PS1-1 : eTraining and medical education, a leverage to restructure the health system


Many countries of Central Asia and Eastern Europe are facing a significant shortage of doctors in the rural areas. This trend is not specific to these regions, it is experienced worldwide. It is the result of a combination of several factors such as lack of incentives and compensation for working in remote areas, isolation, , difficult living and working conditions, difficult access to experts’ support, difficult access to training etc. Medical education bears some responsibility and contributes indirectly to this situation. By concentrating the majority, if not all, of the training process in academic institutions located in the major urban centers, cutting off the students from the rural areas for the several years, exposing students only to university settings with easy access to technology and specialized expertise, with no links maintained with rural services, promoting mainly specialty training instead of general practice, no doubt young residents don’t want to train and practice in rural areas.

The Swiss Agency for Development and Cooperation (SDC) supports medical education reform in several countries of this region as part of broader health system reforms. The goal is to improve the quality of training, establish structural and functional links with secondary and primary care facilities and decentralized part of the training process in the regions. In doing so, academic institutions increase access to clinical practice in regional services, strengthen the capacity of the local services and de facto contribute to the resolution of the rural human resources shortage.

This ongoing decentralization of the pre-, post-graduate and continuing medical education (CME) challenges the traditional role of academic institutions within the health system, forces also the health system to include in its organization and planning the medical education dimension by providing short term positions for residents in training, provide salaries and establish closer interaction in capacity development, training and improving the quality of services provided.

New communication technologies are playing an increasing role in this process, in facilitating the training of young residents when practicing in the regions, CME distance learning programs and simply maintaining regular contacts between the academic and tertiary institutions with the primary care level. Formal e- training courses are provided, tele-consultations can be organized, but less formal connections start to play an increasing role via skypes, WhatsApp, etc. The combined medical education reform and technology development provide promising opportunities for innovative health system strengthening.



This session will illustrate how medical education reforms contribute to the reform and upgrading of the health system and how communication technologies can play a significant role in developing innovative approaches to training and capacity building.



Loutan LouisChairmanHUGSwitzerland
Muratalieva ElviraChairmanSDC Bishkek Kyrgyzstan
Azimova Aigul E-learning as a driver to reform the academic medical institutions training model PublicFoundation Initiatives in Medical EducationKyrgyzstan
Dunganova Azel
Integrating medical education in the health system: lessons learnt from KyrgyzstanHPACKyrgyzstan
Glybochko Petr
E learning in RussiaUniversity of SechenovRussia
Nargis RakhmatovaEvaluation of Continuing Medical Education among family doctors in pilot and nonpilot districts of the Republic of TajikistanSwiss TPHTajikistan


PS : Parallel session PS-1 : Health system