In Country Pediatric Training for Liberian Doctors

Dr. Ellie Graham in consultation with Dr. Bamenla Goka, Director of the Pediatric

Section of WACP and Professor of Pediatrics at Korle Bu Hospital, Accra, Ghana

Goal of Pediatric Work in Liberia

• Develop conditions to end MD “brain drain” • Offer a 4 year Pediatric Residency Training • Adapted to the conditions and training

available in Liberia and West Africa • Qualify residents who complete the training to

sit for Parts I and II of the West African College of Physician (WACP) Examinations in General Pediatrics.

Core Competencies of the Training Program: Adapt to Liberia Setting

• Patient Care• Medical Knowledge • Practice-based Learning and Improvement • Interpersonal and Communication Skills • Professionalism • Systems-based Practice

Pediatric Training to meet the requirements of the WACP curriculum

• WACP or ABP certified faculty and US peds residents provide teaching/supervision

• WACP log-book of procedures• Develop system of monthly evaluations

of Liberian interns and residents

WACP Rotation Requirements

• Core Clinical Rotations for 3 months each– Newborn, – Emergency Pediatrics – General Pediatrics

• 3 month rotation in Primary Health Care/School Health Program/Community Pediatrics– collaboration with Ministry of Health

• 4 subspecialty rotations, 2 months each• 8 weeks elective rotations

Subspecialty Rotations (need 4)

• Pediatric Cardiology• Pediatric Nephrology• Pediatric Nutrition / Gastroenterology • Pediatric Endocrinology and metabolism• Pediatric Neurology• Pediatric Hematology / Oncology (available in Ghana

at Korle Bu Hospital)• Pediatric Pulmonary Disease• Pediatric Infectious diseases• Neonatology (available in Ghana at Korle Bu Hospital)

Elective Rotations (8 weeks)

• Pediatric surgery (could be available at JFK through a pediatric surgery service that the pediatric team managed)

• Anesthesia (potentially available at JFK or Redemption)

• Ophthalmology (possibly available at JFK with Dr. Guizie in eye clinic)

• Orthorhinolaryngology (ENT)• Radiology

Additional Training Not Required by WACP but Desirable for Liberia

• A Resident Continuity Clinic X 4 years– for normal and medically complex children– 2 half days clinic weekly

• Health Care Quality Improvement & Health Administration Training X 4-6 mo in 3-4th yr

• Research methods training/thesis planning: 4-6 months in 3rd or 4th year (thesis is WACP requirement)

• Chief Residency in 4th year: 4-6 months with focus on teaching skills and preparation for faculty work.

Schedule of Major Trainings and Examinations

• PL 1 Year (1/20XX)– PALS; Newborn Resuscitation; Basic Science

– August Revision/Update Course in Ghana (2 wks– October: Primary Examination of WACP in Ghana

• PL 2 Year (10/20XX) (Residency officially starts after pass of primary exam) – Begin logbook of WACP after passing the primary exam

• PL 3 Year: Continue clinical pediatric training

PL 4 Year and Post Residency

• PL 4 Year: October: Part I of Pediatric Exam of WACP (not eligible until 2 years of training after passing the primary exam)

• Post Residency: Part II of Pediatric Exam of WACP – Taken 2 years following completion of residency– Defense of research dissertation– If pass, eligible to be a Fellow of WACP– Typically employed as a clinic or hospital medical

director

Time Line and Commitment

• By 2011, establish an accredited program• In 6 years the first graduates could sit for Part

II of the WACP examinations in Pediatrics • When they pass: Liberian Pediatric Fellows of

WACP • Liberian core of the faculty in Pediatrics• Major commitment for volunteer faculty from

the US would be at least 10 years.

Steps to Establish Residency• Buy-In and financial support from Ministry of

Health, Medical School, JFK and Redemption Hospital admin and HEARTT (? World Bank)

• Hire a Director of Pediatrics• Continuous US Pediatric Faculty/Residents• Recruit 2-3 Liberian resident candidates• Rotations of core pediatric subspecialist faculty • Apply to WACP for accreditation of a pediatric

training program (site visit within 2 mos; can be provisional for first 1-2 years)