A Systems Approach to Medical Education

doi:10.1017/9781108884709.003

Chapter 1 - A Systems Approach to Medical Education

from Section I - Abortion Training: Workforce, Leadership, Social & Political Impact

Published online by Cambridge University Press: 30 July 2021

Uta Landy

Edited by

Uta Landy ,

Philip D Darney and

Jody Steinauer

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Uta Landy: Affiliation:
University of California, San Francisco
Philip D Darney: Affiliation:
University of California, San Francisco
Jody Steinauer: Affiliation:
University of California, San Francisco

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Summary

The first reforms in health education occurred in response to the publication of the Flexner Report in 1910, more than a hundred years ago [1]. The reforms, sparked by the discovery of the germ theory in Europe and other scientific advances, led to the integration of early developments in medical science into the academic education of physicians. Ten years ago, the Lancet published a report, “Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World,” based on the findings of a global independent commission to address the inequities in health, despite enormous scientific advances in medicine [2]. In this report, twenty professional and academic leaders representing the perspective of diverse countries defined an educational strategy for medicine, nursing and public health. Its intention was to consider the relationship between health systems and education and recommend strategies to produce a workforce that addresses the health needs of a particular country.

Type: Chapter
Information: Advancing Women's Health Through Medical Education
A Systems Approach in Family Planning and Abortion
, pp. 7 - 20

DOI: https://doi.org/10.1017/9781108884709.003 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2021

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References

Flexner, A. Medical education in the United States and Canada. From the Carnegie Foundation for the Advancement of Teaching, Bulletin Number Four, 1910. Bull World Health Organ. 2002;80(7):594–602.Google Scholar PubMed

Frenk, J, Chen, L, Bhutta, ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–1958. doi:10.1016/S0140-6736(10)61854-5Google Scholar

Manyazewal, T. Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Arch Public Health. 2017;75:50. doi:10.1186/s13690-017-0221-9CrossRef Google Scholar PubMed

A statement on abortion by one hundred professors of obstetrics. Am J Obstet Gynecol. 1972;112(7):992–998. doi:10.1016/0002-9378(72)90826-5CrossRef Google Scholar

Federal Support for Graduate Medical Education: An Overview. Congressional Research Service; 2018. https://fas.org/sgp/crs/misc/R44376.pdf.Google Scholar

ABMS | American Board of Medical Specialties. www.abms.org. Accessed April 4, 2020.Google Scholar

Ryan, KJ. Historical Perspective, 1972–73 Revisited. In Conference on Impact of Subspecialization on Residency Training and Practice of Obstetrics and Gynecology. Chicago, IL: The American Board of Obstetrics and Gynecology; 1991:3–4.Google Scholar

Creinin, MD, Darney, PD. Methotrexate and misoprostol for early abortion. Contraception. 1993;48(4):339–348. doi:10.1016/0010-7824(93)90079-mGoogle Scholar

Goldberg, AB, Greenberg, MB, Darney, PD. Misoprostol and pregnancy. N Engl J Med. 2001;344(1):38–47. doi:10.1056/NEJM200101043440107Google Scholar

ABOG. www.abog.org. Accessed April 4, 2020.Google Scholar

ACGME Home. www.acgme.org. Accessed April 4, 2020.Google Scholar

Committees and Members Selection Process. www.acgme.org/About-Us/Committees-and-Members-Selection-Process. Accessed April 4, 2020.Google Scholar

Fellowship in Complex Family Planning Advisory Board. Guide to Learning in Complex Family Planning. 2019.Google Scholar

Fellowship in Complex Family Planning. General Requirements for a Post-Graduate Program in the Subspecialty Area of Complex Family Planning. 2019.Google Scholar

Zeldovich, VB, Rocca, CH, Langton, C, Landy, U, Ly, E, Freedman, L. Abortion policies in United States teaching hospitals: formal and informal parameters beyond the law. Obstet Gynecol. 2020;135(6):1296–1305.Google Scholar

Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd ed. Geneva: World Health Organization; 2012. www.ncbi.nlm.nih.gov/books/NBK138196/. Accessed April 4, 2020.Google Scholar

Safe Abortion: Technical and Policy Guidance for Health Systems. Geneva: World Health Organization; 2003.Google Scholar

Landy, U. Medical education in family planning in the United States: why and how. Poster presented at Cape Town, South Africa; 2009.Google Scholar

Zieman, M, Hatcher, RA, Allen, AZ, Lathrop, E, Haddad, L. Managing Contraception: For Your Pocket. 15th ed. Managing Contraception, LLC; 2018.Google Scholar

Morse, JE, Rowen, TS, Steinauer, J, Byamugisha, J, Kakaire, O. A qualitative assessment of Ugandan women’s perceptions and knowledge of contraception. Int J Gynaecol Obstet. 2014;124(1):30–33. doi:10.1016/j.ijgo.2013.07.014Google Scholar

Lester, F, Kakaire, O, Byamugisha, J, et al. Intracesarean insertion of the copper T380A versus 6 weeks postcesarean: a randomized clinical trial. Contraception. 2015;91(3):198–203. doi:10.1016/j.contraception.2014.12.002Google Scholar

Kakaire, O, Byamugisha, JK, Tumwesigye, NM, Gemzell-Danielsson, K. Clinical versus laboratory screening for sexually transmitted infections prior to insertion of intrauterine contraception among women living with HIV/AIDS: a randomized controlled trial. Hum Reprod Oxf Engl. 2015;30(7):1573–1579. doi:10.1093/humrep/dev109Google Scholar

Averbach, S, Kakaire, O, McDiehl, R, Dehlendorf, C, Lester, F, Steinauer, J. The effect of immediate postpartum levonorgestrel contraceptive implant use on breastfeeding and infant growth: a randomized controlled trial. Contraception. 2019;99(2):87–93. doi:10.1016/j.contraception.2018.10.008Google Scholar

Averbach, S, Kakaire, O, Kayiga, H, et al. Immediate versus delayed postpartum use of levonorgestrel contraceptive implants: a randomized controlled trial in Uganda. Am J Obstet Gynecol. 2017;217(5):568.e1–568.e7. doi:10.1016/j.ajog.2017.06.005Google Scholar

Lemani, C, Tang, JH, Kopp, D, et al. Contraceptive uptake after training community health workers in couples counseling: a cluster randomized trial. PloS One. 2017;12(4):e0175879. doi:10.1371/journal.pone.0175879CrossRef Google Scholar PubMed

Lemani, C, Kamtuwanje, N, Phiri, B, et al. Effect of family planning interventions on couple years of protection in Malawi. Int J Gynaecol Obstet. 2018;141(1):37-44. doi:10.1002/ijgo.12439Google Scholar

Tang, JH, Kaliti, C, Bengtson, A, et al. Improvement and retention of emergency obstetrics and neonatal care knowledge and skills in a hospital mentorship program in Lilongwe, Malawi. Int J Gynaecol Obstet. 2016;132(2):240–243. doi:10.1016/j.ijgo.2015.06.062CrossRef Google Scholar

Krashin, JW, Lemani, C, Nkambule, J, et al. A comparison of breastfeeding exclusivity and duration rates between immediate postpartum levonorgestrel versus etonogestrel implant users: a prospective cohort study. Breastfeed Med. 2019;14(1):69–76. doi:10.1089/bfm.2018.0165Google Scholar

Krashin, JW, Haddad, LB, Tweya, H, et al. Factors associated with desired fertility among HIV-positive women and men attending two urban clinics in Lilongwe, Malawi. PloS One. 2018;13(6):e0198798. doi:10.1371/journal.pone.0198798CrossRef Google Scholar PubMed

Chinula, L, Nelson, JAE, Wiener, J, et al. Effect of the depot medroxyprogesterone acetate injectable and levonorgestrel implant on HIV genital shedding: a randomized trial. Contraception. 2018;98(3):193–198. doi:10.1016/j.contraception.2018.05.001Google Scholar

Chinula, L, Hicks, M, Chiudzu, G, et al. A tailored approach to building specialized surgical oncology capacity: early experiences and outcomes in Malawi. Gynecol Oncol Rep. 2018;26:60–65. doi:10.1016/j.gore.2018.10.001Google Scholar

Gausi, B, Chagomerana, MB, Tang, JH, et al. Human immunodeficiency virus serodiscordance and dual contraceptive method use among human immunodeficiency virus-infected men and women in Lilongwe, Malawi. Sex Transm Dis. 2018;45(11):747–753. doi:10.1097/OLQ.0000000000000868CrossRef Google Scholar PubMed

Mbichila, TH, Chagomerana, M, Tang, JH, et al. Partnership duration and HIV serodisclosure among people living with HIV/AIDS in Lilongwe, Malawi. Int J STD AIDS. 2018;29(10):987–993. doi:10.1177/0956462418769730CrossRef Google Scholar PubMed

Bula, A, Kopp, DM, Maman, S, Chinula, L, Tsidya, M, Tang, JH. Family planning knowledge, experiences and reproductive desires among women who had experienced a poor obstetric outcome in Lilongwe Malawi: a qualitative study. Contracept Reprod Med. 2018;3:22. doi:10.1186/s40834-018-0075-8Google Scholar

Mwafulirwa, T, O’Shea, MS, Hamela, G, et al. Family planning providers’ experiences and perceptions of long-acting reversible contraception in Lilongwe, Malawi. Afr J Reprod Health. 2016;20(2):62–71. doi:10.29063/ajrh2016/v20i2.7CrossRef Google Scholar PubMed

Bernard, C, Pekny, C, Omukagah, CO, et al. Integration of contraceptive services into anticoagulation management services improves access to long-acting reversible contraception. Contraception. 2018;98(6):486–491. doi:10.1016/j.contraception.2018.07.139Google Scholar

Patel, RC, Jakait, B, Thomas, K, et al. Increasing body mass index or weight does not appear to influence the association between efavirenz-based antiretroviral therapy and implant effectiveness among HIV-positive women in western Kenya. Contraception. 2019;100(4):288–295. doi:10.1016/j.contraception.2019.06.011Google Scholar

Bernard, C, Jakait, B, Fadel, W, et al. Preferences for multipurpose technology and alternative methods of antiretroviral therapy among women living with HIV in western Kenya. Poster presented at Mexico City, Mexico; 2019.Google Scholar

Negussie, D, Bekele, D, Curran, D, et al. Ethiopian and American collaboration: process, accomplishments, and lessons learned. Obstet Gynecol. 2020;135(3):703–708. doi:10.1097/AOG.0000000000003705CrossRef Google Scholar PubMed

Truong, M, Wood, SY. Unconscionable: When Providers Deny Abortion Care. International Women’s Health Coalition; 2018. https://31u5ac2nrwj6247cya153vw9-wpengine.netdna-ssl.com/wp-content/uploads/2018/06/IWHC_CO_Report-Web_single_pg.pdf.Google Scholar

Stifani, BM, Couto, M, Lopez, Gomez A. From harm reduction to legalization: the Uruguayan model for safe abortion. Int J Gynaecol Obstet. 2018;143(Suppl 4):45–51. doi:10.1002/ijgo.12677Google Scholar