Practice analysis of junior doctors in Ethiopia: implications for strengthening medical education, practice and regulation.

Autor: Dejene D; Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia., Yigzaw T; Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia., Mengistu S; Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia., Wolde Z; 2University of Maryland Prince George's Hospital center, Cheverly, Maryland USA., Hiruy A; 3Federal Ministry of Health, Addis Ababa, Ethiopia., Woldemariam D; Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia., Awol M; 4Ethiopian Medical Association, Addis Ababa, Ethiopia.
Jazyk: angličtina
Zdroj: Global health research and policy [Glob Health Res Policy] 2018 Nov 08; Vol. 3, pp. 31. Date of Electronic Publication: 2018 Nov 08 (Print Publication: 2018).
DOI: 10.1186/s41256-018-0086-7
Abstrakt: Background: A high performing physician workforce is critical to attain nationally set health sector goals. Ethiopia has expanded training of medical doctors. However, little is known about junior doctors' performance. Understanding medical practice is essential to inform medical education and practice, establish licensure examination and guide workforce management decisions. We conducted a practice analysis study to identify gaps in Ethiopian medical education and practice, and to determine composition of subjects in national licensing examination.
Methods: We conducted a cross-sectional study with national representative sample of junior doctors. After calculating a sample size of 198, we used a two-stage stratified cluster sampling method to select study participants. We collected data using a structured questionnaire comprising 222 tasks. Study participants reported in interviews on frequency of, competence at, and importance of doing each task for improved health outcome. We developed proportions, averages, graphs and tables. Using the results of practice analysis and experts' ratings, relative weights of subjects in the national licensing examination for medical undergraduates were determined.
Results: A total of 191 junior doctors participated. Most were males (74.6%) and had less than 2 years of experience (69.8%). Junior doctors frequently performed tasks of internal medicine and pediatrics. Their participation in obstetrics and gynecology, ophthalmology, psychiatry and dentistry services was infrequent. Junior doctors had competency gaps to conduct clinical procedures, research and health programming tasks. Practice analysis results and expert ratings generated comparable recommendations for composition of a national licensing examination, with more than three-quarters of the items focusing on internal medicine, pediatrics, surgery, obstetrics and gynecology, and public health.
Conclusion: Junior doctors in Ethiopia rarely managed psychiatry, ophthalmology and dental patients. They had competence gaps in clinical procedures, research and health programming skills. The findings have implications for establishing licensing examination, and reviewing curriculum, continuing professional development, placement and rotation policy, and distribution of responsibilities.
Competing Interests: Authors declare that the study was conducted after securing ethical clearance from Johns Hopkins School of Public Health IRB, and obtaining consent from study participants.Not applicableThe authors declare that they have no competing interest.
Databáze: MEDLINE
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