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Health ensures vitality and productivity, and health care is a basic human right encompassed in various UN declarations and WHO commitments.1,2 Provision of health to its people demands structural organisation and systems planning by a government. This in turn requires emphasis on health professions education and material resources, after analyses of demographic inputs and unique local health issues.  The Flexner Report of 1910 was a watershed in providing a roadmap for marrying technological advances in medicine with systemic reforms in health education—translating into better health care.3 An in-depth review of the 100 years that have elapsed since the Flexner Report by a Global Commission of experts (published in The Lancet in 2010), has provided a reality check for health planners of the 21st century.4 The Commission estimated a global count of 2,420 medical schools, 467 schools or departments of public health, and an indeterminate number of postsecondary nursing educational institutions, training about 1 million new doctors, nurses, midwives, and public health professionals every year. This seemingly positive picture is, unfortunately, counter-balanced by the realisation that four countries (China, India, Brazil, and USA) each have more than 150 medical schools, whereas 36 countries have no medical schools at all.4 Besides these astounding figures, the Report points out glaring gaps in health professions education due to outdated curricula, poor manpower planning (qualitative and quantitative) and a dismal financial outlay on health education (only 2% of the annual budget in some of the most advanced countries).5  Against this backdrop, a very contemporary article by Gillian White, Transforming education to strengthen health systems in the Sultanate of Oman, is published in this issue of SQUMJ.6 Its comprehensive framework reviews the links between education and health systems in Oman. Through interaction with the labour market, the provision of educational services supplies an educated workforce to meet the demand for professionals to work in the health system. The author refers extensively to the findings outlined in the Lancet Commission’s Report 2010,4 and its recommendations for new instructional and institutional strategies for the design of health care professions education subsystems.  It is noteworthy that, like other Gulf Cooperation Council (GCC) countries, Oman was a net importer of its health workforce only four decades ago. Visionary self-reliance initiatives, prompted by an increasing competition for health workforce in the global market place and the urgency to create more employment opportunities for citizens, improved the public health sector manpower. From just 13 physicians and a few nurses in 1970 (serving a total population of approximately 732,000), by 2007 the physician-population ratio had risen from 0.18 per 10,000 to 17.9 per 10,000 and a nurse-population ratio to 37.9 per 10,000. The total number of physicians employed by the Ministry of Health (MoH) grew 5.4-fold during the period 1985–2007 (from 638 to 3,459). During the same period, the number of nurses grew 4.5-fold (from 1947 to 8,143). The representation of Omanis in the MoH workforce grew from about 52% in 1990 to 68% in 2007, including leading categories such as physicians, nurses and laboratory technicians.7  Contributing to this remarkable achievement were MOH-established nursing and allied health science institutes, the College of Medicine & Health Sciences at Sultan Qaboos University (SQU) established in 1986, the Oman Medical College (a private medical school) and the Oman Medical Specialty Board pioneering postgraduate residency programmes in the country. In all, 1,053 students earned their MDs from SQU during 1993–2007.8 These figures classically illustrate the sequential progression from assessing health needs to planning health education, with a resultant trained workforce to meet the health delivery challenges of the country.  The Lancet Commission Report, and in turn the article by Gillian White,6 refer to three sequential generations of educational reforms through the last century: the first taught a science-based curriculum; the second introduced problem-based instructional innovations; the third now proposes to refine educational systems by adapting core professional competencies to specific local contexts, while drawing on global knowledge.4,6 The process of achieving this is through transformative learning and interdependence in education.  Transformative learning involves three fundamental shifts: from fact memorisation to searching, analysis, and synthesis of information for decision making; from seeking professional credentials to achieving core competencies for effective teamwork in health systems, and from non-critical adoption of educational models to creative adaptation of global resources to address local priorities. ‘Instructional’ reforms enable this form of learning.4  Interdependence in education also involves three fundamental shifts: from isolated to harmonised education and health systems; from stand-alone institutions to networks, alliances, and consortia; and from inward-looking institutional preoccupations to harnessing global flows of educational content, teaching resources, and innovations. ‘Institutional’ reforms are the key to achieving these transformations.4  Gillian White effectively summarises the emerging generations of health profession educational reforms over the last century and the complexities of the health challenges of the new millennium detailed in the 2010 Lancet Commission Report. She then provides a historical overview of health planning, delivery and education over the last 40 years in the Sultanate of Oman and discusses the implications and applicability of the Report for health profession education in the country. The article lays specific emphasis on the organisation and education of nursing and allied health sciences, the achievements thus far and an incisive critique of unaccomplished goals.6  It is pertinent to draw the reader’s attention to a number of existing transformations already in place in the College of Medicine & Health Sciences at SQU, the premier public university of Oman, and in the Oman Medical Specialty Board which governs postgraduate medical residency training in Oman. The succeeding paragraphs highlight how these measures fulfil in part or whole the six recommendations of the Lancet Report4 for instructional, and four recommendations for institutional reforms in health professions education to achieve the outcomes of transformative learning and interdependence in education.

Health Professions Education in Oman : A Contemporary Perspective = تعليم المهن الصحية في سلطنة عمان : منظور معاصر