Published date: Mar 31 2020

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 15 (2020), Issue No. 1

Pages: 20-34

DOI: 10.18502/sjms.v15i1.6699

Ahmad AbdulAzeem Abdullaha.omer@psau.edu.saDepartment of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia

Competency-based medical education has emerged recently as a novel model of medical training driven by its ability to reconcile the desired attributes in future physicians and address the overarching and demanding issues of the discipline in this century. The rising concerns of social accountability, patient safety, and cost effectiveness of medical education programs have contributed significantly to the popularity of this paradigm worldwide. This is translated in turn to the evolution of national competency frameworks for medical graduates that are increasingly implemented in different jurisdictions to standardize and ensure equivalent outcomes of medical curricula and readiness of their graduates to better serve their communities. Medical education in Sudan is deeply rooted in the history of the nation and the continent and is tinged with remarkable success and achievements. It is challenged nowadays with unprecedented expansion in basic medical education which may hinder the quality of medical schools’ programs and their graduates. This article explores the feasibility of one such framework in Sudan: the “SudanMeds” to ensure minimum standards and comparability of medical schools’ curricula and their outcomes across the Country. The framework would also arm the regulatory bodies with a tool for accreditation and recognition of basic medical education programs in Sudan and reflect quality assurance in their settings. Once this approach is deemed feasible, the contribution of all stakeholders from the highest top to the bottom – the government, the regulatory bodies, the public and civil organizations, and the medical schools’ community – is required to allow for creation, implementation, and follow-up of the “SudanMeds” framework.

Keywords: Sudan, competency-based medical education, national competency frameworks, medical schools, basic medical education

[1] Gruppen, L., Lypson, M., Burkhardt, J., et al. (2016). Competency-based education: programme design and challenges to implementation. Medical Education, vol. 50, no. 5, pp. 532–539.

[2] Burnette, D. (2016). The renewal of competency-based education: a review of the literature. Journal of Continuing Higher Education, vol. 64, no. 2, pp. 84–93.

[3] Touchie, C. and Cate, O. (2016). The promise, perils, problems and progress of competency-based medical education. Medical Education, vol. 50, no. 1, pp. 93–100.

[4] Hawkins, R., Simons, K., Welcher, C., et al. (2015). Implementation of competency-based medical education: are we addressing the concerns and challenges? Medical Education, vol. 49, no. 11, pp. 1086–1102.

[5] Frank, J., Snell, L., Cate, O., et al. (2010). Competency-based medical education: theory to practice. Medical Teacher, vol. 32, no. 8, pp. 638–645.

[6] Girma, T., Asaminew, T., Siebeck, M., et al. (2016). Establishing medical schools in limited resource settings. Ethiopian Journal of Health Sciences, vol. 26, no. 3, pp. 277–284.

[7] Frank, J., Mungroo, R., Ahmad, Y., et al. (2010). Toward a definition of competency-based education in medicine: a systematic review of published definitions. Medical Teacher, vol. 32, no. 8, pp. 631–637.

[8] Karrar, Z. (2009). Professionalism and good medical practice: the role of Sudan Medical Council. Sudan Medical Journal, vol. 45, no. 2, pp. 1–4.

[9] Hassan, K., Doumi, A., Eltayeb, B., et al. (2009). Patients’ satisfaction by information given to them by doctors concerning their illness and their views about the consent form signed before surgical procedures in Khartoum Teaching Hospital. Sudan Medical Journal, vol. 45, no. 2, pp. 84–85.

[10] Gaffar, A. M., Magzoub, M., and Mahmoud, I. (2019). Do community-based medical schools produce more community-based research? A review of four medical schools in Sudan and Saudi Arabia. Health Professions Education. Retrieved from: https://doi.org/10.1016/j.hpe.2019.02.001

[11] Murray, R., Larkins, S., Russell, H., et al. (2012). Medical schools as agents of change: socially accountable medical education. Medical Journal of Australia, vol. 196, no. 10, p. 653.

[12] Boelen, C. and Woollard, B. (2009). Social accountability and accreditation: a new frontier for educational institutions. Medical Education, vol. 43, pp. 887–894.

[13] Harris, P., Snell, L., Talbot, M., et al. (2010). Competency-based medical education: implications for undergraduate programs. Medical Teacher, vol. 32, no. 8, pp. 646–650.

[14] Smith, S. (1999). AMEE guide no. 14: outcome-based education: part 2-planning, implementing and evaluating a competency-based curriculum. Medical Teacher, vol. 21, no. 1, pp. 15–22.

[15] Amin, Z. and Alshammary, S. (2015). CanMEDS curriculum in Saudi Arabian context: lessons learned and way forward. Journal of Health Specialties, vol. 3, pp. 206–211.

[16] Dalt, L., Callegaro, S., Mazzi, A., et al. (2010). A model of quality assurance and quality improvement for post-graduate medical education in Europe. Medical Teacher, vol. 32, no. 2, pp. e57–e64.

[17] Tang, K., Yang, Y., Chu, J., et al. (2019). From indifference to internalisation: the definition of good doctors by CanMEDS Roles. Medical Education, vol. 53, no. 5, pp. 498–528.

[18] Ellaway, R., Roy, K., Preston, R., et al. (2018). Translating medical school social missions to student experiences. Medical Education, vol. 52, no. 2, pp. 171–181.

[19] Boker, A. (2016). Toward competency-based curriculum: application of workplace-based assessment tools in the National Saudi Arabian Anesthesia Training Program. Saudi Journal of Anesthesia, vol. 10, no. 4, pp. 417–422.

[20] Liu, Z., Tian, L., Chang, Q., et al. (2016). A competency model for clinical physicians in china: a cross-sectional survey. PLOS ONE, vol. 11, no. 12, e0166252.

[21] Tekian, A. and Al Ahwal, M. (2015). Aligning the SaudiMED framework with the National Commission for Academic Accreditation and Assessment domains. Saudi Medical Journal, vol. 36, no. 12, pp. 1496–1497.

[22] Mirzazadeh, A., Hejri, S., Jalili, M., et al. (2014). Defining a competency framework: the first step toward competency-based medical education. Acta Medica Iranica, vol. 52, no. 9, pp. 710–716.

[23] Al Bu Ali, W., Balaha, M., Kaliyadan, F., et al. (2013). A framework for a competency based medical curriculum in Saudi Arabia. Materia Socio Medica, vol. 25, no. 3, pp. 148–152.

[24] Zaini, R., Abdulrahman, K., Al-Khotani, A., et al. (2011). Saudi Meds: a competence specification for Saudi medical graduates. Medical Teacher, vol. 33, no. 7, pp. 582–584.

[25] Husain, N., Elsheikh, N., Elsheikh, M., et al. (2018). Final year medical students and professionalism: lessons from six Sudanese medical schools? Journal of Public Health and Emergency, vol. 2, p. 27.

[26] Elamin, S., Ahmed, A., Ovla, H., et al. (2018). Community-based medical education from gezira medical students’ perspective. Journal of Medical Education, vol. 17, no. 4, pp. 215–221.

[27] Ahmed, Y. and Alneel, S. (2017). Analyzing the curriculum of the faculty of medicine, University of Gezira using Harden’s 10 questions framework. Journal of Advances in Medical Education & Professionalism, vol. 5, no. 2, pp. 60–66.

[28] Busari, J., Verhagen, E., Muskiet, F., et al. (2008). Implementation of a competency-based residency curriculum: experiences from a resource-limited environment in the Caribbean. Medical Teacher, vol. 30, no. 9–10, pp. e189–e195.

[29] Frank, J. and Danoff, D. (2007). The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Medical Teacher, vol. 29, pp. 642–647.

[30] Fahal, A. (2007). Medical education in the Sudan: its strengths and weaknesses. Medical Teacher, vol. 29, pp. 910–914.

[31] Khalil, S. (2015). Physicians of Sudan: historical perspective. Sudan Medical Journal, vol. 51, no. 1, pp. 53–58.

[32] Bayoumi, A. (2018). Critical analysis of education in medicine and health sciences in Sudan 2010–2014. Journal of Medical Education and Training, vol. 2, p. 037.

[33] Sukkar, M. Y. (1977). Medical Education. Sudan Medical Journal, vol. 15, no. 2, pp. 63–64.

[34] Mutwali, I., Omer, A., and Abdalhalim, S. (2015). Why a medical career? What makes Sudanese students to join a medical college and pursue a medical career? World Journal of Education, vol. 5, no. 2, pp. 19–25.

[35] General Administration of Acceptance, Evaluation and Documentation of Higher Education Certificates. Retrieved from: daleel.admission.gov.sa

[36] ElMakki, M. (2015). Health service, teaching medical students and training of residents in Khartoum as applied to the surgical specialty. Sudan Medical Journal, vol. 50, no. 2, pp. 1–3.

[37] Mullan, F., Frehywot, S., Omaswa, F., et al. (2011). Medical schools in sub-Saharan Africa. Lancet, vol. 377, pp. 1113–1121.

[38] Karle, H. (2008). International recognition of basic medical education programmes. Medical Education, vol. 42, no. 1, pp. 12–17.

[39] Gordon, D. (2016). Criteria for establishment of a new medical school: guidance for governments, regulators and universities. Retrieved from: https://wfme.org/download/new-medical-school/

[40] Hamad, B. (1999). Establishing community-orientated medical schools: key issues and steps in early planning. Medical Education, vol. 33, no. 2, pp. 382–389.

[41] Mahgoub, E. (2010). The dilemma of medical education in the Sudan. Sudan Medical Journal, vol. 46, no. 1, pp. 2–3.

[42] Ebrahim, E., Ghebrehiwot, L., Abdalgfar, T., et al. (2017). Health care system in Sudan: review and analysis of strength, weakness, opportunity, and threats (SWOT analysis). Sudan Journal of Medical Sciences, vol. 12, no. 3, pp. 133–150.

[43] Nurelhuda, N. and Yousif, A. (2017). Generic skills training through interprofessional peer-assisted learning. Medical Education, vol. 51, no. 11, pp. 1162–1188.

[44] Sukkar, M. and Beleil, O. (1975). Current directions of medical education in the Sudan. Sudan Medical Journal, vol. 13, no. 4, pp. 153–166.

[45] El Tahir, M., Elsheikh, A., Abodoum, A., et al. (2019). Evaluation of undergraduate psychiatric teaching in Sudan. BJPsych International, vol. 16, no. 1, pp. 13–15.

[46] Greysen, S., Dovlo, D., Olapade-Olaopa, O., et al. (2011). Medical education in sub-Saharan Africa: a literature review. Medical Education, vol. 45, no. 10, pp. 973–986.

[47] Bates, J., Schrewe, B., Ellaway, R., et al. (2019). Embracing standardisation and contextualisation in medical education. Medical Education, vol. 53, no. 1, pp. 15–24.

[48] Nurelhuda, N., Morahan, P., Hamad, B., et al. (2018). Incorporating community-based education to develop socially responsible Sudanese dentists. Medical Education, vol. 52, no. 1, pp. 1180–1209.

[49] Gismalla, M. (2017). Teaching procedures and skills in medical schools: gaps, weakness, and challenges. Sudan Journal of Medical Sciences, vol. 12, no. 1, pp. 46–51.

[50] Awadalla, M., Abdalla, A., and Taha, S. (2017). Graduates perception towards instructional methods of emergency medicine: affecting their self-confidence in emergency departments. Sudan Journal of Medical Sciences, vol. 12, no. 4, pp. 207–214.

[51] Ellaway, R., Evans, P., Mckillop, J., et al. (2007). Cross-referencing the Scottish Doctor And Tomorrow's Doctors learning outcome frameworks. Medical Teacher, vol. 29, no. 7, pp. 630–635.

[52] Osman, T. (2016). Medical students’ perceptions towards research at a Sudanese University. BMC Medical Education, vol. 16, p. 253.

[53] Doumi, A., Hassan, K., Eltayeb, B., et al. (2009). Patients' complaints against their treating doctors at the Sudan Medical Council 2005–2008. Sudan Medical Journal, vol. 45, no. 2, pp. 82–83.

[54] Vallance, A. and Higham, J. (2011). A toolkit to meet Tomorrow’s Doctors standards. Medical Education, vol. 45, no. 5, pp. 508–535.

[55] Karrar, Z. (2018). Global trends in quality assurance in medical education: implications and challenges to medical education in Sudan. Khartoum Medical Journal, vol. 11, bo. 3, pp. 1518–1523.

[56] Zanten, M., Norcini, J., Boulet, J., et al. (2008). Overview of accreditation of undergraduate medical education programmes worldwide. Medical Education, vol. 42, pp. 930–937.

[57] Sethi, A. and Javaid, A. (2017). Accreditation system and standards for medical education in Pakistan: it’s time we raise the Bar. Pakistan Journal of Medical Sciences, vol. 33, no. 6, pp. 1299–1300.

[58] Ahmed, H. and Elzien, A. (2007). Global standards in basic medical education: Are they suitable for accreditation of schools of medicine in developing countries? Sudanese Journal of Paediatrics, vol. 8, pp. 48–65.

[59] Czabanowska, K., Klemenc-Ketis, Z., Potter, A., et al. (2012). Development of a competency framework for quality improvement in family medicine: a qualitative study. Journal of Continuing Education in the Health Professions, vol. 32, no. 3, pp. 174–180.

[60] Teunissen, P. and Westerman, M. (2011). Opportunity or threat: the ambiguity of the consequences of transitions in medical education. Medical Education, vol. 45, pp. 51–59.

[61] Khoo, S., Lahiri, M., and Huggan, P. (2014). When traditional model meets competencies in Singapore: beyond conflict resolution. ANNALS Academy of Medicine Singapore, vol. 43, pp. 544–549.

[62] Lineberry, M., Osta, A., Barnes, M., et al. (2015). Educational interventions for international medical graduates: a review and agenda. Medical Education, vol. 49, no. 9, pp. 863–879.

[63] Ringsted, C., Hansen, T., Davis, D., et al. (2006). Are some of the challenging aspects of the CanMEDS roles valid outside Canada. Medical Education, vol. 40, no. 8, pp. 807–815.

[64] Caccia, N., Nakajima, A., Scheele, F., et al. (2015). Competency-based medical education: developing a framework for obstetrics and gynaecology. Journal of Obstetrics and Gynaecology Canada, vol. 37, no. 12, pp. 1104–1112.