title: Innovative strategies for transforming internal medicine residency training in resource-limited settings: the Mozambique experience.
abstract: With approximately 4 physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient well-trained medical school faculty is one of Mozambique's major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. After an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital's internal medicine residency program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the internal medicine residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities.
authors: Dr. Mocumbi is professor, Instituto Nacional de Saúde and Department of Medicine, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique. Dr. Carrilho is associate professor, Department of Pathology, Faculdade de Medicina, Universidade Eduardo Mondlane and Hospital Central de Maputo, Maputo, Mozambique. Dr. Aronoff-Spencer is codirector, Distributed Health Labs and Medical Education Partnership Initiative, and informatics coordinator and VA staff physician in infectious diseases (HIV), University of California, San Diego, San Diego, California. Dr. Funzamo is medical researcher, Instituto Nacional de Saúde, Ministério da Saúde and Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique. Dr. Patel is professor, Department of Medicine, Hospital Central de Maputo and Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique, and University of California, San Diego, San Diego, California. Dr. Preziosi is assistant professor of medicine and clinical director for the residents, University of California, San Diego, San Diego, California. Dr. Lederer is Health Sciences assistant clinical professor, Department of Medicine, University of California, San Diego, San Diego, California. Dr. Tilghman is assistant professor of medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, California. Dr. Benson is professor of medicine and director, Infectious Disease Training Program, Divisions of Infectious Diseases and Global Public Health, and director, Antiviral Research Center, University of California, San Diego, San Diego, California. Dr. Badaró is professor, Universidade Federal da Bahia, Salvador-Bahia, Brazil. Prof. Nguenha is head, Mozambique Institute for Health Education and Research, Maputo, Mozambique. Dr. Schooley is professor of medicine and head, Division of Infectious Diseases, University of California, San Diego, San Diego, California. Dr. Noormahomed is professor, Faculdade de M
authors: Ana Olga
authors: AO
authors: Mocumbi
authors: Carla
authors: C
authors: Carrilho
authors: Eliah
authors: E
authors: Aronoff-Spencer
authors: Carlos
authors: C
authors: Funzamo
authors: Sam
authors: S
authors: Patel
authors: Michael
authors: M
authors: Preziosi
authors: Philip
authors: P
authors: Lederer
authors: Winston
authors: W
authors: Tilghman
authors: Constance A
authors: CA
authors: Benson
authors: Roberto
authors: R
authors: Badaró
authors: A
authors: A
authors: Nguenha
authors: Robert T
authors: RT
authors: Schooley
authors: Emília V
authors: EV
authors: Noormahomed
mesh_terms: D035843:Biomedical Research / Q000193:education; D002140:California; D057191:Capacity Building; D003479:Curriculum; D004059:Diffusion of Innovation; D004503:Education, Medical, Graduate / Q000639:trends*; D017144:Focus Groups; D007388:Internal Medicine / Q000193:education*; D007391:International Cooperation; D007396:Internship and Residency; D008490:Medical Informatics; D017145:Models, Educational; D009073:Mozambique; D020380:Needs Assessment; D010820:Physicians / Q000600:supply & distribution; D012577:Schools, Medical / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000639:trends