Medical colleges' challenges and coping strategies in implementing accreditation standards in Pakistan

Objectives: To explore the challenges faced by medical colleges and coping strategies used in implementing accreditation standards by Pakistan Medical Commission during accreditation inspection 2019. Methods: In this qualitative case study, four medical colleges and their affiliated hospitals from three cities in Khyber Pakhtunkhwa province of Pakistan were selected through purposive sampling. Data was collected through focus group discussions (FGD) through Open-ended questions, based on CIPP (context, input, process, and product) model. Each focus group comprised of Dean, the Director Department of Medical Education (DME) and the Medical Director of the hospital. Data were thematically analyzed and results were based on the CIPP model. Results: Three themes identified were administrative challenges, accreditation challenges and resource challenges. The administrative challenges theme was further explained under subthemes of rules and regulation challenges, documentation and record challenges, and DME-related challenges. The accreditation-related challenges theme was explored in-depth with subthemes of accreditation process-related challenges, accreditation standards-related challenges and curriculum-related challenges. The resource challenges theme was described under sub-themes of infrastructure-related challenges, human resources and financial challenges. The commonest coping strategies adopted by medical colleges were establishing DME, emergency preparatory meetings of staff, and hiring staff on an emergency basis, to overcome administrative, accreditation and resource challenges respectively. Future suggestions for improving the accreditation process in the local context were highlighted. Conclusion: Main challenges identified were administrative challenges, accreditation challenges and resource challenges. Coping strategies by the medical colleges for these challenges are highlighted. The accreditation body should harmonize the process of accreditation with medical colleges and other stakeholders.

Impact of COVID-19 on health professionals' education in Eastern Mediterranean Region.

Background: The education sector is one of the major sectors adversely affected by the COVID-19 pandemic globally, and education of health professionals is no exception. Thousands of health professional institutions in the Eastern Mediterranean Region were closed abruptly to ensure the safety of students and staff. Aims: This study aims to describe the situation of health professionals' education in the EMR during COVID-19 and review strategies adopted by institutions to ensure continuity of education. Methods: A qualitative, exploratory, key informant-based survey involving 50 institutions was conducted in 13 Member States of the EMR. The survey included medicine (n=23), dentistry (n=9), nursing (n=13), and pharmacy (n=5) colleges. The questionnaire included 40 open-ended questions about the challenges facing health professionals' education during the COVID-19 lockdown and strategies adopted for the continuation of education. Data were analysed and summarized to reach meaningful conclusions. Results: Almost all institutions in the EMR were closed during February and March 2020 as the number of cases increased. Most institutions, with few exceptions, in resource-constrained countries switched to online learning through emergency remote teaching mechanisms. COVID-19 caused delays in the completion of academic sessions and modifications to the curricula to cover courses within a short time. Conclusion: COVID-19 may continue to impact health professionals' education. However, countries with better IT infrastructure and support will likely continue to develop their online educational capacities to reap the benefits of e-learning in the future.

Promoting family practice-based model of care: the role of WHO's professional diploma in family medicine in the Eastern Mediterranean Region.

Strengthening Primary Health Care (PHC) through family practice-based model of care is an essential bedrock in achieving Universal Health Coverage (UHC), as called for in Sustainable Development Goal (SDG) 3, target 3.8. However, the shortage of family practitioners worldwide and in most countries of the Eastern Mediterranean Region (EMR) is a daunting challenge. The current production rate of family physicians in the EMR is around 700 annually, against the needed estimate of 21 000 physicians per year based on one family physician/1300 population and the current EMR population growth rate, which reflects the huge shortage of family physicians in the Region.