Premium
Medical electives in sub‐Saharan Africa: a host perspective
Author(s) -
Kumwenda Ben,
Dowell Jon,
Daniels Katy,
Merrylees Neil
Publication year - 2015
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.12727
Subject(s) - tanzania , curriculum , perspective (graphical) , context (archaeology) , medical education , developing country , qualitative research , health care , quality (philosophy) , psychology , medicine , nursing , political science , sociology , pedagogy , economic growth , socioeconomics , geography , social science , philosophy , archaeology , epistemology , artificial intelligence , computer science , law , economics
Context Electives are part of most Western medical school curricula. It is estimated that each year 3000–4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate. Objectives The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub‐Saharan Africa from a host perspective. Methods A qualitative analysis of 14 semi‐structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio‐recorded data. Results Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under‐resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care. Conclusions The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts’ perspective, but individually host institutions lack the opportunity or ability to achieve change.