Strategies for developing innovative programs in international medical education. A viewpoint from Latin America

Problems affecting the quality of medical education and health services in Latin America include variable standards of medical education, geographic maldistribution of physicians, a shortage of nurses and allied health workers, overtraining of physicians in high technology, government control of health and education systems, and economic problems. The Panamerican Federation of Associations of Medical Schools (PAFAMS) was founded for the purpose of addressing such problems in Latin American medical education. PAFAMS has promoted the exchange of ideas and experience among its member associations and schools by establishing a data base of information on medical education and developing mechanisms to disseminate such information. Other PAFAMS initiatives include a program to integrate professional health education and health care services within individual communities, and the linkage of medical education programs with health care institutions as a means of improving the quality of health care. A crucial next step in Latin America is the development of a leadership program to identify and nurture leaders in individual countries who will be instrumental in developing community-based health services by means of medical education oriented to such purpose. Thus, the key issue is to develop healthcare-oriented medical education.