Competency-based medical education in two Sub-Saharan African medical schools

Abstract

Elsie Kiguli-Malwadde,1,2 E Oluwabunmi Olapade-Olaopa,1,3 Sarah Kiguli,2 Candice Chen,4 Nelson K Sewankambo,2 Adesola O Ogunniyi,3 Solome Mukwaya,1 Francis Omaswa11African Centre for Global Health and Social Transformation, Kampala, Uganda; 2Makerere University, College of Health Sciences, Kampala, Uganda; 3College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; 4School of Public Health and Health Services, The George Washington University, Washington, DC, USA Background: Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME). Institutional reviews: This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes are highlighted. Both schools used similar processes in developing their CBME curricula, with early and significant stakeholder involvement. Competencies were determined taking into consideration each country's health and education systems. Final competency domains were similar between the two schools. Both schools established medical education departments to support their new curricula. New teaching methodologies and assessment methods were needed to support CBME, requiring investments in faculty training. Both schools received external funding to support CBME development and implementation. Conclusion: CBME has emerged as an important change in medical education in Sub-Saharan Africa with schools adopting it as an approach to transformative medical education. Makerere University and the University of Ibadan have successfully adopted CBME and show that CBME can be implemented even for the low-resourced countries in Africa, supported by external investments to address the human resources gap. Keywords: CBME, medical education, competency domains, competencies, curricular reforms