Towards State-of-the-Art Healthcare Education

Towards State-of-the-Art Healthcare Education
Amer Sharif, MD, MSc
Director
Continuing Education Dept.
Dubai Health Authority – DHA
Presented at NAAMA 28-12-08
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Objectives
•
Improving quality of healthcare in Dubai through quality education and CPD
•
DOHMS – Historical Journey
•
DHA – upcoming reform
•
Healthcare Education in Dubai & UAE - Overview
•
Continuing Education Dept – CED, DHA
•
Gaps & Challenges
•
Recommendations
•
Q and As..
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Presentation’s guide
•
HCP - HealthCare Professionals
•
CME - Continuous Medical Education
•
CPD - Continuous Professional Development -`broader term on developing healthcare
professionals than the traditionally used term CME
•
CPD is used instead of CME
•
Residency Program - Postgraduate medical education
– DRTP – Dubai Residency Training Program
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Introduction
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Sheikh Mohammad Bin Rashid Al Maktoom’s Vision
•
I feel uneasy knowing our children have to travel abroad for educational attainment and
treatment. This fact must change, the government is responsible to the president and the
people, and we should all work to attract others to provide healthcare and education in our
country…
Speaking at induction of new ministers ‐ March 2008.
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Improving quality of healthcare in Dubai through quality education and
CPD..
Dubai, the City that Cares …
•
A metropolis famed for its rapid economic growth, Dubai is now bracing itself for
facing the future and the ensuing challenges..
•
Since healthcare is a major component of the Dubai Strategic Plan 2007-2015, no
effort was spared to help achieve this vision..
•
Dubai Health Authority - DHA was set up to materialize Dubai Government’s Strategy
for health by 2012..
•
Achieving DHA strategic goals calls for well-educated and trained healthcare
professionals on par with international standards..
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Improving quality of healthcare in Dubai through quality education and
CPD..
•
Achieved by developing highly skilled healthcare Specialists with emphasis on..
– medical expertise, communication skills, collaboration, patient care
management, advocacy of health, commitment to life-long learning and
professionalism
•
and promoting a culture of multi-disciplinary education, team work, research and
evidence-based practice..
•
leading to a competent workforce, improved performance, enhanced team work
and communication, high quality health service and trust..
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DOHMS
A journey of Medical History in Dubai..
DOHMS - HQ
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Mission - DOHMS
“The Department of Health & Medical Services is the responsible Health Authority
in the Emirate of Dubai. It aims to provide, to international standards, preventive
and curative health services to the community by utilizing the best technology and
human resources”
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Introduction - DOHMS
•
Main Local Government Health Care Provider with long standing
history
•
Fully equipped health establishments & Specialized Centers serving
the Population of Dubai
– 3 main hospitals
– 20 Primary Health Care Centers
– Specialized Centers
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Introduction - DOHMS
•
Regulation of Private Sector in Dubai through Licensing &
Specification Department
•
Excellent infrastructure and information technology
•
JCIA Accredited - 2007
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Historical Milestones
•
1943 – 1st clinic in Al-Ras
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1951 – Al-Maktoom Hospital
•
1970 – Establishment of DOHMS
•
1972 – Rashid Hospital
•
1983 – Dubai Hospital
•
1986 – Al-Wasl Hospital
•
1990’s – Primary Health Care centers
•
2006 – New Trauma Center
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DOHMS Hospitals
D.O.H.M.S
Rashid
New Trauma Center + Multi Specialty
Al-Wasl
Maternal and Pediatric
Dubai
Multi Specialty
Primary Health Care Centers
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Rashid Hospital
PHC
Trauma Center
Al-Wasl Hospital
Dubai Hospital
DOHMS Specialized Centers
D.O.H.M.S
Thalassemia Center
Dental Center
Dubai Gynecology & Fertility Center
Dubai Cord Blood Bank Center
Blood Donation Center
Care Center for the Elderly
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Healthcare Reform..
Started 2007…
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Healthcare Reform.. Started..
•
DoHMS has done a good job in delivering quality healthcare to the
people of Dubai since it was created over 30 years ago
•
However, the population of Dubai has grown from 300,000 people to
nearly 1.5 million and continues to grow
•
Therefore, a need for healthcare reform has become evident..
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Dubai Health Authority
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Provide a Health Strategy for Dubai
•
Ensure Public Health is protected and quality of life improved
•
Ensure partnership between public and private health service providers
•
Achieve international accreditation
•
Ensure effective regulation and licensing
•
Increase transparency and accountability of the healthcare system
•
Provide proper and efficient funding model
•
Improve accessibility to the healthcare system and sustainability for the
future
•
Create the best training, education & research opportunities for
Dubai healthcare professionals
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Key Change
DHA
DHA
Policy,
Policy, Strategy
Strategy and
and Funding
Funding
Separation
of duties
Health
Health Service
Service Delivery
Delivery
Public
Public&&Private
Private
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The DHA Transition has 4 stages:
The DHA Transition is currently in
Implementation (Stage 3)
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Healthcare education in Dubai and UAE –
Situational analysis
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Overview of Current Players
DOHMS - CED
Free zones
DHCC/Dubiotech
Others..
Healthcare
Workforce
Development
Public &
Private Hospitals
MOH/HAAD
Academic Institutions/FMHS/KHDA/MoHE
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Healthcare professionals are developed in an
educational journey …
- The journey for educating HCP • Length of education depends on
profession and speciality in
healthcare
• Obtain undergraduate qualification,
e.g. MD, MBBS, BN
• Length of education depends on
profession and speciality in healthcare
• Ends with a specialty qualification,
e.g. Master
Undergraduate
Postgraduate
For physicians:
For physicians:
• Followed by 1 year of internship
(could be merged with the
Residency program)
• Residency program. 3-6 years
training in a speciality, e.g. Internal
medicine (Specialty Board
Membership)
• Continuous Professional Development
(CPD) is training and up-skilling
during practice
• Re-licensing of HCP is based on CPD
documentation and evidence
CPD
• Fellowship: 2-5 years sub-speciality
program, e.g. cardiology (SubSpecialty Board Membership)
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Importance of the Educational journey
•
Critical for the quality of the healthcare services
•
HCPs have to continually update and develop their competences, knowledge and
skills in order to improve their performance, patient care, and hospital services
•
Allow HCPs to retain and re-new their license of practice
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… where quality is dependent on three levers
• Workforce and education planning
• Standards for education and accreditation
Policy and
strategy
Undergraduate
Postgraduate
• Funding Model
CPD
• Education
• CPD/CME
• Research
Service
delivery
Regulation
• Accreditation
• Licensing and re-licensing
• Training
• Scholarships
• Support services
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Continuing Education Department in DoHMS
Overview
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DOHMS CED manages training, education and
scholarship in DOHMS
Development and administration of Dubai Residency Training Program (DRTP)
Administration of Scholarships (100+ in UAE* and 50+ in overseas institutions)
The Training Center (Improve Skills… Improve Healthcare)
Events Management
DoHMS
CED
International Exam Center (the office of MRCP)**
Administration of clinical attachments
MOUs – University of Toronto, Harvard Medical Faculty Physicians, Higher
College of Technology
Running the Rashid Medical Library (e-Library) and DoHMS hospital libraries
Dubai Medical College for Girls (DMSG) – Clinical Deanship
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DRTP - Introduction
•
Mission: develop, train and produce medical specialists
– capable of independent practice
– using mainly local resources
– supplementing with external resources where and when necessary
•
structured, goals-oriented, objectives-driven program
– Designed to meet and/or exceed requirements of international accrediting bodies
– Incorporates structure & requirements of Arab Board, British Royal Colleges, European &
North American bodies..
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DRTP - Requirements
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Recognized MBBS + Internship Year
•
Pass PRE ENTRY EVALUATION
– Written Exam
– Structured, Specialty-oriented Oral Interview
•
UAE Nationals have priority
– Then the BEST of Non-UAE Nationals
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DRTP
•
Specialties Provided
•
Hopefully next year..
– Internal Medicine
– Trauma
– General Surgery
– Anesthesia
– Obs/Gyne
– Dentistry
– Pediatrics
•
– State-of the-art Hospitals
– Family Medicine
– Patients
– Community Medicine
– Medical Expertise
– Psychiatry
•
– Emergency Medicine
– Dermatology
Resources available
Opportunities
– Private Sector Participation
– Collaborating with other systems in UAE
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Actors in Residency Programs in UAE
Program
Accreditation
DoHMS Dubai Residency Training Program
Specialty Board (Arab Board + Royal Colleges of UK)
FMHS
Specialty Board (Arab Board + Royal Colleges of UK)
Health Authority Abu Dhabi (HAAD)
Specialty Board (Arab Board + Royal Colleges of UK)
Ministry of Health (MoH)
Specialty Board (Arab Board + Royal Colleges of UK)
Conclusion:
• Multiple providers of residency programs with differing standards within UAE
• Lack of a national standard setting and accreditation body (e.g. a parallel to Saudi Board)
• A possibility for coordination and cooperation providing residency programs to elevate standards of
speciality training across UAE
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Current Situation - DOHMS
•
Continuing Education Department (CED)
– Training Center (Improve Skills.. Improve Healthcare)
• CPD\CME Courses
• Internationally Accredited Medical Courses & Workshops
– BLS, ACLS, PHTLS…
• ICDL Accredited Lab
– CPD/CME Accreditation for Public & Private Sector
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Current Situation - DOHMS
– Hosts & Manages events, lectures and conferences
– Rashid Medical Library (e-Library)
– Scholarship Section (Locally + Overseas)
• Postgraduate Medical Scholars (>50 overseas)
• Sponsored Programs Locally
– Dental Nursing Diploma
– Bachelor of Nursing
– Midwifery Diploma
– Dubai Medical College for Girls – Clinical Deanship
• Clinical Training in DOHMS Hospitals
• Internship
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Gaps & Challenges
Need to be addressed to ensure high-quality healthcare workforce..
Hence, improved healthcare delivery
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Dubai Health Care Professionals Statistics
•
•
•
•
•
Doctors
Dentists
Nurses
Pharmacists
Technicians
6,064
962
7,062
1,394
4,041
Total
19,523
.
Source Dubai Healthcare Provision Report, June 2007
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Gaps & Challenges in the healthcare education
system in Dubai and UAE
… characterised by:
Policy and Strategy
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Strategic healthcare workforce education and planning is not related to service needs
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Lack of proper standards for CPD/CME to assure quality of education and courses offered
•
Limited coordination among different healthcare education providers and stakeholders
Regulation
•
Accreditation of CPD/CME courses (e.g. conferences, short courses) not properly established
•
Multiple accreditation systems across UAE (DOHMS, HAAD, HMSDC, MOH, FMHS..)
Service Delivery
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Lack of undergraduate and postgraduate healthcare education programs
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Lack of career advancement and CPD opportunities
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…with the consequence of:
•
Policy and strategy
–shortage of doctors & HCPs in required specialities
•
Regulation
–Multiple providers and accreditation body of CPD in the market that are not properly
regulated
–Divergent quality in education institutions and providers and hence in clinical staff
–Re-licensing not based on objective data reflecting efforts for CPD by the HCP
•
Service delivery
–Nationals and expats have to use universities outside Dubai, e.g. UAE University or abroad
–Only female physicians can be educated in Dubai (undergraduate)
–Limited opportunities to develop and update through CPD training
Recommendations for DHA
Better Workforce.. Better Healthcare
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Recommendations for DHA
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Establish standards setting and accreditation
body for healthcare education and CPD
involving key stakeholders
•
Work closely with stakeholders and establish a
collaborative educational environment across
the healthcare system promoting academia,
research and evidence-based practice
•
Strategic workforce planning and development
activity should be linked to service needs
•
Ensure that the healthcare workforce is
developed and has access to internationally
recognized education, training and Continuous
Professional Development
•
Build education and training
capabilities in the healthcare sector by
training the trainers and expanding the
pool of healthcare educators
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The reform is the best time to address
such challenges and provide solutions..
•
Ideally, this should take place across
the UAE
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Let’s work together towards best evidence healthcare
education and CPD in the region..
Thank you…