The New Innovative Medical
Education Initiative
Launching at Ambo University
Dr. Yodit Abraham (Col)
Consultant Internist ,MBA
Federal Ministry of Health
Ambo
Feb 4, 2012
◦ No one should get sick when we can Prevent i
◦ No one should die when we can cure !
Our vision is
For All Ethiopians to enjoy highest possible standard of
health care.
To take this vision to the remotest parts of Ethiopia to the
villages beyond the villages
◦ W e need to saw the seeds here and now!
◦ If not now when if not us who !
◦ We cannot harvest what we have what we have not sawn !
◦ let us plough the land, eradicate the weed, water the soil
and plant the best seeds now!

NIMEI is a Government Initiative

Leadership : joint FMOH and FMOE

Under the focus of the of Medical and Health Sciences
and Curriculum council .

Curriculum development: was by taskforce from FMOH,
Tulane University ,FMOE,5 Universities,WHO and Jhpiego.

Currently has wide base partner’s involvement on the
implementation.
The Need : to fill the demand and supply gap

The inherent gap : in number of Physicians in the
Health care in absolute terms and distribution

The countries development pace and induced needs
◦ Economic ,Social and basic infrastructure growth
and induced needs for services from the health sector
Doctor to Population ratio:
1 physician per 36,158 people
43% working in Addis Ababa.
The shortage of physicians is attributed to a
combination of factors:
a) Limited number of medical schools,
b) Limited capacity of enrolling students of MS,
c) Shortage of medical educators and faculty,
d) Internal displacement and Brain-drain
The predicted Doctor to Population ratio in 5-8
years time :
>1 physician per 10,000 people

New Innovative Medical Education Initiative (NIMEI):
◦ A new medical education system has already been
developed
◦ Enrollees graduates with BSc degree in Health and
natural sciences
◦ 10 Universities and 3 hospital based medical schools
established
A new medical education system

A New Competency Based Curriculum

Faculty Development system




Student recruitment and selection and graduation system
IT support system of the education
Educational environment and recourses standards
System of continuous monitoring and evaluation
Goal:

To educate medical doctors quantitatively sufficient and
professionally competent to provide quality health care
services to meet the demand of the Nation .

To educate the 21st century medical doctors of Ethiopia.
To produce medical doctors of the 21st century for Ethiopia who will
be “six star doctors” equipped with a comprehensive knowledge to
functions as :
• Care Provider
• Decision -maker
• Team leaders
• Researchers
• Teachers in the health sector
• Social mobilizer

In 2009 Taskforce was established with members form :
◦ The Federal Ministry of Education,
◦ The Federal Ministry of Health/Tulane University ,
◦ Addis Ababa University, Jimma University, Mekele
University, Hawassa University ,Gondar University
◦ WHO and JHPEIGO
Global trends in medical education

Changes and reforms even in the developed
countries

Direction & strategies for in "The Edinburgh
Declaration”

Social accountability of medical education
Basic
Sciences
Clinical
Sciences
hospital based
Basic
Sciences
Clinical Sciences
hospital -based
Basic
Sciences
Hospital based
Clinical
Sciences
Communit
y based
Study the
current situation
• Desk review
• Ethiopian
situation
• Global trends
of medical
Education
• Advantages
• Anticipated
challenges
National
Surveys
conducted
• Stakeholders
opinion
survey
• Competency
assessment
survey of
General
Practitioners
Stakeholders
Opinion
Survey
• University
presidents
• Deans
• Hospital
Directors
• Practising
Physicians
• Professional
association
leaders
Competency
Assessment
Survey
• 700 doctors and
health
professionals in
72 hospitals
participated
• Self report GPs
with in 5yrs of
service on their
medical
Education
Ethiopian
Experience
• National medical
Curriculum
• Jimma University
: CBE
• Defence college of
HS : HO to MD
• St. Paul Millennium
college :
Benchmarking
International
Experiences
-Visit of 12
universities
• Canada
• Netherlands
• South Africa
• Sudan
• Egypt
- Review of
Several other
curricula
Globally
Curriculum
Development
Approach
-Six step approach
Based on the
-Competency
assessment result
-Stakeholder opinion
survey result
-Benchmark result
-International
experts
consultation
-Desk review
NIME
Curriculum
• Competency
Based
• Hybrid
• Integrated
• Inquiry driven
methods
• Modular
National
Area
Experts
work shop
• Universities
• Professional
Association
• Partner
organizations
• Private
hospitals and
colleges
National
Medical &
Health science
Council
• 21 Universities
• 5 regional Health
bureaus
• Private collages
and hospitals
• Partner
organization
• and other
stakeholders
The following medical curricula were reviewed:

Addis Ababa University medical faculty

Jimma University

Defense college of health sciences

St. Paul's millennium medical school
2.7.Competency assessment survey
6/28/2016
22
Clear needs for Changes and improvement

Gaps in skills in emergency surgical and life saving clinical
skills

Missing and redundant courses were identified

Improving quality of care and teaching the hospitals

Evaluation of students should be objective following several
methods and progressively
6/28/2016
23
The survey included four categories
◦
Universities : Presidents/AVP/Medical/Health science
faculty Deans (16)
◦
Hospitals :Chief Executive Officers , Directors and Deputy
Directors of hospitals affiliated hospitals(28) ,
◦
Professional association :Leaders (6)
◦
Physicians: GPs and specialists ( 44)

Canada: Mac masters &Northern Ontario Universities

South Africa: Walter –Sisulu Universities and Nelson
Mandela University

Sudan: Khartoum university , AHFAD, Academy for
Medical Studies and Jezira university.


Netherlands : Maastricht University
Egypt : University Cairo aSuez canal University




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Step 1 : Problem identification &needs ass
Step 2 : Identifying competencies
Step 3: Objective of the curriculum
Step4 : Educational strategies
Step5 :Resources standard Development
Step 6: Implementation plan & M/E of the
program
The NIME curriculum is a Competency Base with the following
principles and strategies
•
Early community and clinical contact
•
Community orientation in medical education (COME)
•
Integration of the different sciences and unity between education &
practice
•
Self-directed learning
•
Problem-based learning (PBL)
•
ICT supported
•
Continuing professional development (CPD)
The NIME Curriculum identifies seven domains of core
competencies expected from a graduate:
1.
Professional Values, Attitudes, Behavior and Ethics
2.
Scientific foundation of Medicine
3.
Communication skills
4.
Clinical skills,
5.
Population Health and Health Systems
6.
Management of Information
7.
Critical thinking and research, Practice-Based Improvement
The major arms of the curriculum

Biomedical and Clinical Sciences

Professional competency development (PCD)

Social and population sciences (SPH)
Five major components:
1. Introduction to Medicine
2. Integrated System Based module
◦
3.
Clerkship
4.
Internship
5.
Social and population health(SPH)
PCD integrated with all
Total : 4 and 1/2 years including 1 year Internship

Year 1
45 weeks

Year 2
48 weeks

Year 3 Clerk ship I
48 weeks

Year 4 Clerkship II
53 Weeks

Internship
48 weeks
• Competency based curriculum
• Incorporated new educational strategies
• Competency, learning objective, methodologies and
assessment linked
• Integrating Biomedical ,Professional competency
development ,social and population health sciences
with in their disciplines and with each other
• Modular delivery

Emphasis on :
◦ Essential clinical and professional skills
◦ Emergency live saving surgical and obstetrics skills
◦ Ethiopian health problems, Infectious diseases& rural
health introduced

Designed to take place under
◦ FMOE : Universities under the Education sector
◦ FMOH : Regional Hospitals and Health Sciences
Collages under the Health sector transforming them in
to medical schools
10 University based Medical schools
1.
Ambo University
6.
DireDawa university
2.
Axum University
7.
Made-Walabu University
3.
Debre-Birhan University
8.
Wolega University
4.
Dilla University
9.
Wolayta Soddo University
5.
Debre-Markos University
10.
Wollo University
3 Hospital based Medical schools
1.
Adama Hospital
2.
Yekatit 12 Hospital
3.
Yirgalem Hospital

Phase One- Preparation

Phase Two- Implementation

Phase Three -Out put evaluation

Activities under taken
◦ Budget allocation and mobilization of resources,
◦ Introduced of Curriculum to all stake holders,
◦ Familiarization training on the NIME Curriculum,
◦ Faculty development training for 110 teachers form
the implementing schools has been completed .
◦
◦ Faculty pool,
◦ Sites preparation ,
◦ Material resources,
◦ Student entrance exam , selection and recruitment
process
◦ Web page development http://info.moe.gov.et
Phase two :
◦ Strengthening of systems: educational, managerial and
other relevant systems
◦ System development for continuous evaluation
◦ Continuous capacity building
◦ Expansion of program
Phase three :
o
Output evaluation

Faculty pool development in the medical schools.
◦
◦
◦
◦
Recruit the existing faculty in the MS
Involve inter professional group of professionals
Encourage Private public partnership
Involve the retired but not tired
◦ Ethiopian Diaspora
◦ Expats and friends of Ethiopia
◦ Volunteers
◦

Faculty development through training
• To shape the minds and hearts of the future Ethiopian.
• Equip medical educators with adequate knowledge, skill
and attitude to teacher and facilitate student learning
Phase 1: Initial training on the curriculum, teaching skills
and other professional relevant areas.
Phase 2: Medical Education at MSC level.

Recruitment and Admission process
◦ Graduate of Natural and Health sciences
◦ Criteria based and credential check
◦ Preparation for National Entrance examination
◦ National Entrance examination(Joint)
◦ Interview

Graduation
◦ National Exit examination before graduation
◦ Preparation for national Entrance examination

2900 registered: System of Registration developed
web supported

2741 sat for the National Entrance Examination

1017 passed the National Entrance Examination
and placmemt in the13 medical schools completed

Registration for class starts Yekatit 5th
Conducted in 13
medical schools

Teleconference applications for Tele education and telemedicine

e-learning platforms

Computer Assisted Learning applications

Tools for the retrieval and management of Information


Computer based assessment of students
Develop the curriculum web based

Simulations for skill and integrated labs

Development Cases for PBL [Simulation ]


Joint program between FMOE,FMOH and
MICT on tele-education; e-learning platforms
and development of web based curriculum and
learning management system is being worked .
Case simulation for PBL with electronic content
will be prepared with partners.

The NIMEI resource standard has been
developed
◦
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Training packages
Integrated Laboratories
Skill laboratories
Books
ICT and audiovisual equipments
Printing and binding
Vehicles
We do not have yet have enough

Faculty

Educational resource

ICT supports
But through time with cooperation of all
stakeholders we will attain our goals!
Let us realize our dreams !
that no one dies for lack of health care and no one get
sick for lack of prevention!
then we can sit back and tell our selves that we were on
the right track !
I thank you !!!