The strengths of African-based training

Medical education that is responsive to extensive community need is no easy task, nor is it taken lightly. In 2023, there were 444 medical schools in Africa – many of which were established in direct response to health workforce shortages. The curricula in these universities are constantly being adapted to better serve the shifting needs of the populations, including adoption of Competency-Based Medical Education (CBME) and Problem-Based Learning (PBL).

In many of the curricula, focus is placed on social responsiveness, with training prioritising the needs of more vulnerable community groups and equipping graduates to be competent rural primary care practitioners. This primary care focus ensures strong knowledge of common conditions in the region, such as malaria, tuberculosis and HIV. This differs from many traditionally prestigious medical schools, which prioritise cutting-edge research, complex diagnoses and advanced treatment methods. 

A growing number of programmes feature cultural competency training and courses to learn medical terminology in local languages. Given the diversity of languages in many contexts, this component is critical for patient communication and experience, but is no small addition. Programmes also aim to foster critical consciousness – a commitment to addressing issues of societal relevance in health care.

African-led health research is on the rise, allowing local actors to determine their own research priorities. This research also tends to have a strong sense of social responsiveness. Rwanda’s University of Global Health Equity was developed for this explicit purpose. The shift to more African research hubs also means the continent has a growing cohort of clinician-scientists, passionate about addressing the issues they witness in clinical practice. Innovations in education and health-tech are also on the rise. For example, Tunisia developed a high-tech medical simulation centre to teach technical clinical procedures during Covid-19.

Breadth and depth of experience are a major contributor to Africa’s capable medical workforce

Finally, there is strength to be found in the clinical competency of African-trained graduates – the breadth and depth of experience are a major contributor to Africa’s capable medical workforce. Training in these settings not only hones practical skills, but also clinical examination and judgement by removing the possibility of reliance on investigations (such as CT scans and MRIs, which may be less available). Adaptability is fostered as graduates learn to work effectively in low-resource settings.

The gap in practical competencies between graduates from Africa and their high-income peers is most frequently noted in reviews of medical elective and exchange programmes. These organised programmes offer medical students and professionals an opportunity to work in different healthcare settings, often with a focus on hands-on experience. The literature describes the benefits of African-based electives for improving the clinical skills of high-income country trainees from a range of disciplines and levels.

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