Medical electives in sub-Saharan Africa

a host perspective

Ben Kumwenda* (Corresponding Author), Jon Dowell, Katy Daniels, Neil Merrylees

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Context Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate.

Objectives The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective.

Methods A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data.

Results Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care.

Conclusions The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change.

Discuss ideas arising from the article at discuss'.

Original languageEnglish
Pages (from-to)623-633
Number of pages11
JournalMedical Education
Volume49
Issue number6
Early online date19 May 2015
DOIs
Publication statusPublished - Jun 2015

Cite this

Kumwenda, B., Dowell, J., Daniels, K., & Merrylees, N. (2015). Medical electives in sub-Saharan Africa: a host perspective. Medical Education, 49(6), 623-633. https://doi.org/10.1111/medu.12727

Medical electives in sub-Saharan Africa : a host perspective. / Kumwenda, Ben (Corresponding Author); Dowell, Jon; Daniels, Katy; Merrylees, Neil.

In: Medical Education, Vol. 49, No. 6, 06.2015, p. 623-633.

Research output: Contribution to journalArticle

Kumwenda, B, Dowell, J, Daniels, K & Merrylees, N 2015, 'Medical electives in sub-Saharan Africa: a host perspective', Medical Education, vol. 49, no. 6, pp. 623-633. https://doi.org/10.1111/medu.12727
Kumwenda B, Dowell J, Daniels K, Merrylees N. Medical electives in sub-Saharan Africa: a host perspective. Medical Education. 2015 Jun;49(6):623-633. https://doi.org/10.1111/medu.12727
Kumwenda, Ben ; Dowell, Jon ; Daniels, Katy ; Merrylees, Neil. / Medical electives in sub-Saharan Africa : a host perspective. In: Medical Education. 2015 ; Vol. 49, No. 6. pp. 623-633.
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abstract = "Context Electives are part of most Western medical school curricula. It is estimated that each year 3000-4000 undergraduate medical students from the UK alone undertake an elective in a developing country. The impact of these electives has given some cause for concern, but the views of elective hosts are largely missing from the debate.Objectives The purpose of this study was to evaluate the organisation, outcomes and impacts of medical electives in sub-Saharan Africa from a host perspective.Methods A qualitative analysis of 14 semi-structured interviews with elective hosts at seven elective sites in Malawi, Zambia and Tanzania was carried out. A framework analysis approach was used to analyse 483 minutes of audio-recorded data.Results Hosts were committed to providing elective experiences but their reasons for doing so varied considerably, in particular between urban or teaching hospitals and rural or mission hospitals. Nurturing a group of professionals who will understand the provision of health care from a global perspective was the main reason reported for hosting an elective, along with generating potential future staff. Hosts argued that the quality of supervision should be judged according to local context. Typical concerns cited in the literature with reference to clinical activities, safety and ethics did not emerge as issues for these hosts. However, in under-resourced clinical contexts, the training of local students sometimes had to take priority. Electives could be improved with greater student preparation and some contribution from sending institutions to support teaching, supervision or patient care.Conclusions The challenge to both students and their sending institutions is to progress towards giving something proportionate back in return for the learning experiences received. There is clearly room to improve electives from the hosts' perspective, but individually host institutions lack the opportunity or ability to achieve change.Discuss ideas arising from the article at discuss'.",
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