Students’ and junior doctors’ preparedness for the reality of practice in sub-Saharan Africa

Abstract

Background: Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region.

Aim: To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context.

Methods: Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model.

Results: Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors’ motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work.

Conclusion: An innovative problem- and community-based curriculum can improve sub-Saharan African doctors’ motivation and preparedness to tackle the challenges of health care practice in this region.

Acknowledgments

We are grateful to all medical students and graduates who participated in this study and to the staff of the participating schools who facilitated this study. We thank Mereke Gorsira (Department of Educational Development and Research, Maastricht University) for editing the manuscript. We thank the Research Centre for Education and the Labour Market for providing us with the REFLEX questionnaire. We are grateful to Bernard Groosjohan (Eduardo Mondlane University) for his assistance in research logistics in Mozambique.

Declaration of interest: The authors report no declarations of interest.