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Dialogue on the state of health worker/ medical training & career development in Uganda

By Daisy Winner | 22 Feb, 2017

On February 23, a variety of stakeholders will meet to discuss the current state of health worker training, medical education, and career development in Uganda. Partners from Makerere University, University of Botswana, Uganda Medical Association, Seed Global Health, and others will convene to discuss the gaps in medical education and the training of health care workers.

During the meeting, students from the Federation of Ugandan Medical Students Assocation will be sharing live updates from the meeting. Stay tuned!



Sulaiman Wasukira Bugosera Replied at 1:41 AM, 23 Feb 2017

We are present at the Uganda Medical Association Stakeholders deliberative dialogue on the state of Health workers/ medical training and career development in Uganda.

Sulaiman Wasukira Bugosera Replied at 1:44 AM, 23 Feb 2017

We are having introductions for the participants in the dialogue. This is after we had an opening prayer by Ms Gloria Nabaasa.

Sulaiman Wasukira Bugosera Replied at 1:54 AM, 23 Feb 2017

"We decided to have a deliberative dialogue. A dialogue not based on emotions but a dialogue guided by experts"- Dr Bisso On why the dialogue was needed.

Sulaiman Wasukira Bugosera Replied at 1:55 AM, 23 Feb 2017

Dr Bisso, the president Uganda Medical Association is giving welcome remarks.

Jostas Mwebembezi Replied at 1:56 AM, 23 Feb 2017

Very interesting
Let me know how to participate Remotely out if land.


kasozi andrew Replied at 2:05 AM, 23 Feb 2017

session on
findings from the FLEXNER report of 1910 conducted in the USA and its impact in the current health training

kasozi andrew Replied at 2:06 AM, 23 Feb 2017

competencies for Ugandan Graduates/MEPI-MESAU findings

kasozi andrew Replied at 2:10 AM, 23 Feb 2017

required competencies; Fit for purpose(FFP)
prepared to work where services are most needed, able to respond to health needs of community, able to deliver quality care with available (limited), clinical excellence as foundation for teaching and research, continuous self-directed learners, Effective communicators

kasozi andrew Replied at 2:12 AM, 23 Feb 2017

health workers ought to be best communicators for their selves and their patients' benefit

kasozi andrew Replied at 2:16 AM, 23 Feb 2017

quality assurance;
strong regulatory bodies, strict and independent accreditation, strong professional association, supportive supervision

human resources for health/ health workforce;
country coordination and facilitation framework, dynamics between public and private

kasozi andrew Replied at 2:25 AM, 23 Feb 2017

remarks from prof Omaswa;
hopefully we can all agree and come up with the best recommendation, there should be a way through which academic leaders assure the best quality of health in the country, and our teaching hospitals should accord us the best learning and teaching experience.
its up to us to show evidence of what works well and should be carried forward

kasozi andrew Replied at 3:11 AM, 23 Feb 2017

Key issues in undergraduate training of medical worker, by Prof Kyamanywa

stimulate critical thought about undergraduate medical training ; what needs to be done differently, kind of curriculum,facilities.
Curriculum(delivery, assessment, use of evidence in curriculum design and review), trainers (5Rs: Recruitment, Resourcing, Retention, Reward, Retirement). We need visionary academic leadership in medical education. poor pay and increaasing demands are eroding the clinical training sites of trainers.
-Low utilization of technological advances
-Under utilization of the several regional referral hospitals
Policies and Regulations
-The role of Uganda Medical and Dental Practitioners council and National council of higher education???

Prem Sigdel Replied at 3:31 AM, 23 Feb 2017


kasozi andrew Replied at 3:46 AM, 23 Feb 2017

We are from a break and the discussion is now open.
Prof. Sarah Kiguli's response and comments from the previous presentations;
-Learners: Students who join medical school are from a few districts who can afford education around the central districts. We need to have students from all over the country.
+All students with two principle passes should be subjected to a test (to evaluate motivation) on top of the school grades. This will ensure equity.
-Curriculum: what are the competencies? competencies need to be defined, then define curriculum, then define teaching methods.
Students should always have life-long learning skills.
-Where are the learners taught from? Schools should agree on the training facilities for the students. Consider: location, relevant methods for assessment of competencies.
-Single curriculum? If competencies are defined then there is no need for single curriculum because the universities need some autonomy.
-Teachers? Universities should work together to continuously update the teachers with skills on how to teach.
in whatever we do, we should use student centered learning that empowers the learners to learn and not the teachers to teach.

kasozi andrew Replied at 3:55 AM, 23 Feb 2017

Mr. Oria Hussein (Department of Pharmacy Makerere University College of Health Sciences)

-We should look at continuity of the professions and the passion for the students
-Curriculum: 2003 Makerere moved from lecture based learning to student based learning ( with evidence for change) but of recent they have turned back (without evidence for change). We should always look for evidence before change of curriculum.
-We should train all our graduates in the environment that they are to work.
-Mentor-ship is important in the medical training but the limited human resource for training and mentor-ship makes it had to effectively do mentor-ship. We should limit the numbers of students in order to effectively train.

Ashiru Abubakar Replied at 3:59 AM, 23 Feb 2017

Great. Let's have the outcome of the deliberationsick.

Best regards ,

Dr. Ashiru Adamu Abubakar

Chevening Scholar 2016/2017
Board Chairman, Mandela Washington Fellowship Alumni Association Nigeria
Mandela Washington Fellow (Civic Leadership Track)
Fellow, Maternal Health Young Champion of Harvard school of Public Health
and Institute of International Education, USA
Nigeria's Maternal and Newborn (MamaYe) Hero, 2013

"Surely, the best among people is he who brings most benefits to mankind..."

kasozi andrew Replied at 4:01 AM, 23 Feb 2017

Dr Ahimbisibwe Hillary (Chair Kabale region)

-Technological advance: Patients have taken up the technological advances so it is upon the students and health workers to catch up and race ahead of them

kasozi andrew Replied at 4:05 AM, 23 Feb 2017

Dr Ahimbisibwe Hillary (Chair Kabale region)

-Technological advance: Patients have taken up the technological advances so it is upon the students and health workers to catch up and race ahead of them

kasozi andrew Replied at 4:22 AM, 23 Feb 2017

Prof. Pauline Byakika (Makerere University College of Health Sciences)

-We are training undergraduates in an environment that is specialized. We need to revise the teaching system on the wards and perhaps have a general ward for teaching.
- Where are the teachers? The promotion is based on research which does not recognize the works of most of the teachers that spend most of their work on the wards.
- Teaching environment: Facilities on the wards. training in very inadequate environment poses a question to the quality of doctors
-Problem Based Learning is good but are the students having the resources to enable them survive in the system. Are the teachers reading?

kasozi andrew Replied at 4:34 AM, 23 Feb 2017

Dr Kyazze Solomon (President Senior House Officers at Makerere University College of Health Sciences): Training of Post-Graduate Medical workers: What are the key issues
-350 senior house officers and cover 16 clinical disciplines and 64% of the workforce.
-Out of 350 students about only 100 students are sponsored by government
- With SHOs the doctor:patient ratio reduces from 1:8000 to 1:3000
-Accommodation: 62 units in Mulago, 4units in Kiruddu and 8 in Kikaaya and Kawaala.
Solution: Accommodation allowances should be given and more housing units created.
-Allowances/salaries: PG courses are full time courses. they resign to come and study.
Solution: Create student loans and salaries
-Lack of supervision:There are a few medical school lecturers to supervise
-Poor working conditions: Lack of basic sundries in hospitals. Affects more of surgical disciplines.
Solution: All stakeholders should rethink about the health system and avoid compromise

kasozi andrew Replied at 4:57 AM, 23 Feb 2017


-Lack of organization; UMA should not lose the opportunity to be proactive for the well being of doctors.
-We should determine who we train so that we can easily outsource for scholarships and other facilitation.
-We should make recommendations of specialists we need in the country according to the needs of the population and send this to the national planning authority.
-Government should plan for MO positions at Mulago National Referral Hospital which are to be filled SHOs an subsequent replacements made when the SHOs graduate.
-Determine the number of people to be admitted and make the plan for proper mentor-ship.
-Bachelor graduate nurses not included in the public service payroll

kasozi andrew Replied at 5:23 AM, 23 Feb 2017

- Curricula harmonization: How to select intake, and how medical education is delivered.
-Human resource issues: University teaching hospitals should be advocated for and teachers recruited who will be teaching while working, this will increase engagement time for students with teachers thus proper supervision.
-Postgraduate is a highly specialized area. "Collectiveness will help us move forward"
-We should move away from improvisation and shift towards achieving ideal situations
- Scholarships: We should outsource for scholarships from collaborations with other international institutions.
-Improve the working environment. we should move away from the acceptance of sub-standard health.
-People moving away from clinical practice to Public health: Most of the people get better motivation from the public health fields.
-Assessment: The kind of assessment that is given to the student drives their learning. The assessment methods should be harmonized to make better physicians.
-Harmonize the curriculum: because the patients are the same and their conditions are similar though the presentations are different.
-Research vs clinical work: Which is more awarding
-Entry examinations: Get interested in the works of UNEB to be examiners.
-Document the contributions of the medical training ( Trainers and Trainees) to the health system
-All regional referral hospitals should be named sites for resident training.
-We should unite as medical doctors and disseminate medical information to the general public

Elizabeth Glaser Replied at 5:33 AM, 23 Feb 2017

Can you clarify , is this about health care professionals or physicians?
If about all health care professionals are you going to have nurses, pharmacists, and other cadres present?

Thank you,


kasozi andrew Replied at 5:51 AM, 23 Feb 2017

-Uganda medical and Dental Practitioners Council (UMDPC) and Ugandan Medical Association (UMA) should be empathetic in the training and help the medical trainees ( post graduate and under graduate) to come up and grow in the discipline of medical.
-The UMDPC should be ensuring that the training of medical practitioners does not deter students fro joining the profession. It should support the calls for well being and welfare of the young doctors (Interns).
-The rewarding system for the medical doctors should be good enough to motivate the work of the medical professions
-The admission system should not be interfered but rather the UMDPC should be able to influence the training of quality doctors. Entry and post training exams should not be considered because they interfere with the autonomy of the Uganda national examinations Board and the University's awarding system of degrees.

kasozi andrew Replied at 5:54 AM, 23 Feb 2017

Elizabeth, the discussion involves all the undergraduate, internship and postgraduate health profession disciplines.

kasozi andrew Replied at 7:39 AM, 23 Feb 2017

internship policy by Dr. kavuma Fauz
the internship policy guidelines 16/17;
the pre-internship exams; one doesn't test quality, lack of statistical data to prove lack of quality of recently graduated health workers, absence of complaints from already working health workers
bonding; literature review and key informant guidelines show low health workers willingness to work in the remote ares because of the forced unpaid which demotivates health workers to abundon the practice, or leave the country, challenges;cost utility, poor ruraal facilities, human rights of people within the profession and
induction; UMA not invited, elected leaders are not recognised by the internship committee,induction allowances not yet paid, certificates were not awarded, channel of communication about data
challenges; poor accomodation at the sites, delayed pay, deductions on intern allowances at the site, long working hours
legal redress; court injuction, human rights?, poor communication,
policy options; accreditation, automatic promotion

kasozi andrew Replied at 8:09 AM, 23 Feb 2017

internship; numbers are too much and the suupervisors are very low

kasozi andrew Replied at 8:11 AM, 23 Feb 2017

currently its a crisis that needs to be thought about immediately , however, in fututer they ought to prior plan to prevent it.

kasozi andrew Replied at 8:21 AM, 23 Feb 2017

need to maximise professional bodies that can help to boost the competence of the interns and what is next after that.

kasozi andrew Replied at 8:28 AM, 23 Feb 2017

health worker BONDING; a suggestion to be made just as a transition BUT with a very clear way forward mainly for further studies and training not as a form of having people in those hard to reach places

kasozi andrew Replied at 8:57 AM, 23 Feb 2017

outcomes of internship; empowerment, raaised fountain source, hospital coverage, learning deepens on seasonal specialist, NO NEED for pre-internship exams, attitudes of leaders ought to change.

kasozi andrew Replied at 9:24 AM, 23 Feb 2017

-Thanks all for coming and thank you for putting the country before our individual interests.
-we who are here today should commit to take the first step towards putting right what has gone wrong in the health sector in this country.
-The outcomes of the meeting will be carried forward to discussion between UMA and the Ministry of Health in the coming week.
-For God and my Country

HUIWEN XU Replied at 9:28 AM, 23 Feb 2017

This is a great event! Please keep updated. Also, I am wondering whether we can watch this video online?

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.