Revitalizing Graduate Medical Education in Global Settings

Lessons From Post-Earthquake Haiti

Bibliographic Data

ID21613439
AuthorsMichelle Morse (0000-0002-3272-4690, M. Morseis cofounder, EqualHealth, internist, Brigham and Women’s Hospital, assistant professor, Harvard Medical School, and former deputy chief medical officer, Partners In Health, Boston, Massachusetts; ORCID:., corresponding author), Lauren Spahn (L. Spahnis senior advisor, Office of the CEO, Partners In Health, Boston, Massachusetts, and former project manager, Operational Planning and Development, University Hospital of Mirebalais, Mirebalais, Haiti.), Paul Pierre (P. Pierrewas previously at Partners In Health (2009–2017) and is currently senior TB/HIV medical advisor, Global Health/Infectious Disease Division, CAMRIS/GHSI-III, United States Agency for International Development, Washington, DC, and lecturer, University of Global Health Equity, Kigali, Rwanda.), Franciscka Lucien (F. Lucienwas previously with Partners In Health (2011–2018) and is currently executive director, Institute for Justice and Democracy in Haiti, Boston, Massachusetts.), Kerling Israel (0000-0003-1841-9945, K. Israelis senior advisor, Medical Education, Zanmi Lasante/Partners In Health, and founding director, Family Medicine Residency Program, Hospital Saint Nicolas, Saint Marc, Haiti; ORCID:.), Sterman Toussaint (0000-0001-9710-716X, S. Toussaintis general surgeon and director, Medical Education, Zanmi Lasante/Partners In Health, Cange, Haiti.), Merly Robert (M. Robertis internist and program director, Internal Medicine Residency Program, Mirebalais Hospital, Mirebalais, Haiti.), Joel T Katz (0000-0002-2491-6510, J.T. Katzis internist, infectious disease specialist, and program director, Internal Medicine Residency Program, Brigham and Women’s Hospital, Boston, Massachusetts.), Jo Buyske (J. Buyskeis general surgeon and chief executive officer and president, American Board of Surgery, Philadelphia, Pennsylvania.), Mary Clisbee (0000-0002-9589-8161, M. Clisbeeis director of research and administrator, Graduate Medical Education, Zanmi Lasante/Partners In Health, Croix-des-Bouquets, Haiti.), Jean Christophe Dimitri Suffrin (0000-0001-7403-3460, Partners In Health), Dimitri J C Suffrin (D.J.C. Suffrinis a physician and TB/HIV/AIDS clinical manager, Zanmi Lasante/Partners In Health, Mirebalais Hospital, Mirebalais, Haiti (2012–2014), and is currently TB/HIV/AIDS clinical manager, Abwenzi Pa Za Umoyo/Partners In Health, Malawi; ORCID:.), Maxi Raymonville (M. Raymonvilleis an obstetrician–gynecologist and chief executive officer, Mirebalais Hospital, Mirebalais, Haiti.), Jean Claude Cadet (J.C. Cadetis ophthalmologist and dean, Faculté de Médecine et de Pharmacie de l‘Université d’État d’Haiti, Port-au-Prince, Haiti.), Jean Cadet (University of Haiti), Sosthene Pierre (S. Pierreis general surgeon and dean, Graduate Medical Education, Faculté de Médecine et de Pharmacie de l‘Université d’État d’Haiti, Port-au-Prince, Haiti.), Joia S Mukherjee (0000-0003-4931-4804, Partners In Health), Joia Mukherjee (J. Mukherjeeis internist, pediatrician, infectious disease specialist, and associate professor, Harvard Medical School, and chief medical officer, Partners In Health, Boston, Massachusetts.), Joseph Rhatigan (0000-0002-4516-7969, J. Rhatiganis internist and associate professor, Harvard Medical School, associate chief, Division of Global Health Equity, Brigham and Women’s Hospital, and associate program director, Internal Medicine Residency, Brigham and Women’s Hospital, Boston, Massachusetts; ORCID:.), Paul E Farmer (P.E. Farmeris internist, infectious disease specialist, and anthropologist, Kolokotrones University, professor of global health and social medicine, Harvard Medical School, chief, Division of Global Health Equity, Brigham and Women’s Hospital, and founder and chief strategist, Partners In Health, Boston, Massachusetts.)
Year2021
Volume96
Issue3
Pages368-374
Publication date2021-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000003857
PMID33239535
OpenAlexW3107395805
LanguageEN
Citations received2
References cited8

Following the massive 7.0-magnitude earthquake that devastated much of the Haitian capital city of Port-au-Prince on January 12, 2010, the Haitian health system and its medical education programs were fragmented, fragile, and facing a significant, overwhelming demand for clinical care. In response, the authors of this paper and the institutions they represent supported the development of a teaching hospital that could fill the void in academic training capacity while prioritizing the health of Haiti’s rural poor—goals aligned with the Haitian Ministry of Health (MOH) strategy. This bold initiative aimed to address both the immediate and long-term health care needs within post-disaster Haiti through a strategic investment in graduate medical education (GME). Here, the authors describe their approach, which included building consensus, aspiring to international standards, and investing in shared governance structures under Haitian leadership. The Haitian MOH strategy and priorities guided the development, implementation, and expansion of solutions to the ongoing crisis in human resources for health within the acute context. Local leadership of this initiative ensured a sustained and transformative model of GME that has carried Haiti beyond acute relief and toward a more reliable health system. The enduring success can be measured through sustained governance systems, graduates who have remained in Haiti, standardized curricula, a culture of continuous improvement, and the historic achievement of international accreditation. While ongoing challenges persist, Haiti has demonstrated that the strategy of investing in GME in response to acute disasters should be considered in other global settings to support the revitalization of tenuous health systems

Accreditation · Capacity building · Curriculum · Economic growth · Economics · Global health · Graduate medical education · Health care · Medical education · Pedagogy · Political science · Public relations · Sociology · Transformative learning · Disaster Response and Management · Global Health and Surgery · Medicine · Nursing · Viral Infections and Outbreaks Research

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