In Country Pediatric Training for
Liberian Doctors
Dr. Ellie Graham in consultation with Dr.
Bamenla Goka, Director of the Pediatric
Section of WACP and Professor of Pediatrics
at Korle Bu Hospital, Accra, Ghana
Goal of Pediatric Work in Liberia
• Develop conditions to end MD “brain drain”
• Offer a 4 year Pediatric Residency Training
• Adapted to the conditions and training
available in Liberia and West Africa
• Qualify residents who complete the training to
sit for Parts I and II of the West African College
of Physician (WACP) Examinations in General
Pediatrics.
Core Competencies of the Training
Program: Adapt to Liberia Setting
•
•
•
•
•
•
Patient Care
Medical Knowledge
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Professionalism
Systems-based Practice
Pediatric Training to meet the
requirements of the WACP curriculum
• WACP or ABP certified faculty and US
peds residents provide
teaching/supervision
• WACP log-book of procedures
• Develop system of monthly evaluations
of Liberian interns and residents
WACP Rotation Requirements
• Core Clinical Rotations for 3 months each
– Newborn,
– Emergency Pediatrics
– General Pediatrics
• 3 month rotation in Primary Health
Care/School Health Program/Community
Pediatrics
– collaboration with Ministry of Health
• 4 subspecialty rotations, 2 months each
• 8 weeks elective rotations
Subspecialty Rotations (need 4)
•
•
•
•
•
•
Pediatric Cardiology
Pediatric Nephrology
Pediatric Nutrition / Gastroenterology
Pediatric Endocrinology and metabolism
Pediatric Neurology
Pediatric Hematology / Oncology (available in Ghana
at Korle Bu Hospital)
• Pediatric Pulmonary Disease
• Pediatric Infectious diseases
• Neonatology (available in Ghana at Korle Bu Hospital)
Elective Rotations (8 weeks)
• Pediatric surgery (could be available at JFK
through a pediatric surgery service that the
pediatric team managed)
• Anesthesia (potentially available at JFK or
Redemption)
• Ophthalmology (possibly available at JFK with
Dr. Guizie in eye clinic)
• Orthorhinolaryngology (ENT)
• Radiology
Additional Training Not Required by
WACP but Desirable for Liberia
• A Resident Continuity Clinic X 4 years
– for normal and medically complex children
– 2 half days clinic weekly
• Health Care Quality Improvement & Health
Administration Training X 4-6 mo in 3-4th yr
• Research methods training/thesis planning: 4-6
months in 3rd or 4th year (thesis is WACP requirement)
• Chief Residency in 4th year: 4-6 months with
focus on teaching skills and preparation for
faculty work.
Schedule of Major Trainings and
Examinations
• PL 1 Year (1/20XX)
– PALS; Newborn Resuscitation; Basic Science
– August Revision/Update Course in Ghana (2 wks
– October: Primary Examination of WACP in Ghana
• PL 2 Year (10/20XX) (Residency officially starts after pass of
primary exam)
– Begin logbook of WACP after passing the primary exam
• PL 3 Year: Continue clinical pediatric training
PL 4 Year and Post Residency
• PL 4 Year: October: Part I of Pediatric Exam of WACP
(not eligible until 2 years of training after passing the
primary exam)
• Post Residency: Part II of Pediatric Exam of WACP
– Taken 2 years following completion of residency
– Defense of research dissertation
– If pass, eligible to be a Fellow of WACP
– Typically employed as a clinic or hospital medical
director
Time Line and Commitment
• By 2011, establish an accredited program
• In 6 years the first graduates could sit for Part
II of the WACP examinations in Pediatrics
• When they pass: Liberian Pediatric Fellows of
WACP
• Liberian core of the faculty in Pediatrics
• Major commitment for volunteer faculty from
the US would be at least 10 years.
Steps to Establish Residency
• Buy-In and financial support from Ministry of
Health, Medical School, JFK and Redemption
Hospital admin and HEARTT (? World Bank)
• Hire a Director of Pediatrics
• Continuous US Pediatric Faculty/Residents
• Recruit 2-3 Liberian resident candidates
• Rotations of core pediatric subspecialist faculty
• Apply to WACP for accreditation of a pediatric
training program (site visit within 2 mos; can be
provisional for first 1-2 years)