Medical education in sub-Saharan Africa: challenges and prospects using the first private medical university in Nigeria as a case-study.

Abstract

Medical education has a significant role in reducing the health inequities and physician shortages in sub-Saharan Africa (SSA). There has been an expansion in medical education in SSA since the early 1900s, with >168 medical schools in the region. This expansion, has, however, been fraught with a myriad of challenges, chief amongst which include massive emigration of medical doctors, poor funding of healthcare and education, and adoption of traditional Western medical curriculum. Emigration creates significant shortages of clinicians and medical faculty, putting extra pressure and strain on the remaining clinicians and faculty, and driving even more emigration. Poor funding translates to poor remuneration, which is the greatest 'push factor' for emigration. Poor remuneration, service conditions and welfare, drive industrial/strike actions in medical schools, prolonging duration of medical training and graduation from medical schools. Western-style medical education can also be a 'push factor' factor for emigration upon graduation. To address the widening inequities in access to and quality of healthcare and physician shortages in SSA, private sector investment in medical education must be encouraged, as well as improved funding of healthcare and education by national governments, and the adoption of community-based medical education and problem-based learning with medical curricula that are tailored to local needs and peculiarities. This review article discusses the challenges and prospects of medical education in SSA using PAMO University of Medical Sciences, the first private medical university in Nigeria, as a case-study.