Medical education in sub-Saharan Africa: A literature review

Medical Education

Volumn 45, Issue 10, 2011, Pages 973-986

  Greysen, S Ryan ^a,b   Dovlo, Dela ^c   Olapade Olaopa, E Oluwabunmi ^d   Jacobs, Marian ^e   Sewankambo, Nelson ^f   Mullan, Fitzhugh ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b GEORGE WASHINGTON UNIVERSITY   (United States)

^c MINISTRY OF HEALTH   (Ghana)

^d UNIVERSITY OF IBADAN   (Nigeria)

^e UNIVERSITY OF CAPE TOWN   (South Africa)

^f MAKERERE UNIVERSITY   (Uganda)

Author keywords

[No Author keywords available]

Indexed keywords

AFRICA SOUTH OF THE SAHARA; CURRICULUM; HUMAN; MEDICAL EDUCATION; MEDICAL SCHOOL; REVIEW; STANDARD;

AFRICA SOUTH OF THE SAHARA; CURRICULUM; EDUCATION, MEDICAL; HUMANS; SCHOOLS, MEDICAL;

EID: 80052825686     PISSN: 03080110     EISSN: 13652923     Source Type: Journal    
DOI: 10.1111/j.1365-2923.2011.04039.x     Document Type: Review

References (152)

1. World Health Organization. The Health of the People. 2008. . [Accessed 25 May 2011.]
2. High Level Forum on the Health MDGs. Addressing Africa's Health Workforce Crisis: an avenue for action. 2004. . [Accessed 25 May 2011.]
3. Gukas ID. Global paradigm shift in medical education: issues of concern for Africa. Med Teach 2007;29 (9):887-92.
4. Omer MI. Can medical education rise to the challenge of the African crisis? Ann Trop Paediatr 2005;25 (4):227-41.
5. Sub-Saharan African Medical Schools Study. Sub-Saharan African Medical Schools Study. . [Accessed 25 May 2011.]
6. Mullen F, Frehywot S, Omaswa F et al. Medical schools in sub-Saharan Africa. Lancet 2011;377 (9771):1113-21.
7. O'Brien HR. The dawn of medical education in tropical Africa. J Med Educ 1958;33 (8):553-64.
8. World Health Organization. WHO Avicenna World Directory of Medical Schools. 2007. . [Accessed 25 May 2011.]
9. Liese B, Dussault G. The State of the Health Workforce in sub-Saharan Africa: evidence of crisis and analysis of contributing factors. 2004. . [Accessed 25 May 2011.]
10. Horton R. North and south: bridging the information gap. Lancet 2000;355:2231-6.
11. Hoffman KJ, Kanyengo CW, Rapp BA, Kotzin S. Mapping the health research landscape in sub-Saharan Africa: a study of trends in biomedical publications. J Med Libr Assoc 2009;97:41-4.
12. Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals. BMC Med Ethics 2004;5:E5.
13. Keiser J, Utzinger J, Tanner M, Singer BH. Representation of authors and editors from countries with different human development indexes in the leading literature on tropical medicine: survey of current evidence. BMJ 2004;328:1229-32.
14. Frenk J, Chen L, Bhutta ZA. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010;376:1923-58.
15. van Niekerk JP. Missions of a medical school: an African perspective. Acad Med 1999;8 (Suppl):38-44.
16. Sewankambo N. Academic medicine and global health responsibilities. BMJ 2004;329 (7469):752-3.
17. Boelen C. Social accountability and accreditation: a new frontier for educational institutions. Pedagogie Medicale 2008;9 (4):235-44.
18. van Zanten MN, Norcini JJ, Boulet JR, Simon F. Overview of accreditation of undergraduate medical education programmes worldwide. Med Educ 2008;42:930-7.
19. Burdick W. Challenges and issues in health professions education in Africa. Med Teach 2007;29 (9):882-6.
20. Sub-Saharan African Medical Schools Study. SAMSS Communiqué. 2008. . [Accessed 25 May 2011.]
21. Sub-Saharan African Medical Schools Study. Site visit reports. 2010. . [Accessed 25 May 2011.]
22. Fleming CM. Medical education in East Africa: a link with the University of Glasgow. Br Med J 1965;1 (5439):918-9.
23. Woodruff AW. A new medical school in Central Africa. Lancet 1982;2 (8297):545-6.
24. Broadhead RL, Muula AS. Creating a medical school for Malawi: problems and achievements. BMJ 2002;325 (7360):384-7.
25. Ameh EA, Adejuyigbe O, Nmadu PT. Paediatric surgery in Nigeria. J Pediatr Surg 2006;41 (3):542-6.
26. Akiode O. Residency training in Nigeria. Arch Ibadan Med 2005;6 (1):43-6.
27. Ibrahim M. Medical education in Nigeria. Med Teach 2007;29 (9):901-5.
28. Mufunda J, Chatora R, Ndambakuwa Y, Samkange C, Sigola L, Vengesa P. Challenges in training the ideal doctor for Africa: lessons learned from Zimbabwe. Med Teach 2007;29 (9):878-81.
29. Muula AS. Every country or state needs two medical schools. Croat Med J 2006;47 (4):669-72.
30. Fahal AH. Medical education in the Sudan: its strengths and weaknesses. Med Teach 2007;29 (9):910-4.
31. Human Resources for Health. Overcoming the Crisis: The Joint Learning Initiative. 2004. . [Accessed 25 May 2011.]
32. Africa Working Group of the Joint Learning Initiative on Human Resources for Health and Development. The Health Workforce in Africa: Challenges and Prospects. 2006. . [Accessed 25 May 2011.]
33. Global Health Workforce Alliance, Human Resources for Health in Africa. Experiences, Challenges, and Realities - The Douala Declaration. 2007. . [Accessed 25 May 2011.]
34. Kober K, van Damme W. Scaling up access to antiretroviral treatment in southern Africa: who will do the job? Lancet 2004;364 (9428):103-7.
35. Regional AIDS Training Network. Promoting excellence in training. UNAIDS Best Practices Collection. 2001. . [Accessed 25 May 2011.]
36. Global Health Workforce Alliance. The Kampala Declaration and Agenda for Global Action. 2008. . [Accessed 25 May 2011.]
37. Africa Union of Ministers of Health. Africa Health Strategy 2007-2015: Strengthening Health Systems for Equity and Development in Africa. 2007. . [Accessed 25 May 2011.]
38. Physicians for Human Rights. The Right to Health and Health Workforce Planning: A Guide for Government Officials, NGOs, Health Workers and Development Partners. 2008. . [Accessed 25 May 2011.]
39. Dovlo D. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review. Hum Resour Health 2004;2 (1):7.
40. Mullan F, Frehywot S. Non-physician clinicians in 47 sub-Saharan African countries. Lancet 2007;370 (9605):2158-63.
41. World Health Organization. Task shifting: rational redistribution of tasks among health workforce teams : global recommendations and guidelines. 2008. . [Accessed 25 May 2011.]
42. New Partnership for Africa's Development. Human Resource Development Initiative. 2003. . [Accessed 25 May 2011.]
43. Parry E, Parry V. Training for health care in developing countries: the work of the Tropical Health and Education Trust. Med Educ 1998;32 (6):630-5.
44. World Health Organization/PEPFAR Scaling up nursing and medical education. 2009. . [Accessed 25 May 2011.]
45. Boulet J, Bede C, McKinley D, Norcini J. An overview of the world's medical schools. Med Teach 2007;29 (1):20-6.
46. Boelen C, Boyer M. A view of the world's medical schools: defining new roles. Geneva: World Health Organization 2001. . [Accessed 25 May 2011.]
47. Brock JF. The training of the physician: adaptation of medical education to regional needs. N Engl J Med 1964;271:989-93.
48. de Villiers MR, van Velden DP. Curriculum development for the rural specialist. S Afr Med J 1996;86 (12):1528.
49. Draper CE, Louw G. Medical students' attitudes towards the primary health care approach - what are they and how do they change? S Afr Fam Pract 2007;49 (2):17.
50. Akinyinka OO, Ohaeri JU, Asuzu MC. Beliefs and attitudes of clinical year students concerning medical specialties: an Ibadan medical school study. Afr J Med Med Sci 1992;21 (2):89-99.
51. Hamilton JD, Ogunbode O. Medical education in the community: a Nigerian experience. Lancet 1991;338 (8759):99-102.
52. Omotara BA, Yahya SJ, Shehu U, Bello HS, Bassi AP. Communities' awareness, perception and participation in the community-based medical education of the University of Maiduguri. Educ Health (Abingdon) 2006;19 (2):147-54.
53. Otti PN. Medical education and primary health care in tropical Africa: evidence for change. East Afr Med J 1989;66 (4):300-6.
54. Ozgediz D. Africa's neglected surgical workforce crisis. Lancet 2008;371:627-8.
55. Martey JO, Hudson CN. Training specialists in the developing world: ten years on, a success story for West Africa. Br J Obstet Gynaecol 1999;106 (2):91-4.
56. Mhando S, Lyamuya S, Lakhoo K. Challenges in developing paediatric surgery in sub-Saharan Africa. Pediatr Surg Int 2006;22:425-7.
57. Dent DM. Surgical training in 21st-century Africa - a South African perspective. S Afr J Surg 1998;36 (2):44.
58. Galukande M, Luboga S, Kijambu S. Improving recruitment of surgical trainees and training of surgeons in Uganda. East Afr Med J 2006;11 (1):17-24.
59. Awojobi OA. Surgical training in Nigeria: a reappraisal. Acad Med 2005;6 (1):59-62.
60. Binam F, Malongte P, Beyiha G, Ze Minkande J, Takongmo S, Bengono G. Emergency medicine training: the future of emergency care in Africa. Med Trop 2002;62 (3):275-7.
61. Aarli JA, Diop AG, Lochmuller H. Neurology in sub-Saharan Africa: a challenge for the World Federation of Neurology. Neurology 2007;69 (17):1715-8.
62. Walker IA. Con: paediatric anaesthesia training in developing countries is best achieved by out of country scholarships. Paediatr Anaesth 2009;19 (1):45-9.
63. Gathuya ZN. Pro: paediatric anaesthesia training in developing countries is best achieved by selective out of country scholarships. Paediatr Anaesth 2009;19 (1):42-4.
64. Rabinowitz DA, Pretorius ES. Postgraduate radiology training in sub-Saharan Africa: a review of current educational resources. Acad Radiol 2005;12 (2):224-31.
65. Bennett JF, Saxton GA, Lutwama JSW, Namboze JM. The role of a rural health centre in the teaching programme of a medical school in East Africa. J Med Educ 1965;50:690-9.
66. Bollag U, Schmidt H, Fryers T, Lawani J. Medical education in action: community-based experience and service in Nigeria. Med Educ 1982;16 (5):282-9.
67. Monekosso GL. The teaching of medicine at the University Centre for Health Sciences Yaounde, Cameroon: its concordance with the Edinburgh Declaration on medical education. Med Educ 1993;27 (4):304-20.
68. Schreier A, Dub B. Attitudes of medical students to a family attachment scheme. S Afr Med J 1977;51 (15):501-3.
69. Brieger WR. Developing service-based teaching in health education for medical students. Health Educ Monogr 1978;6 (4):345-58.
70. Whittaker DE, Hoffman M. Students' attitudes to small-group work in community health. Med Educ 1987;21 (4):350-2.
71. Iputo JE, Nganwa-Bagumah AB. The innovative medical curriculum of the University of Transkei Medical School. Part II. Community-based learning. S Afr Med J 1996;86 (6):651-2.
72. Matchaya M, Muula AS. Perceptions toward private medical practitioners' attachments for undergraduate medical students in Malawi. Malawi Med J 2009;21 (1):6-11.
73. Ogunbode O. Features and controversies in community-based education. Arch Ibadan Med 2005;6 (1):24-8.
74. Kwizera EN, Igumbor EU, Mazwai LE. Twenty years of medical education in rural South Africa - experiences of the University of Transkei Medical School and lessons for the future. S Afr Med J 2005;95 (12):920-2.
75. Jinadu MK, Ojofeitimi EO, Oribabor P. Evaluation of an innovative approach to community-based medical undergraduate education in Nigeria. Educ Health (Abingdon) 2002;15 (2):139-48.
76. Iputo JE, Kwizera E. Problem-based learning improves the academic performance of medical students in South Africa. Med Educ 2005;39 (4):388-93.
77. Gukas ID. Problem-based learning in undergraduate medical education: can we really implement it in the West African subregion? West Afr J Med 2007;26 (2):87-92.
78. Adeogun M. Paradigm shifts in medical education: implications for medical/health librarians in sub-Saharan Africa. University of Dar es Salaam Library Journal 2007;9 (2):72-85.
79. Iputo JE. Impact of the problem-based learning curriculum on the learning styles and strategies of medical students at the University of Transkei. S Afr Med J 1999;89 (5):550-4.
80. Boon JM, Meiring JH, Richards PA, Jacobs CJ. Evaluation of clinical relevance of problem-oriented teaching in undergraduate anatomy at the University of Pretoria. Surg Radiol Anat 2001;23 (1):57-60.
81. McLean M. Clinical role models are important in the early years of a problem-based learning curriculum. Med Teach 2006;28 (1):64-9.
82. Kwizera EN, Dambisya YM, Aguirre JH. Does tutor subject-matter expertise influence student achievement in the problem-based learning curriculum at UNITRA Medical School? S Afr Med J 2001;91 (6):514-6.
83. McLean M. What can we learn from facilitator and student perceptions of facilitation skills and roles in the first year of a problem-based learning curriculum? BMC Med Educ 2003;3:1-10.
84. Kiguli-Malwadde EK, Kijjambu S, Kiguli S etal. Problem-based learning, curriculum development and change process at Faculty of Medicine, Makerere University, Uganda. Afr Health Sci 2006;6 (2):127-30.
85. Cameron D, Blitz J, Durrheim D. Teaching young docs old tricks - was Aristotle right? An assessment of the skills training needs and transformation of interns and community service doctors working at a district hospital. S Afr Med J 2002;92 (4):276-8.
86. Connolly C, Seneque M. Evaluating problem-based learning in a multilingual student population. Med Educ 1999;33 (10):738-44.
87. Oviasu E. Clinical skills evaluation in a resource-constrainedenvironment. Med Educ 2008;42 (5):524-5.
88. Burch VC, Nash RC, Zabow T, Gibbs T, Aubin L, Jacobs B, Hift RJ. A structured assessment of newly qualified medical graduates. Med Educ 2005;39 (7):723-31.
89. Kiguli S, Kijjambu S, Mwanika A. Clinical skills training in a resource-constrained medical school. Med Educ 2006;40 (5):473.
90. Anochie IC, Nkanginieme KE, Eke N, Gbogo I. Development and validation of standardised clinical summary format. Niger J Med 2008;17 (3):300-3.
91. de Villiers M, Van Heusden M. A comparison of clinical communication skills between two groups of final year medical students with different levels of communication skills training. S Afr Fam Pract 2007;49 (7):1-5.
92. Mash B, Couper I, Hugo J. Building consensus on clinical procedural skills for South African family medicine training using the Delphi technique. S Afr Fam Pract 2006;48 (10):14.
93. Walubo A, Burch V, Parmar P, Raidoo D, Cassimjee M, Onia R, Ofei F. A model for selecting assessment methods for evaluating medical students in African medical schools. Acad Med 2003;78 (9):899-906.
94. McLean M, Henson Q, Hiles L. The possible contribution of student drawings to evaluation in a new problem-based learning medical programme: a pilot study. Med Educ 2003;37 (10):895-906.
95. Beylefeld AA, Struwig MC. A gaming approach to learning medical microbiology: students' experiences of flow. Med Teach 2007;29 (9):933-40.
96. World Federation for Medical Education. Guidelines for Using Computers in Medical Education. Med Educ 1998;32:205-8.
97. McLean M, Murrell K. WebCT: integrating computer-mediated communication and resource delivery into a new problem-based curriculum. J Audiov Media Med 2002;25 (1):8-15.
98. Masters K, Gibbs T. The spiral curriculum: implications for online learning. BMC Med Educ 2007;7:52.
99. El Shallaly GH, Ali EA. Use of video-projected structured clinical examination (ViPSCE) instead of the traditional oral (viva) examination in the assessment of final year medical students. Educ Health (Abingdon) 2004;17 (1):17-26.
100. Hadley GP, Mars M. Postgraduate medical education in paediatric surgery: videoconferencing - a possible solution for Africa? Ped Surg Int 2008;24 (2):223-6.
101. Williams CD, Pitchfork EL, O'Callaghan C. Computers, the Internet and medical education in Africa. Med Educ 2010;44:485-8.
102. Samuel M, Coombes JC, Miranda JJ, Melvin R, Young EJ, Azarmina P. Assessing computer skills in Tanzanian medical students: an elective experience. BMC Public Health 2004;4:37.
103. Ameh N, Kene TS, Ameh ES. Computer knowledge amongst clinical year medical students in a resource-poor setting. Afr Health Sci 2008;8 (1):40-3.
104. Olantuji-Bello II, Ibegwam A, Odugbemi TO. A review of the use of computer and Internet services in a Lagos tertiary institution. Niger J Health Biomed Sci 2002;1 (1):13-21.
105. Mullan F. The metrics of the physician brain drain. N Engl J Med 2005;353:1810-8.
106. Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health 2004;2:17.
107. Scheffler RM, Liu JX, Kinfu Y, Dal Poz MR. Forecasting the global shortage of physicians: an economic- and needs-based approach. Bull World Health Organ 2008;86 (7):516-23.
108. Clemens MA, Pettersen G. New data on African health professionals abroad. Hum Resour Health 2007;6:1.
109. Kirigia JM, Gbary AR, Muthuri LK, Nyoni J, Seddoh A. The cost of health professionals' brain drain in Kenya. BMC Health Serv Res 2006;6 (89); [Accessed 25 May 2011.]
110. Awases M, Gbary A, Nyoni J, Chatora R. Migration of health professionals in six countries: a synthesis report. 2004. . [Accessed 25 May 2011.]
111. Dovlo D. Wastage in the health workforce: some perspectives from African countries. Hum Resour Health 2005;3:6.
112. Astor A, Tasleem A, Matallana VM, Olowu FA, Tallo V, Lie RK. Physician migration: views from professionals in Colombia, Nigeria, India, Pakistan and the Philippines. Soc Sci Med 2005;61 (12):2492-500.
113. Hagopian A, Ofosu A, Fatusi A, Biritwum R, Essel A, Hart LG, Watts C. The flight of physicians from West Africa: views of African physicians and implications for policy. Soc Sci Med 2005;61 (8):1750-60.
114. Mills EJ, Schabas WA, Volmink J, Walker R, Ford N, Katabira E, Anema A, Joffres M, Cahn P, Montaner J. Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime? Lancet 2008;371 (9613):685-8.
115. Coombes R. Developed world is robbing African countries of health staff. BMJ 2005;330:923.
116. World Health Organization. Global Code of Practice on the International Recruitment of Health Personnel. 2010. . [Accessed 25 May 2011.]
117. Eastwood JB, Conroy RE, Naicker S, West PA, Tutt RC, Plange-Rhule J. Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. Lancet 2005;365 (9474):1893-900.
118. Labonte R, Packer C, Klassen N etal. The brain drain of health professionals from sub-Saharan Africa to Canada. 2006. . [Accessed 25 May 2011.]
119. Scott ML, Whelan A, Dewdney J, Zwi AB. 'Brain drain' or ethical recruitment? Med J Aust 2004;180 (4):174-6.
120. Longombe A, Burch V, Luboga S, Mkony C, Olapade-Olaopa E, Otieno-Nyunya B etal. Research on medical migration from sub-Saharan medical schools: usefulness of a feasibility process to define barriers to data collection and develop a practical study. Educ Health (Abingdon) 2007;20 (1):27.
121. Bekele A, Mekonnen A, Osman M. Medical students' perspective towards their future medical practice. J Ethiop Med Pract 2001;3 (2):85-91.
122. Bourne D, Gunst C, Snyders S. Medical students' attitudes to emigration. S Afr Med J 1993;83 (11):861-2.
123. Dambisya Y. Career intentions of UNITRA medical students and their perceptions about the future. Educ Health (Abingdon) 2003;16 (3):286-97.
124. Ihekweazu C, Anya I, Anosike E. Nigerian medical graduates: where are they now? Lancet 2005;365 (9474):1847-8.
125. Price M, Weiner R. Where have all the doctors gone? Career choices of Wits medical graduates. S Afr Med J 2005;95 (6):414-9.
126. Igumbor EU, Kwizera EN. The positive impact of rural medical schools on rural intern choices. Rural Remote Health 2005;5 (2):417.
127. Raviola G, Machoki M, Mwaikambo E, Good MJ. HIV, disease plague, demoralisation and 'burnout': resident experience of the medical profession in Nairobi, Kenya. Cult Med Psychiatry 2002;26 (1):55-86.
128. de Castella T. Health workers struggle to provide care in Zimbabwe. Brain drain adds to woes of a cash-strapped health-care system. Lancet 2003;362 (9377):46-7.
129. Kline MW, Ferris MG, Jones DC, Calles NR, Mizwa MB, Schwarzwald HL etal. The Pediatric AIDS Corps: responding to the African HIV/AIDS health professional resource crisis. Pediatrics 2009;123 (1):134-6.
130. Mullan F. Responding to the global HIV/AIDS crisis: a Peace Corps for health. JAMA 2007;297 (7):744-6.
131. Physicians for Human Rights. An action plan to prevent brain drain: building equitable health systems in Africa. 2004. . [Accessed 25 May 2011.]
132. Renggli V, Ryck ID, Jacob S, Yeneneh H, Sirgu S, Sebuyira LM etal. HIV education for health care professionals in high prevalence countries: time to integrate a pre-service approach into training. Lancet 2008;372 (9635):341-3.
133. Weaver MR, Nakitto C, Schneider G, Kamya MR, Kambugu A, Lukwago R etal. Measuring the outcomes of a comprehensive HIV care course: pilot test at the Infectious Diseases Institute, Kampala, Uganda. J AIDS 2006;43 (3):293-303.
134. Dovlo D. The brain drain and retention of health professionals in Africa. Regional Training Conference on Improving Tertiary Education in Sub-Saharan Africa: Things that Work! 2003. . [Accessed 25 May 2011.]
135. de Vries E, Reid S. Do South African medical students of rural origin return to rural practice? S Afr Med J 2003;93:789-93.
136. Kotzee TJ, Couper ID. What interventions do South African qualified doctors think will retain them in rural hospitals of the Limpopo province of South Africa? Rural Remote Health 2006;6 (3):581.
137. Serneels P, Lindelow M, Montalvo JG, Barr A. For public service or money: understanding geographical imbalances in the health workforce. Health Policy Plan 2007;22 (3):128-38.
138. Frehywot S, Mullan F, Payne PW, Ross H. Compulsory service programmes for recruiting health workers in remote and rural areas: do they work? Bull World Health Organ 2010;80:364-70.
139. Barnighausen T, Bloom DE. 'Conditional scholarships' for HIV/AIDS health workers: educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa. Soc Sci Med 2009;68:544-51.
140. van Zyl GJ, Nel M. The PRIME model: a management solution in academic medicine. S Afr Fam Pract 2008;50 (1):71.
141. Ofoegbu EN, Ozumba BC. Establishment of an office of medical education: Nigeria. Med Educ 2007;41 (5):507.
142. Monekosso GL. Strategies for developing innovative programmes in international medical education. A viewpoint from Africa. Acad Med 1989;5 (Suppl):27-31.
143. Olmesdahl PJ, Manning DM. Impact of training on PBL facilitators. Med Educ 1999;33 (10):753-5.
144. Olmesdahl PJ. Rewards for teaching excellence: practice in South African medical schools. Med Educ 1997;31 (1):27-32.
145. Burdick WP, Morahan PS, Norcini JJ. Slowing the brain drain: FAIMER education programmes. Med Teach 2006;28 (7):631-4.
146. Sande M, Ronald A. The academic alliance for AIDS care and prevention in Africa. Acad Med 2008;83 (2):180-4.
147. Einterz R. Responding to the HIV pandemic: the power of an academic medical partnership. Acad Med 2008;82 (8):812-8.
148. Ozgediz D, Wang J, Jayaraman S, Ayzengart A, Jamshidi R, Lipnick M etal. Surgical training and global health: initial results of a 5-year partnership with a surgical training programme in a low-income country. Arch Surg 2008;143 (9):860-5.
149. Afolabi BB, Olapade-Olaopa E. International training in medical education. Afr J Med Med Sci 2006;35:59-67.
150. Glew RH. Promoting collaborations between biomedical scholars in the US and sub-Saharan Africa. Exp Biol Med (Maywood) 2008;233 (3):277-85.
151. American International Health Alliance Twining Center. HIV/AIDS Twinning Center Program Overview: American International Health Alliance-Twinning Center, 2009: [Accessed 25 May 2011.]
152. World Health Organization/PEPFAR. Collaboration for transformative scale-up of medical and nursing education. 2010. . [Accessed 25 May 2011.]