Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

Brittney S Mengistu; Holly Vins; Caitrin M Kelly; Daphne R McGee; Jennifer O Spicer; Miliard Derbew; Abebe Bekele; Damen Haile Mariam; Carlos Del Rio; Henry M Blumberg; Dawn L Comeau

doi:10.1186/s12909-016-0849-0

Student and faculty perceptions on the rapid scale-up of medical students in Ethiopia

BMC Med Educ. 2017 Jan 13;17(1):11. doi: 10.1186/s12909-016-0849-0.

Authors

Affiliations

¹ Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Rm 510, Atlanta, GA, 30322, USA.
² Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
³ Emory University School of Medicine, 1599 Clifton Rd, 6th fl, Atlanta, GA, 30322, USA.
⁴ Emory University School of Law and Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
⁵ Department of Medicine, Emory University School of Medicine, 1599 Clifton Rd, 6th fl, Atlanta, GA, 30322, USA.
⁶ College of Health Sciences, Addis Ababa University, Black Lion Hospital Campus, Second Floor, Office No 35, PO Box 5729, Addis Ababa, Ethiopia.
⁷ School of Medicine, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia.
⁸ School of Public Health, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia.
⁹ Hubert Department of Global Health, Rollins School of Public Health and, Department of Medicine, Emory University School of Medicine, 1518 Clifton Rd #7011, Claudia Nance Rollins Bldg, Atlanta, GA, 30322, USA.
¹⁰ Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine and Departments of Epidemiology and Global Health Rollins School of Public Health, Emory University, 1599 Clifton Rd, 6th fl, Atlanta, GA, 30322, USA.
¹¹ Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Rm 510, Atlanta, GA, 30322, USA. dcomeau@emory.edu.

Abstract

Background: Ethiopia is a country of over 94 million people that has a severe physician shortage with approximately only 2.5 physicians per 100,000 persons. Recently, the Ethiopian government implemented a "flood and retain" initiative to rapidly increase the quantity of physicians in Ethiopia. Consequently, medical student enrollment at Addis Ababa University (AAU) School of Medicine increased from 100 to approximately 300-400 students per class. This study evaluated the impact of the rapid scale-up in the number of medical students on the quality of medical education at AAU and the impact of the U.S. government-funded Medical Education Partnership Initiative (MEPI) grant awarded to AAU to provide resources to strengthen the quality of medical education at AAU.

Methods: Qualitative, semi-structured, in-depth interviews were conducted with 22 key informants including faculty members, administrators and medical students at AAU. The audio recordings were transcribed verbatim and interview data were analyzed with thematic analysis.

Results: Four key themes emerged from the data. Overall, participants perceived a decrease in the quality of medical education at AAU due to challenges created by the rapid scale-up in the number of medical students. Positive learning environments were described as difficult to achieve due to overcrowding in classrooms and the limited numbers of textbooks. Overall, participants stated that infrastructure improvement is needed to provide adequate medical student training. The medical education initiatives implemented and funded by MEPI have provided significant resources to support the medical student curriculum but additional resources are required to accommodate a large student body.

Conclusions: The unprecedented rapid scale-up of medical students has impacted multiple facets of medical education at AAU. It is important to consider the perspectives of students and faculty in order to focus future medical education policies, MEPI programming and the allocation of resources.

Keywords: Africa; Evaluation; Medical education.

MeSH terms

Adult
Curriculum
Ethiopia
Faculty, Medical / psychology*
Female
Humans
Male
Physicians / supply & distribution
Qualitative Research
Schools, Medical*
Students, Medical / psychology*
Students, Medical / statistics & numerical data*