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

Postgraduate medical education is an important factor in Africa's present emphasis on health care as a basis for socioeconomic development. Such education must be relevant to the realities of health problems in Africa. The priority of most African governments is training in traditional health care management and in fields related to community- and problem-based medicine. Presently, opportunities for such training exist in only seven centers throughout Africa. A model health care system, offered by most national governments, is described. This system, which includes district, provincial, and central levels of care, delivers over 80% of health services, and it is within such a system that nationals returning from postgraduate medical education abroad will function. Problems currently associated with these systems are the shortages of expertise in the areas of management, logistics, informatics, and resources mobilization, as well as the generally low literacy of the community. Africa also needs more teachers in the basic sciences, further development of biomedical research, courses in continuing education, particularly for field workers in isolated areas, short courses on investigative techniques, and goal-oriented research aimed at solving public health problems in the student's country.