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Problem: In many limited resource countries, medical and nursing school faculties are small and understaffed, contributing to the sparse output of physicians and nurses to support the country's health system. The World Health Organization declared that 37 African nations suffer a "critical shortage" of health practitioners., Approach: The Global Health Service Partnership (GHSP) is a new program that sends U.S. physicians and nurses to serve as faculty at medical and nursing schools in low-resource countries to increase the quantity and quality of graduates, thereby strengthening local health systems. The GHSP is a collaboration between the Peace Corps and Seed Global Health, a private nongovernmental organization, and is supported by the President's Emergency Plan for AIDS Relief., Outcomes: In July 2013, the GHSP sent 15 physicians and 15 nurses to serve as faculty at 11 schools in Uganda, Tanzania, and Malawi. These volunteers will serve for one year, working with their African counterparts teaching and building academic capacity. The program aims to help train more physicians and nurses for patient care, some of whom will become faculty in the future., Next Steps: An evaluation program will track and analyze the impact of the GHSP on the schools, the volunteers, and, over time, the impact on local health care. The authors propose a "sabbatical corps" to enable more U.S. academic medical and nursing faculty to participate in the program through the sponsorship of their home institutions. In future years, the GHSP will expand to more countries and include more health professions.

The early success of the President's Emergency Plan for AIDS Relief (PEPFAR) in delivering antiretroviral medications in poor countries unmasked the reality that many lacked sufficient health workers to dispense the drugs effectively. The 2008 reauthorization of PEPFAR embraced this challenge and committed to supporting the education and training of thousands of new health workers. In 2010 the program, with financial support from the US National Institutes of Health and administrative support from the Health Resources and Services Administration, launched the Medical Education Partnership Initiative to fund thirteen African medical schools and a US university. The US university would serve as a coordinating center to improve the quantity, quality, and retention of the schools' graduates. The program was not limited to training in the delivery of services for patients with HIV/AIDS. Rather, it was based on the principle that investment in medical education and retention would lead to health system strengthening overall. Although results are limited at this stage, this article reviews the opportunities and challenges of the first year of this major transnational medical education initiative and considers directions for future efforts and reforms, national governmental roles, and the sustainability of the program over time.

Objectives: This review synthesises research published in the traditional and 'grey' literature to promote a broader understanding of the history and current status of medical education in sub-Saharan Africa (SSA)., Methods: We performed an extensive review and analysis of existing literature on medical education in SSA. Relevant literature was identified through searches of five traditional medical databases and three non-traditional or grey literature databases featuring many African journals not indexed by the traditional databases. We focused our inquiry upon three themes of importance to educators and policymakers: innovation; capacity building, and workforce retention., Results: Despite the tremendous heterogeneity of languages and institutions in the region, the available literature is published predominantly in English in journals based in South Africa, the UK and the USA. In addition, first authors usually come from those countries. Several topics are thoroughly described in this literature: (i) human resources planning priorities; (ii) curricular innovations such as problem-based and community-based learning, and (iii) the 'brain drain' and internal drain. Other important topics are largely neglected, including: (i) solution implementation; (ii) programme outcomes, and (iii) the development of medical education as a specialised field of inquiry., Conclusions: Medical education in SSA has undergone dramatic changes over the last 50 years, which are recorded within both the traditionally indexed literature and the non-traditional, grey literature. Greater diversity in perspectives and experiences in medical education, as well as focused inquiry into neglected topics, is needed to advance medical education in the region. Lessons learned from this review may be relevant to other regions afflicted by doctor shortages and inequities in health care resulting from inadequate capacity in medical education; the findings from this study might be used to inform specific efforts to address these issues., (© Blackwell Publishing Ltd 2011.)

Because managed care is likely to feature prominently in a reformed health care system, policymakers need to examine the impact managed care will have on medical practice, physician supply, and access to primary care providers. Goals for work-force reform should focus on five areas: (1) training physicians in the generalist disciplines of family practice, general internal medicine, and general pediatrics; (2) shaping the physician work force to reflect the nation's ethnic diversity; (3) distributing physicians in a geographically equitable way; (4) maintaining the current physician-to-population ratio rather than letting it continue to grow; and (5) establishing supply needs for nurse practitioners, primary care physician assistants, and certified nurse midwives.