Ethiopian medical schools' rapid scale-up to support the government's goal of universal coverage

In 2003, Ethiopia declared it would pursue the goal of universal primary health coverage. In response to the critical shortage of human resources for health care, the government decided to rapidly increase the training of health workers to provide basic services, including health education, disease prevention, and family health services primarily to rural areas. This approach, which became known as the "flooding strategy," was extended in 2005 to include medical doctors. Between 2003 and 2009, the number of universities and health science colleges grew from 5 to 23, and the original 5 medical schools were given a mandate to increase their annual enrollment by three to four times. This article describes how the "flooding strategy" strained and threatened the quality of the Ethiopian medical education system and how Addis Ababa University responded by leveraging a timely grant through the Medical Education Partnership Initiative (MEPI) to support the establishment of a consortium of four Ethiopian medical schools (MEPI-E). The consortium goals are to address the new demands by (1) maintaining and improving the quality of education through innovation and efficient use of resources, (2) developing and implementing new strategies to build human capacity and promote faculty retention, and (3) increasing locally relevant research and bioethics capacity. Implementation of program began in May 2011. Although it is still under way, MEPI-E has already catalyzed the development of a national network of medical schools, enabling unprecedented collaboration to respond to the increased demands on the Ethiopian medical education system.