and interesting increased across the three time points, while scary, depressing, unbearable, and anxiety‐provoking emotions significantly decreased. These results suggest that while cultural attachment appears to affect the rate of change over time in several different emotional responses, religious affiliation (Christian, Muslim) or an ethnic background (Amhara, Oromo or others) per se, do not manifest any significant differences across these emotional experiences, nor the rate at which they change for individuals in the sample.

Assessment of the determinants of Knowledge, Attitude and Practice (KAP) of Ethiopian Medical Students towards ethical Cadaver Dissection

IntroductionAnatomy is one of the essential basic medical sciences and a key to understand the practice of medicine. Its stduy has been conventionally based around the use of cadaver dissection. Several findings ensured that dissection experience significantly improve KAP towards ethical use of human body. But, they are limited to such effect on early impression and single institution. The effect of dissection experience on KAP towards ethical use of cadaver in education and research in the subsequent years of study and evaluation of factors associated to them are lacking. ObjectiveThe purpose of this study was to investigate the Knowledge, Attitude and Practice of Ethiopian Medical Students towards ethical Cadaver Dissection. MethodMulti-centered cross-sectional study design was implemented. The study was conducted in selected Ethiopian Medical Schools among 279 Pre-clinical Medical Students of Jimma University, Addis Ababa University, Saint Paul's Hospital Millennium Medical College and University of Gondar from April 01 to April 30, 2019. Data were collected by a structured and pre-tested questionnaire and analysis was done by SPSS version 20.0. ResultsA total of 279 respondents were included in the study out of whom 156 (55.9%) were male and 123(44.1%) were female and most of the respondents were in the age groups of ≥ 21years (SD = 0.492 and variance = 0.242). The study result showed that about 45.5%, 48.7% and 39.1% of the study participants had adequate knowledge, favorable attitude, and good practice towards ethical cadaver dissection, respectively. Respecting cadaver as first patient (AOR = 2.098, 95%CI: 1.245-3.531), attending dissection session regularly (AOR = 0.572, 95%CI: 0.338-0.968), actively dissecting cadaver (AOR = 1.459, 95%CI: 0.284-0.742), utmost respect to cadaver (AOR = 0.720, 95%CI: 0.431:1.238), practice > 2 Hrs/day (AOR = 2.224, 95% CI: 0.947-5.228) and apprehension to cadaver dissection (AOR = 1.658, 95%CI: 0.537-0.962) were significantly associated with Knowledge, Attitude and Practice of Ethiopian Preclinical Medical Students towards Cadaver Dissection. ConclusionAlmost half of our study participants had favorable attitude towards ethical cadaver dissection. However, only 39.1% and 45.5% of our participants had adequate knowledge and good practice towards similar issues, respectively. Respecting cadaver as first patient, attending dissection session regularly, actively dissecting cadaver, utmost respect to cadaver, practice > 2 Hrs/day and apprehension to cadaver dissection were significantly associated factors among Ethiopian Preclinical Medical Students towards ethical Cadaver Dissection. Furthermore, though the proportion was low, exposure to cadaver dissection had lasting retention on bettter KAP towards human body usage. We envisage such experience will be translated into humanistic patient care.

Practice of code of ethics and associated factors among medical doctors in Addis Ababa, Ethiopia.

IntroductionIn the health sector, questions are being raised about the possible threats to the accepted principles of ethics such as autonomy, beneficence, non malfeasance and justice in the delivery of health care. There is limited information in Ethiopia regarding to practice of code of ethics among medical doctors. Hence, this study aimed to assess practice of code of ethics and associated factors among medical doctors working in governmental and private hospitals in Addis Ababa, Ethiopia.MethodsInstitution based cross sectional quantitative study triangulated with qualitative study was conducted among 500 medical doctors working in governmental and private hospitals and three key informants from Federal Ministry of Health, Ethiopian Food, Medicine and Healthcare Administration and Control Authority and Ethiopian Medical Association in Addis Ababa from May 8, 2017 to June 30, 2017. Data were collected using pretested self-administered structured questionnaire and semi-structured questionnaire. Binary Logistic Regression and Content Analysis methods were used for the quantitative and qualitative data analysis respectively.ResultsThe study showed that only 152 (30.4%) of medical doctors had good practice of code of ethics. The odds of having good practice of code of ethics among medical doctors in the age group of 25–29 years were 2.749 times the odds of those in the age group of 30–34 years (AOR = 2.749, 95% CI: 1.483, 5.096), medical doctors working in governmental hospitals were 65.4% less likely to have good practice of code of ethics compared to those working in private hospitals (AOR = 0.346, 95% CI: 0.184, 0.652), knowledgeable medical doctors were 83.5% more likely to have good practice of code of ethics compared to those who were not knowledgeable about code of ethics (AOR = 1.835, 95% CI: 0.999, 3.368), and the odds of having good practice of code of ethics among medical doctors with favourable attitude were 7.404 times the odds of those with unfavourable attitude towards code of ethics (AOR = 7.404, 95% CI: 4.254, 12.887). Furthermore lack of motivation, unfavorable working environment, working at various health facilities simultaneously, public awareness, taking courses on medical ethics, lack of unethical conduct reporting and complaint handling system, incompetence of medical doctors, and weak collaboration among key stakeholders were identified as determinants of practice of code of ethics.ConclusionsOnly 30.4% of medical doctors had good practice of code of ethics. This indicates that practice of code of ethics among medical doctors in Addis Ababa is poor. The factors associated with practice of code of ethics were age, type of hospital, knowledge, attitude, lack of motivation, unfavorable working environment, working at various health facilities simultaneously, public awareness, medical ethics course, lack of unethical conduct reporting and compliant handling system, incompetence of medical doctors and weak collaboration among key stakeholders. Hence, awareness creation and attitudinal change on code of ethics by continuous training, implementation of integrated medical ethics course, enforcement of code of ethics and continuing professional development (CPD) implementation are important.

Renal artery origins, destinations and variations: Cadaveric study in Ethiopian population

Introduction: Renal arteries are paired end arteries branched from abdominal aorta at the level of first lumbar vertebra (L1) and second lumbar vertebra (L2), which consumes around 20% of the cardiac output. Due to embryological and racial reasons variation in distribution of the renal artery is common. The aim of the present study is to describe the origin, distribution and possible variations of renal arteries. Methods and materials: Observational based study was conducted by using 30 cadavers (60 sides) obtained from the Department of Human Anatomy of six Ethiopian Medical Schools. Data analysis was conducted using thematic approaches. Results: Forty-seven percent of the main renal artery originates at the level of L1 from the abdominal aorta. Of the 10 (33.3%) accessory renal arteries, 7(63.63%) and 3 (27.27%) were identified on the left and right sides respectively. Conclusions: The variations of the main renal arteries mainly revolved around the level of origin and manifested prehilar branching pattern while entering into the kidney parenchyma. Another commonly observed variation was the existence of an accessory renal artery in different patterns. Hence, knowledge of renal vascular pattern and possible variations is very important in clinical and surgical procedures mainly during renal transplantation and other vascular interventions.

Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School.

IntroductionEmergency Medicine is a medical specialty based on knowledge and skills required for the prevention, diagnosis and management of the acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders. Addis Ababa University School of Medicine started its Emergency Medicine Residency in 2010 and Emergency Medicine training for fourth-year medical students started in 2013. This study aims to assess attitudes of fifth year medical students towards Emergency Medicine training and its contribution to their final year of medical school training.MethodsTwo hundred fifth year medical students participated in the study by convenience sampling. Self-administered questionnaires and Likert scales were used for data collection. Descriptive frequencies and chi-square analysis were done for categorical data. Ethical oversight was provided by the Institutional Review Board of the Addis Ababa University College of Health Sciences.ResultsOf the 200 participants, 150 were male and 50 were female. 80% agreed its relevance for undergraduates. Relevance was significantly associated with recommendation to other medical schools (χ2 = 8.34, Pr = 0.004). 72% of respondents agreed lectures are appropriate teaching methods, 70% agreed group activity, 68.5% skill sessions, 67.5% morning discussions, 64% diagnostic session, 60% duty exposures and 45% seminars. Difficulties faced during internship are primarily attributed to lack of facilities, ranging from the setup of the emergency centre to instruments and emergency drugs. 60% of respondents agreed that Emergency Medicine training is important to future careers. 65% agreed recommending training to other medical schools.ConclusionAn Emergency Medicine rotation during the final year of medical school provides opportunities to learn about undifferentiated medical emergencies and it should be included for other medical schools in the country. Participants suggest that leadership aspects of Emergency Medicine need more emphasis as the curriculum is further developed in the future.

Ethiopian medical schools' rapid scale-up to support the government's goal of universal coverage.

In 2003, Ethiopia declared it would pursue the goal of universal primary health coverage. In response to the critical shortage of human resources for health care, the government decided to rapidly increase the training of health workers to provide basic services, including health education, disease prevention, and family health services primarily to rural areas. This approach, which became known as the "flooding strategy," was extended in 2005 to include medical doctors. Between 2003 and 2009, the number of universities and health science colleges grew from 5 to 23, and the original 5 medical schools were given a mandate to increase their annual enrollment by three to four times. This article describes how the "flooding strategy" strained and threatened the quality of the Ethiopian medical education system and how Addis Ababa University responded by leveraging a timely grant through the Medical Education Partnership Initiative (MEPI) to support the establishment of a consortium of four Ethiopian medical schools (MEPI-E). The consortium goals are to address the new demands by (1) maintaining and improving the quality of education through innovation and efficient use of resources, (2) developing and implementing new strategies to build human capacity and promote faculty retention, and (3) increasing locally relevant research and bioethics capacity. Implementation of program began in May 2011. Although it is still under way, MEPI-E has already catalyzed the development of a national network of medical schools, enabling unprecedented collaboration to respond to the increased demands on the Ethiopian medical education system.