In a major new Lancet Commission report, released November 29, 20 academic and professional leaders call for “major reform” in the education and training of doctors and other health care professionals to equip them for the 21st century. Dr Zulfiqar Bhutta, Chair, Aga Khan University’s Division of Women and Child Health, Pakistan is among the 20 Global Commission Members.
The report Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World has been put together by this Global Commission led by Professor Julio Frenk, Dean, Harvard School of Public Health, Boston, MA, USA, Dr Lincoln Chen, China Medical Board, Cambridge, MA, USA.
The Report underscores the need for change. Change is needed because of fragmented, outdated, and static curricula that produce ill-equipped doctors, nurses, midwives and public health professionals. Mismatch of competencies to actual patient and population needs; predominant hospital orientation at the expense of primary care; and weak leadership to improve health-system performance are some of the systemic problems that the authors point out.
“Much of the findings of the Global Commission’s work are of particular relevance to developing countries, especially Pakistan where increasingly, undergraduate and postgraduate medical education and training institutions are struggling to meet today’s public health challenges ,” says Dr Bhutta.
The report suggests a number of reforms that are both “instructional and institutional”. These include adoption of competency-based curricula that are responsive to rapidly changing needs and can be adapted to local contexts; the promotion of inter-professional and trans-professional education that breaks down barriers between health care professions and specialties; providing balanced opportunities for women and enrolling students from marginalised areas; and nurturing a culture of critical inquiry.
“Educational reform is a long and difficult process that demands leadership and requires changing perspectives, work styles, and good relationships between all stakeholders,” write the authors. They suggest that national efforts should focus on institutional reform, through joint planning in the education and health sectors. All stakeholders should be engaged in the reform process to extend academic learning sites into communities, develop global collaborative networks for mutual strengthening in developing and developed countries , and lead in the promotion of a culture of “critical inquiry and public reasoning”.
“The authors also call on international agencies, professional bodies, educators, students and others to “embrace the imperative for reform through dialogue, open exchange, discussion, and debate about these recommendations,” concluding that, “ultimately, reform must begin with a change in the mindset that acknowledges challenges and seeks to solve them.”