Reforms in medical education: lessons learnt from Kyrgyzstan

ABSTRACT

Human resources are one of the six building blocks of a health system. In order to ensure that these resources are adequately trained to meet the evolving needs of populations, medical education reforms are needed. In Kyrgyzstan, like in many other low- and middle-income countries, human resources for health are a key challenge for the health system in both the quantity and having their training aligned with the health system priorities. Here we present the experience of the Medical Education Reform Project, a project aimed at improving the quality of health professionals through reforming medical education, funded by the Swiss Agency for Development and Cooperation, as a collaborative effort between partners in Kyrgyzstan and Switzerland since 2013. We used a qualitative study taking a cooperative inquiry approach with an experiential perspective in order to present the implementation of the Medical Education Reform Project in Kyrgyzstan. In order to look at the different components impacting the reform process, a framework comprising: Setting the direction; Building a consensus; Engaging stakeholders; Pilot projects and evaluation; Capacity building; Timing, and Key partners was used to disentangle the lessons learnt. Champions and partnering with key institutions were essential in building consensus, as was the catalytic and facilitating role the project played. This enabled active engagement of a variety of stakeholders in the reform process using different means of interaction ranging from large roundtable discussions, workshops, trainings and even study tours. Pilot projects and research provided tangible actions that could be used to further the reforms. For capacity building, the project offered a wide range of activities that improved clinical competencies, empowered stakeholders, and strengthened organizational capacity. The timing of this reform process in medical education was facilitated by the overall reforms and policies in the health system.

KEYWORDS:

• Education, medical
• education, medical, undergraduate
• education, medical, graduate
• education, medical, continuing
• health care reform

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Acknowledgments

The authors would like to acknowledge the support of all stakeholders involved in the reform process in Kyrgyzstan and the support from the Swiss Embassy in Kyrgyzstan.

Additional support for some activities was provided by the Geneva University Hospitals and Maurice Foundation.

Authors contributions

DB carried out the first analysis and prepared the first draft; LL and OH carried out further analysis; All authors contributed to the critical review of the results and finalization of the manuscript.

Ethics and consent

There were no human participants in this study beyond the authors.

Data sharing statement

All reports and material are available at http://www.ime.org.kg/ or on request from the authors.

Disclosure statement

EM is an employee of the SDC who funded this work.

Paper context

Education reforms are needed to align health worker competencies with population health needs. We present the Medical Education Reform project in Kyrgyzstan, which since 2013 has worked to improve the quality of health professionals through reforming medical education. The lessons from this project in order to implement successful reforms are the: catalytic effect and facilitating role of external support; importance of working with champions; and partnering with key institutions to build a consensus.

Additional information

Funding

The MER Project is funded by the Swiss Agency for Development and Cooperation, Grant: 7F-08530.02.01.