BackgroundThe purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future.MethodsData were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year.ResultsStudents decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor.The degree of feminization of the student population differs among the different countries.Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education.Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation.Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries.Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad.ConclusionsMedical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given to the socialization of students and the role model status of their teachers.In countries with scarce medical resources, the hospital orientation of students' expectations is understandable, although it should be associated with the development of skills to coordinate hospital work with the network of peripheral facilities. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country.
BackgroundMedical training has shown to be strategic for strengthening health systems, especially in those countries identified to have critical shortage of human resources for health. In the past few years, several studies have been conducted to characterize and identify major challenges faced by medical schools worldwide, and particularly in Africa. Nevertheless, none has previously addressed medical training issues in Portuguese Speaking African Countries (PSAC). The aim of this study was to establish baseline knowledge of the PSAC’s medical schools in terms of creation and ownership, programmes offered, applicants and registered students, barriers to increased intake of students, teaching workforce and available resources.MethodsA quantitative, observational, multicentric, cross-sectional study of all medical schools active in 2012 in the PSAC. An adapted version of the questionnaires developed by Chen et al. (2012) was sent to all medical schools electronically. Data were analyzed using descriptive statistics.ResultsA total of nine medical schools answered the questionnaire (three from Angola, two from Guinea Bissau and four from Mozambique). Since 2006 an effort has been made to increase the number of medical trainees. Besides the medical degree offered by all schools, some offered other undergraduate and postgraduate training programmes. The number of applicants to medical schools largely outnumbers the available vacancies in all countries but insufficient infrastructures and lack of teaching personnel are important constraints to increase vacancies. The teaching personnel are mainly trained abroad, employed part-time by the medical school and do not have a PhD qualification.ConclusionGovernments in the PSAC have significantly invested in training to address medical shortages. However, medical schools are still struggling to give an adequate and effective response. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country and develop local faculty capacity.
BackgroundA global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools.MethodsThe information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country.ResultsThe order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043).ConclusionsThe reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.
Os apelos para reformas na educação médica são constantes e têm sido objeto de recomendações produzidas nos últimos cem anos, destacando-se as resultantes da avaliação crítica feita por Abraham Flexner, em 1910, nos Estados Unidos da América. No presente trabalho, abordam-se as tendências e os desafios atuais da educação médica e da investigação em saúde, com ênfase para os países em desenvolvimento, ressaltando-se a realidade africana. Com base na bibliografia consultada, apontam-se e discutem-se alguns desafios que se colocam ao binômio educação médica/investigação em saúde em Angola, muito em especial no contexto da II Região Acadêmica, que integra as províncias de Benguela e Kwanza Sul, destacando-se: (i) a necessidade de incorporar novas abordagens curriculares para o reforço da aprendizagem ao longo da vida; (ii) a aquisição e o desenvolvimento de competências de investigação científica orientadas para a caracterização e intervenção sobre a situação de saúde local; (iii) a inovação dos métodos de ensino e a incorporação de novas tecnologias na educação e prática médica; (iv) a contribuição para o reforço e melhoria da distribuição de médicos na região.
Trata-se do editorial da edição inaugural da Revista Angolana de Ciências da Saúde (RACSAÚDE).
Background Angola is among one of the most deprived countries in the world in terms of medical professionals. In the past decade, the Angolan Government has invested in the expansion of faculties of medicine in the country. We analysed the profiles of medical students in Angola according to four clusters of medical schools: older faculty in the country, private faculties, Cuban sponsored faculties and military faculty; under the assumption that the organizational culture of the different faculties might influence the expectations and decisions towards future professional life of medical students regarding where they want to work (community versus hospital) and in which sector (exclusively public versus not exclusively public). Methods Observational cross-sectional study. Piloted, standardized questionnaire to final year medical students or higher year of training in the first four-month of 2014 (N = 402). Data were entered into a SPSS v.20 database and descriptive statistics computed. Statistical significance for categorical variables was tested by Pearson chi-square, Fisher exact or likelihood ratio tests as appropriate. Comparison of means was tested with Anova. Backward elimination binary logistic regression was used to test the hypothesis that type of faculty of medicine is an important determinant of future professional practice, i.e., level (hospital vs. community) or sector of practice (exclusive public sector vs. private or private and public), while controlling for confounders. Results After controlling for age, sex, marital status, place of birth and place of primary and secondary education, type of family and family influence, students were more likely to choose community over hospital practice and to prefer exclusive public practice if attending a Cuba supported faculty of medicine. Conclusions Medical education cannot be isolated from planning of the medical workforce. Some important and impactful careers choices, like choosing rural over urban practice, public over private sector practice, have deep influences in the medical professionals’ labour market. Some of these decisions are shaped even before the end of the medical training. As such, the monitoring of future professional intentions in medical schools should be done regularly to accommodate both the health system needs and the hopes and dreams of medical trainees.
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