Training programme on health workforce analysys and planning Lecture B3: Demand for health workforce education and training (part 2) Training programme on health workforce analysys and planning Rio de Janeiro, 8-13 July Dr Mario Roberto Dal Poz Coordinator Human Resources for health Department dalpozm@who.int

What is the quality of medical education in Europe? I don't want to sound arrogant or ignorant but what is the quality of education in Europe in medicine compared to USA/Canada (which are at the forefront of medical science/research/engineering)? I have already found possible places to apply in Europe to English speaking schools. (there are such schools in Poland, Sweden, Czech and even Italy). But is the quality good? Do they produce knowledgeable innovative doctors who can compete with North American students for residency? Do they have comparable clinical skills? Again, I realize that Europe has a good medical system, but I honestly don't know much about it. And I haven't met any foreign residents/doctors to be able to judge for myself or even talk to them? Student Doctor Network Forums http://forums.studentdoctor.net

"fragmented, static and outdated" One answer …. "the current medical training model, which annually consumes about 100 billion USD per year worldwide, no longer works'. "fragmented, static and outdated" The Lancet 376(9756): 1923-1958. 2010

Global efforts

Countries with a critical shortage of health service providers (doctors, nurses and midwives)

World Health Organization The same countries are making slow progress towards the health-related MDGs 27 November, 2018 Maternal mortality ratio per 100 000 live births in 2000 Source: WHO (2005). The World Health Report 2005 – Make Every Mother and Child Count. Geneva, World Health Organization

Stock of physicians WHR 2006 statistics compared to the latest statistics

Density of medical schools by region (2008 estimate)

Countries by number of medical schools (2008 estimates)

Institutions, graduates and workforce by region (estimates 2008) Population (millions) Estimated number of schools Estimated graduates per year (thousands) Workforce (thousands) Medical Public Health Doctors Nurses/ midwives Asia China 1371 188 72 175 29 1861 1259 India 1230 300 4 30 36 646 1372 Other 1075 241 33 18 55 494 1300 Central 82 51 2 6 15 235 603 High Income Asia Pacific 227 168 26 10 56 409 1543 Europe 122 64 19 8 28 281 670 Eastern 212 100 22 48 840 1798 Western 435 282 52 42 119 1350 3379 Americas North America 361 173 65 74 793 2997 Latin America/Caribbean 602 513 35 827 1099 Africa North Africa/Middle East 450 206 46 17 540 925 Sub - Saharan Africa 868 134 125 739 World 7036 2420 467 389 541 8401 17684

New medical schools (public and private) in India and Brazil Number of medical schools Brazil

Quality of health training programmes / institutions Insufficient infrastructure and equipment Uneven Faculty shortages Uneven regulation and accreditation Fragmented and static methods Inadequate secondary and post-graduate education Unregulated private schools

Many countries are prioritizing the scale up of medical education as part of overall health sector strengthening. Accreditation and quality measurement are important developments for standardizing medical education and physician capabilities The status of the country’s health system affects medical education and physician retention Coordination among ministries of education and ministries of health improves medical schools’ ability to increase health workforce capacity. Educational planning that focuses on national health needs is improving the ability of medical graduates to meet those needs Impressive curricular innovations are occurring in many schools. Beyond the creation of new knowledge, research is an important instrument for medical school faculty development, retention, and infrastructure strengthening.

Recent global initiatives related to the education of health professions