Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-19T09:02:35.213Z Has data issue: false hasContentIssue false

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
Affiliation:
University of California, San Francisco
Philip D Darney
Affiliation:
University of California, San Francisco
Jody Steinauer
Affiliation:
University of California, San Francisco
Get access

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
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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):594602.Google ScholarPubMed
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):19231958. 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/s13690-017-0221-9CrossRefGoogle ScholarPubMed
A statement on abortion by one hundred professors of obstetrics. Am J Obstet Gynecol. 1972;112(7):992998. doi:10.1016/0002-9378(72)90826-5CrossRefGoogle 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; 1991:34.Google Scholar
Creinin, MD, Darney, PD. Methotrexate and misoprostol for early abortion. Contraception. 1993;48(4):339348. 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):3847. 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):12961305.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):3033. 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):198203. 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):15731579. 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):8793. 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.e1568.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.0175879CrossRefGoogle ScholarPubMed
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):240243. doi:10.1016/j.ijgo.2015.06.062CrossRefGoogle 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):6976. 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.0198798CrossRefGoogle ScholarPubMed
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):193198. 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;26:6065. 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):747753. doi:10.1097/OLQ.0000000000000868CrossRefGoogle ScholarPubMed
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):987993. doi:10.1177/0956462418769730CrossRefGoogle ScholarPubMed
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):6271. doi:10.29063/ajrh2016/v20i2.7CrossRefGoogle ScholarPubMed
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):486491. 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):288295. 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):703708. doi:10.1097/AOG.0000000000003705CrossRefGoogle ScholarPubMed
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):4551. doi:10.1002/ijgo.12677Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×