title: Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq.
abstract: OBJECTIVE
  This study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development.
  
  
  METHODS
  Deans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically.
  
  
  RESULTS
  Primary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions.
  
  
  RESULTS
  Of 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating.
  
  
  CONCLUSIONS
  Medical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation.
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK Faculty of Medicine, St George's University of London, London, UK Catastrophe and Conflict Forum, Royal Society of Medicine, London, UK.
authors.forename: Ashton
authors.initials: A
authors.lastname: Barnett-Vanes
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
authors.forename: Sondus
authors.identifier: http://orcid.org/0000-0001-9763-1332
authors.initials: S
authors.lastname: Hassounah
authors.affiliation: University of Baghdad, Baghdad, Iraq.
authors.forename: Marwan
authors.initials: M
authors.lastname: Shawki
authors.affiliation: University of Baghdad, Baghdad, Iraq.
authors.forename: Omar Abdulkadir
authors.initials: OA
authors.lastname: Ismail
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Chi
authors.initials: C
authors.lastname: Fung
authors.affiliation: Dartmouth Medical School, Hanover, New Hampshire, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Kedia
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
authors.forename: Salman
authors.identifier: http://orcid.org/0000-0001-7191-2355
authors.initials: S
authors.lastname: Rawaf
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
authors.forename: Azeem
authors.identifier: http://orcid.org/0000-0002-2357-9858
authors.initials: A
authors.lastname: Majeed
mesh_terms: D000068337:Armed Conflicts; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003479:Curriculum; D004501:Education, Medical / Q000592:standards*; D006801:Humans; D007493:Iraq; D012577:Schools, Medical / Q000592:standards*; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Conflict; Medical education; Training; War; healthcare