Transcript The New Innovative Medical Curriculum for Ethiopia
The New Innovative Medical Education Initiative
Launching at Ambo University Dr. Yodit Abraham (Col) Consultant Internist ,MBA Federal Ministry of Health Ambo Feb 4, 2012
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No one should get sick when we can Prevent i
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No one should die when we can cure !
Our vision is For All Ethiopians to enjoy highest possible standard of health care.
To take this vision to the remotest parts of Ethiopia to the villages beyond the villages ◦
W e need to saw the seeds here and now!
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If not now when if not us who !
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We cannot harvest what we have what we have not sawn !
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let us plough the land, eradicate the weed, water the soil and plant the best seeds now!
NIMEI is a Government Initiative Leadership : joint FMOH and FMOE Under the focus of the of Medical and Health Sciences and Curriculum council .
Curriculum development: was by taskforce from FMOH, Tulane University ,FMOE,5 Universities,WHO and Jhpiego.
Currently has wide base partner’s involvement on the implementation.
The Need : to fill the demand and supply gap
The inherent gap :
in number of Physicians in the Health care in absolute terms and distribution
The countries development pace and induced needs
◦ Economic ,Social and basic infrastructure growth and induced needs for services from the health sector
Doctor to Population ratio:
1 physician per 36,158 people 43% working in Addis Ababa .
The shortage of physicians is attributed to a combination of factors : a) Limited number of medical schools, b) Limited capacity of enrolling students of MS, c) Shortage of medical educators and faculty, d) Internal displacement and Brain-drain
The predicted Doctor to Population ratio in 5-8 years time : >
1 physician per 10,000 people
New Innovative Medical Education Initiative (NIMEI):
◦ A new medical education system has already been developed ◦ Enrollees graduates with BSc degree in Health and natural sciences ◦ 10 Universities and 3 hospital based medical schools established
A new medical education system A New Competency Based Curriculum Faculty Development system Student recruitment and selection and graduation system IT support system of the education Educational environment and recourses standards System of continuous monitoring and evaluation
Goal:
To educate medical doctors quantitatively sufficient and professionally competent to provide quality health care services to meet the demand of the Nation .
To educate the 21st century medical doctors of Ethiopia.
To produce medical doctors of the 21 st be century for Ethiopia who will “six star doctors” equipped with a comprehensive knowledge to functions as : • Care Provider • Decision -maker • Team leaders • Researchers • Teachers in the health sector • Social mobilizer
In 2009 Taskforce was established with members form : ◦ The Federal Ministry of Education, ◦ The Federal Ministry of Health/Tulane University , ◦ Addis Ababa University, Jimma University, Mekele University, Hawassa University ,Gondar University ◦ WHO and JHPEIGO
Global trends in medical education Changes and reforms even in the developed countries Direction & strategies for in "The Edinburgh Declaration” Social accountability of medical education
Basic Sciences Clinical Sciences hospital based Basic Sciences Clinical Sciences hospital -based Basic Sciences Clinical Sciences Hospital based Communit y based
Study the current situation National Surveys conducted Stakeholders Opinion Survey • • • • • Desk review Ethiopian situation Global trends of medical Education Advantages Anticipated challenges • Stakeholders opinion survey • Competency assessment survey of General Practitioners • University presidents • Deans • Hospital Directors • Practising Physicians • Professional association leaders Competency Assessment Survey Ethiopian Experience • • 700 doctors and health professionals in 72 hospitals participated Self report GPs with in 5yrs of service on their medical Education • National medical Curriculum • Jimma University : CBE • Defence college of HS : HO to MD • St. Paul Millennium college :
Benchmarking International Experiences Curriculum Development NIME Curriculum Visit of 12 universities • Canada • • Netherlands South Africa • Sudan • Egypt - Review of Several other curricula Globally
Approach
-Six step approach
Based on the
-Competency assessment result -Stakeholder opinion survey result -Benchmark result -International experts consultation -Desk review • Competency Based • Hybrid • Integrated • Inquiry driven methods • Modular National Area Experts work shop National Medical & Health science Council • Universities • Professional Association • Partner organizations • Private hospitals and colleges • 21 Universities • 5 regional Health bureaus • Private collages and hospitals • Partner organization • and other stakeholders
The following medical curricula were reviewed: Addis Ababa University medical faculty Jimma University Defense college of health sciences St. Paul's millennium medical school
2.7.Competency assessment survey
5/1/2020 22
Clear needs for Changes and improvement Gaps in skills in emergency surgical and life saving clinical skills Missing and redundant courses were identified Improving quality of care and teaching the hospitals Evaluation of students should be objective following several methods and progressively 5/1/2020 23
The survey included four categories ◦ Universities : Presidents/AVP/Medical/Health science faculty Deans (16) ◦ ◦ ◦ Hospitals :Chief Executive Officers , Directors and Deputy Directors of hospitals affiliated hospitals(28) , Professional association :Leaders (6) Physicians: GPs and specialists ( 44)
Canada: Mac masters &Northern Ontario Universities South Africa: Walter –Sisulu Universities and Nelson Mandela University Sudan: Khartoum university , AHFAD, Academy for Medical Studies and Jezira university.
Netherlands : Maastricht University Egypt : University Cairo aSuez canal University
Step 1 : Problem identification &needs ass Step 2 : Identifying competencies Step 3: Objective of the curriculum Step4 : Educational strategies Step5 :Resources standard Development Step 6: Implementation plan & M/E of the program
• The NIME curriculum is a Competency Base with the following principles and strategies Early community and clinical contact • Community orientation in medical education (COME) • Integration of the different sciences and unity between education & practice • Self-directed learning • Problem-based learning (PBL) • ICT supported • Continuing professional development (CPD)
The NIME Curriculum identifies seven domains of core competencies expected from a graduate: 1.
Professional Values, Attitudes, Behavior and Ethics 2.
Scientific foundation of Medicine 3.
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Communication skills Clinical skills, Population Health and Health Systems Management of Information Critical thinking and research, Practice-Based Improvement
The major arms of the curriculum Biomedical and Clinical Sciences Professional competency development (PCD) Social and population sciences (SPH)
Five major components: 1.
Introduction to Medicine 2.
Integrated System Based module 3.
Clerkship 4.
Internship 5.
Social and population health(SPH) ◦ PCD integrated with all
Total : 4 and 1/2 years including 1 year Internship Year 1 45 weeks Year 2 48 weeks Year 3 Clerk ship I Year 4 Clerkship II Internship 48 weeks 53 Weeks 48 weeks
• Competency based curriculum • Incorporated new educational strategies • Competency, learning objective, methodologies and assessment linked • Integrating Biomedical ,Professional competency development ,social and population health sciences with in their disciplines and with each other • Modular delivery
Emphasis on : ◦ Essential clinical and professional skills ◦ Emergency live saving surgical and obstetrics skills ◦ Ethiopian health problems, Infectious diseases& rural health introduced
Designed to take place under ◦ FMOE : Universities under the Education sector ◦ FMOH : Regional Hospitals and Health Sciences Collages under the Health sector transforming them in to medical schools
10 University based Medical schools 1.
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Ambo University Axum University Debre-Birhan University Dilla University 5.
Debre-Markos University 6.
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DireDawa university Made-Walabu University Wolega University Wolayta Soddo University 10.
Wollo University
3 Hospital based Medical schools
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Adama Hospital Yekatit 12 Hospital Yirgalem Hospital
Phase One- Preparation Phase Two- Implementation Phase Three -Out put evaluation
Activities under taken ◦ Budget allocation and mobilization of resources, ◦ Introduced of Curriculum to all stake holders, ◦ Familiarization training on the NIME Curriculum, ◦ Faculty development training for 110 teachers form the implementing schools has been completed .
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◦ Faculty pool, ◦ Sites preparation , ◦ Material resources, ◦ Student entrance exam , selection and recruitment ◦ process Web page development http://info.moe.gov.et
Phase two
: ◦ Strengthening of systems: educational, managerial and other relevant systems ◦ System development for continuous evaluation ◦ Continuous capacity building ◦ Expansion of program
Phase three
: o Output evaluation
Faculty pool development in the medical schools.
◦ ◦ ◦ ◦ Recruit the existing faculty in the MS Involve inter professional group of professionals Encourage Private public partnership Involve the retired but not tired ◦ ◦ ◦ ◦ Ethiopian Diaspora Expats and friends of Ethiopia Volunteers
Faculty development through training • To shape the minds and hearts of the future Ethiopian.
• Equip medical educators with adequate knowledge, skill and attitude to teacher and facilitate student learning Phase 1: Initial training on the curriculum, teaching skills and other professional relevant areas.
Phase 2: Medical Education at MSC level.
Recruitment and Admission process ◦ Graduate of Natural and Health sciences ◦ ◦ ◦ ◦ Criteria based and credential check Preparation for National Entrance examination National Entrance examination(Joint) Interview ◦ ◦ Graduation National Exit examination before graduation Preparation for national Entrance examination
2900 registered: System of Registration developed web supported 2741 sat for the National Entrance Examination 1017 passed the National Entrance Examination and placmemt in the13 medical schools completed Registration for class starts Yekatit 5 th
Conducted in 13 medical schools
Teleconference applications for Tele education and tele medicine e-learning platforms Computer Assisted Learning applications Tools for the retrieval and management of Information Computer based assessment of students Develop the curriculum web based Simulations for skill and integrated labs Development Cases for PBL [Simulation ]
Joint program between FMOE,FMOH and MICT on tele-education; e-learning platforms and development of web based curriculum and learning management system is being worked .
Case simulation for PBL with electronic content will be prepared with partners.
◦ ◦ ◦ ◦ ◦ ◦ ◦ The NIMEI resource standard has been developed Training packages Integrated Laboratories Skill laboratories Books ICT and audiovisual equipments Printing and binding Vehicles
We do not have yet have enough Faculty Educational resource ICT supports But through time with cooperation of all stakeholders we will attain our goals!
Let us realize our dreams !
that no one dies for lack of health care and no one get sick for lack of prevention!
then we can sit back and tell our selves that we were on the right track !
I thank you !!!