Gender-based support systems influencing female students to pursue a bachelor of medicine, bachelor of surgery (MBBS) in Rwanda.

BACKGROUND: While Sub-Saharan Africa contains nearly one third of the global burden of disease, it only contains 3.5% of the healthcare workforce. Furthermore, female medical doctors are underrepresented across the continent. Studies show that increasing gender representation in medicine not only bridges this gap but may have a positive impact on patient care. This study explores the support systems influencing female students to pursue medical school in Rwanda, aiming to recommend ways to increase female participation through support systems. METHODS: This is an exploratory, interpretive study employing qualitative methods. The study was conducted at thirteen secondary schools within two provinces and three universities in Rwanda that offer a medical degree program. Participants were divided into focus groups, including female and male secondary students in science and non-science combinations; teachers of secondary students; female and male students enrolled in medical school; and parents of secondary students in science and non-science combinations. Private and public, mixed and girls-only secondary schools that met the criteria were selected in each province, and all universities offering a medical degree. Participants were selected via random stratified sampling. Thirty-four semi-structured focus group discussions were conducted (28 secondary-level and 6 university-level) and 16 interviews. Data was coded inductively, with common themes identified. RESULTS: Four main themes were identified as support systems that can either serve as facilitators or barriers to pursuing an MBBS, including teacher support, parental or familial support, financial or institutional policy support, and having access to female mentors or role models. CONCLUSION: Social support systems are enablers encouraging female students to join medical school. Integrating social support systems in schools and the community has the potential to increase female applicants to medical school in Rwanda.

Advancing Global Health Equity: The Role of the Liberal Arts in Health Professional Education.

Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report on the "liberal arts approach" to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians' education and subsequent practices.