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Graduate Medical Education in Lebanon: Challenges, Support, and Adaptation Amid the Compounding Crises.

Fatima Msheik-El Khoury1, Carine Zeeni1, Halah Ibrahim2

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Lebanese residents showed resilience and preparedness despite crises. Institutional support was crucial for maintaining graduate medical education (GME) and resident well-being during challenging times.

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Area of Science:

  • Medical Education
  • Resilience in Healthcare
  • Crisis Management in GME

Background:

  • Lebanon's Graduate Medical Education (GME) system faces unprecedented disruptions due to repeated national crises.
  • These crises include political instability, economic collapse, the COVID-19 pandemic, and military conflict, impacting institutional support and resident preparedness.
  • The study addresses the resilience of the GME system and its ability to support clinical residents.

Purpose of the Study:

  • To examine clinical residents' perceived preparedness and competency at graduation.
  • To identify challenges faced by residents during compounding national crises.
  • To assess how training institutions supported residents and adapted GME to maintain training and well-being.

Main Methods:

  • A cross-sectional survey of 127 graduating clinical residents and fellows was conducted in June 2024 at a large academic medical center in Lebanon.
  • Quantitative data assessed self-perceived preparedness across six ACGME core competencies.
  • Qualitative data explored challenges, institutional interventions, and recommendations, analyzed using Maslow's Hierarchy of Needs and thematic analysis.

Main Results:

  • Despite training disruptions, most residents reported feeling well-prepared in core competencies (e.g., 67% patient care, 72% professionalism).
  • Crises unexpectedly fostered skill development in systems-based practice.
  • Key challenges included meeting basic needs, ensuring well-being, and maintaining personal/professional life; institutional support was vital but some challenges exceeded institutional capacity.

Conclusions:

  • Lebanese GME programs demonstrate unique resilience, highlighting strengths and vulnerabilities in institutional support systems.
  • Prioritizing resident well-being, fostering supportive learning environments, and developing crisis-relevant competencies are essential for future medical education success.
  • Effective institutional strategies, including financial and psychological support, were critical in maintaining training continuity amidst severe challenges.