AIDS in the 21^st Century and the training of African medical students: there should be a change in medical school curricula? An Observational and Interview Study at a Public Medical School in Dar-es-Salaam-Tanzania

Stephen E.D. Nsimba^{1, 2}*,  Robin T. Kelley³ and Richard Kasesela⁴

¹The University of Dodoma, College of Health Sciences, School of Medicine and Dentistry, P. O. Box 259, Dodoma-Tanzania.

²Formerly with the Muhimbili University of Health and Allied Sciences, Department of Clinical Pharmacology, P. O. 65010, Dar-es-Salaam-Tanzania.

³Georgetown University, School of  Foreign Service.

⁴HIV/AIDS Business Coalition of Tanzania, Dar-es-Salaam-Tanzania.

*Corresponding author E-mail: nsimbastephen@yahoo.co.uk

Received 23 January, 2012; Accepted 04 February, 2012

Abstract

In any higher learning institution like universities in Africa and abroad, review of curriculums is carried out every 3 – 5 years depending on availability of funds. The exercise is an important one but sometimes can be time consuming and costly. These reviews of curricula helps to fill in the deficits or gaps by improving specific subjects or topics so as to tailor curriculars/training programmes suiting firstly the local need, national, and international requirements of final consumers of university products. So can these change in the medical curricula taught to African medical students be the way to attract and retain more medical and health providers?  As researchers grapple with the influx of international funds on the African continent to manage the various epidemics, such as malaria, HIV/AIDS and TB, what are health care providers and medical students learning to prepare them to be effective and sustained leaders, virus managers, particularly after funding streams change or shift? As this observational analysis focuses on Tanzania, a country where there are approximately more than 500 students entering medical training in various public as well private medical universities after completion of their advanced level of education secondary schools (i.e. Form six) each year.  There are also those who are trained as clinical officers (medical assistants) and Assistant Medical Officers (AMOs). These are paramedical staff who serve as well as doctors in some regional, district hospitals, other health centres and dispensaries located in rural parts of the country. However, these paramedical staff require 2-5 five years of paramedical training but they do not require a one year of internship after completion as opposed to medical officers/medical graduates. However, the current curricula used to train medical and paramedical students in the public and private universities or medical schools in Tanzania may not be adequate to address the new levels of care and treatment. Thus, for health care providers and clinicians treating traditional diseases, such as malaria, HIV/AIDS and TB etc, requires more business skills, such as procurement, supply distribution and in rural areas, as well, as clinic management.  Traditional medical training in this country and Africa may need to shift to prepare the student to compete in the global world of disease management including building skills for self-employment after completion of their studies as this shift now is changing from depending on government created jobs. As it stands today most governments be developed and developing ones, there is an increasingly high rates of an employment to most youngsters after completion of their studies. To address the issue of training, we sought to inquire of the students, what knowledge they felt would help to best prepare them for health care in the 21^st century. We asked approximately 134 third year students in Medicine, Dentistry, and Nursing students, average age 25yrs., at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania during a clinical pharmacology lecture class conducted by Dr Nsimba, SED.  There was significant interest by the students in the concept of business, in fact, (76%) felt that they would like to learn more about entrepreneurship in addition to their medical training. Thus based on this, it may be recommended that African Medical Institutions may want to consider inclusion of some business skills so that medical students get an opportunity or be exposed to business and entrepreneurship skills apart from their conventional medical training curriculum. 

Keywords: Aids, Africa, medical student, medical school