Building resilient health professions education in fragile contexts: AMEE guide No. 182

Health Professions Education (HPE) cannot rely on assumptions of stability. Fragile contexts - wars, disasters, political upheaval, and systemic weakness - disrupt teaching and learning, assessment, accreditation, and the well-being of learners and faculty. This AMEE Guide provides a framework for building resilient HPE that survive crises and use them as opportunities for reform. The Guide identifies three types of fragility and explores their impact on institutions, human capital, clinical training, and social accountability. To boost resilience, the guide recommended adaptive strategies that include creating crisis management committees, implementing modular and competency-based curricula, allowing credit transfers for displaced learners, and incorporating tailored training programs. For curriculum delivery innovations range from hybrid and low-tech methods to peer-assisted approaches, diaspora involvement, and community-based services. A practical model for fair and feasible assessment in disrupted environments is suggested, with a focus on outcomes, flexibility, and cross-border recognition for rethinking accreditation and quality assurance. Systems thinking underpins the Guide, highlighting how destructive cycles such as brain drain can erode capacity, while virtuous cycles - driven by technology adoption, partnerships, and community integration - can foster recovery and growth. The guide also calls on educators, institutional leaders, and policymakers to move from reactive responses to proactive preparedness.