Academic journal article Higher Education Studies

The Perceptions of the Preparedness of Medical Graduates to Take on Internship Responsibilities in Low Resource Hospitals in Kenya

Academic journal article Higher Education Studies

The Perceptions of the Preparedness of Medical Graduates to Take on Internship Responsibilities in Low Resource Hospitals in Kenya

Article excerpt

Abstract

The Aga Khan University is developing an Undergraduate Medical Education (UGME) curriculum for implementation in East Africa in 2016, which aims to serve the health needs of the populations there. Pilot focus group discussions of recent interns were conducted at the Aga Khan University Hospital, Nairobi to find out: (1) If Kenyan medical students are adequately prepared for their roles as interns in low resource hospitals upon graduation from medical schools; (2) The likely clinical conditions that interns will face in low resource hospitals in Kenya; and (3) How might the UGME curriculum best prepare interns for their roles in low resource hospital settings? Through focus group discussions, current and recent interns expressed feeling ill prepared for working in low resource settings, unequipped with the clinical skills for the tasks and procedures expected of an intern ,in adequately exposed to obstetrics, paediatrics, emergency medicine and lacking in resuscitation training. These findings will inform the development of the UGME curriculum to ensure learning outcomes that meet stakeholder requirements.

Keywords: preparedness, medical, internship, Kenya

1. Introduction

The shortage of qualified medical providers is well known in the developing world. According to 2006 WHO statistics, in Kenya, it is estimated that there are 14 doctors per 100,000 people (Ahmed, Vellani, & Awiti, 2009).This is ten times less fewer than the World Health Organization recommendation of one doctor per 1000 people. Over the past six years, the number of new medical colleges and internship training sites has increased to address this shortage. There are now 54 recognized internship-training sites at district hospitals, provincial hospitals, national referral hospitals, private and missionary teaching hospitals. Twenty-nine of these internship-training centres are at district hospitals. A new intern will most likely work at a district hospital, where conditions are in sharp contrast to the national hospital where a medical student does their clerkship. In the Lancet Commission Report on the Education of Health Professionals for the 21st Century: from Concept to Implementation (2010), it is noted that "professional education has not kept pace with these challenges, largely because of fragmented, outdated, and static curricula that produce ill-equipped graduates."To date,several studies have been conducted in different countries that require internship or an equivalent experience prior to registration, such as the England, Scotland, Ireland, and the United States (Hesketh, Allen, Harden &Macpherson, 2003; Coberly & Goldenhar, 2007; Abuhusain, Chotirmall, Hamid, & O'Neill, 2009). These studies reveal that a significant gap exists between the competencies achieved in medical college and those required to fulfil the roles of an intern equivalent (Cave, Wolf, & Jones, 2009). A study in New Zealand (Dare, Fancourt, Robinson, Wilkinson, & Bagg, 2008) and in the UK (Watmough, 2009) has shown that changes in the undergraduate medical education (UGME) curriculum can improve competencies and better prepare interns for their role. Although most of the findings from these studies can be extrapolated to East Africa, there are circumstances unique to the region, such as its state of socioeconomic development and health services, which prompt a fresh insight.

The Aga Khan University (AKU) is developing a UGME curriculum that is outcomes based with an emphasis on those competencies and learning outcomes that will define the roles of physicians for the 21st century in East Africa. The credibility of the AKU UGME curriculum would be significantly enhanced by aligning its outcomes with what might be realistically expected during a well-supervised and well-supported internship. In addition to informing the AKU UGME curriculum development and learning outcomes directly, the findings and conclusions from the study could have regional impact on educational and health service policies. …

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