Transformative Education
for Health Professionals

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Alternative learning for health equity: lessons from student organizations

Social Determinants to Health (SDH); Over the next ten days we will be featuring blogs SDH in the lead up to the Prince Mahidol Award Conference (PMAC), Bangkok, Thailand 27-31 Jan 2014.

WHO has a number of side events and parallel sessions, which highlight SDH within its work on transformative education.

For this blog we are very pleased to post a guest editorial from Dr Renzo R. Guinto, MD, currently a public health consultant in the Philippines, who is the former Liaison Officer to the World Health Organization of the International Federation of Medical Students’ Associations (IFMSA) and a member of the Youth Commission on Global Governance for Health hosted by the Lancet and the University of Oslo in cooperation with the Harvard Global Health Institute

Alternative learning for health equity: lessons from student organizations

 

 Just as health systems do not naturally gravitate toward health equity – the absence of avoidable and unfair differences in health, health workforce education may also not necessarily emphasize health equity in the training of doctors, nurses, and other health professionals. For example, medical schools may produce physicians who are highly competent in clinical skills and manifest deep sense of empathy for the individual patient – attributes that are expected of and entailed in the medical vocation. On the other hand, while providing high quality, evidence-based medical care to individuals, doctors may not always look at entire populations, show concern for access and affordability of health services, and give priority to marginalized and vulnerable groups, as these are issues traditionally deemed as beyond the purview of the clinic and the hospital.

Nevertheless, education cannot be solely blamed. Ultimately, the educational system in general and health professional education in particular are products of the wider health system and the broader society. The way health care is financed and provided, the planning of human resources, and the priorities set by health policy profoundly influence the content and manner of health workforce education. Furthermore, once the health professional is deployed to the real world, the same factors reinforce the knowledge and values he acquired during training. Such vicious cycle indeed needs to be disrupted through transformative education.

The role of student organizations

While the movement towards transformative education is now gaining traction in some parts of the world, many institutions of higher learning are still yet to hear and heed the call for reform. It has been said once that it is easier to move a cemetery than change a medical school. So when students are reached by the news in advance – sometimes much earlier than their teachers – they begin to look outwards for alternatives – and student organizations are one such venue.

I was fortunate that, throughout my medical education, I got involved in numerous student organizations that worked on a wide range of topics – often non-clinical – and at different levels. During my early days in the University of the Philippines (UP) Manila, I joined an association named Medical Students for Social Responsibility – a junior rehash of the world-renowned Physicians for Social Responsibility – and my years as an officer in the club exposed me to a broad array of issues, from environmental degradation to peace and conflict resolution – subjects that will never be taught inside the classroom or in front of a patient in the ward. This alternative learning experience warranted exposures to the surrounding community and interactions with policy leaders from many disciplines that we consider “non-health.”

Another organization that contributed greatly to my holistic formation is UP One Earth, which is an environmental organization I co-founded with a junior in medical school. There are two features that make UP One Earth unique – it is an environmental organization in a health sciences university, and it allows inter-professional collaboration as it recruits members not just from the school of medicine, but also from nursing, pharmacy, dentistry, physical therapy, and other disciplines. The organization has brought health students together and sent them to communities to plant trees, teach proper waste management, and help craft sound environmental policies – all for the protection of both human and planetary health.

These local student organizations of course will not survive without the support of like-minded professors and school administrators who generously extend their expertise and time and serve as living examples. They may have been considered as “voices in the wilderness,” that is the conventional and rigid environment of a medical school, but they never tire out in advocating for the reorientation of medical education and the practice of medicine at large. In UP Manila, for example, two units – Community Oriented Medical Education (COME) and Social Medicine Unit (SMU) – offer innovative courses on community medicine, health policy, and medical anthropology, as well as a summer school in global health, to name a few, in order to complement the rigorous clinical training provided by the rest of the faculty.

Promoting global understanding and solidarity

Finally, my numerous extracurricular involvements as a student culminated in my participation in the International Federation of Medical Students’ Associations (IFMSA), a global network of more than a million medical students from 110 countries. Having occupied various positions in the Federation for three years, I witnessed the challenges faced both by the world’s medical students and by global health at large. IFMSA was also an exciting training ground for sharpening communication and negotiation skills, as well as grasping the world’s seemingly-insurmountable challenges.

In 2012, inspired by the work of the WHO Commission on Social Determinants of Health, we even established the Global Health Equity Initiative which acts as a nerve center for all activities, campaigns, and knowledge resources that relate to the social determinants of health. Ultimately, the Federation, through its annual conferences, international workshops, and exchange programs, promotes global understanding and solidarity among young doctors-in-training even before they enter medical practice.

These are just a few examples of student organizations that provide alternative venues for learning and understanding equity in health. The University of the Philippines, for example, has a century-old tradition of student activism, and its students and faculty have been pivotal in building the society we have today. Other organizations in UP Manila that I have been part of were even involved in providing direct care to underserved communities in remote areas of the country. Such examples demonstrate the power of student organizations to reach out to the downtrodden and advocate for social justice. In order for this positive energy to be sustained, transformations in the formal educational system are necessary.

Today, health has already evolved from merely an issue of an individual patient into a population-wide concern driven by broader social and environmental determinants. The health sector – and the professionals that work within it – therefore needs to catch up. Acquiring an understanding of, concern for, and skills for the promotion of health equity should therefore become paramount requirements for the 21st century health professional. Student organizations play a vital role in this movement, and ensuring that they are part of the global conversation is absolutely critical.

ABOUT THE AUTHOR

Currently a public health consultant in the Philippines, Dr. Renzo R. Guinto is the former Liaison Officer to the World Health Organization of the International Federation of Medical Students’ Associations (IFMSA) and a member of the Youth Commission on Global Governance for Health hosted by the Lancet and the University of Oslo in cooperation with the Harvard Global Health Institute

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