Table 5 Recommendations for improving postgraduate specialization training programs in Malawi
Recommendation | Explanation | Quotes |
|---|---|---|
More training options | Students felt more specialty options would improve the opportunities for training in Malawi | “Ideally, if we had a wider scope of fields within Malawi to train, that would be the best way.” |
“I am not very keen on specializing here because the options are limited…Here there are less than ten options of things you can do. So, if I was to make it better, I would increase the options.” | ||
“I think people would be able to stay here in Malawi and it would be cheaper to specialize in your own country.” | ||
Increase teaching staff | Students recognized the need to increase the number of staff for teaching at the postgraduate level | “The College of medicine should make sure each department is well-staffed…Isn’t it possible in some institutions they have people who are just special for teaching?” |
“I would want to make sure we have adequate teachers and staff for [postgraduate training].” | ||
Retain expatriate teachers | Students felt that the expatriate teachers play a vital role in their training, and that there were not enough academic Malawian-trained physicians to support training | “We have concerns because some of the consultants from other countries have been told that their contracts are not being renewed…They say that we have enough doctors in Malawi and enough teachers, but we feel these are the people that are key in training us.” |
“It seems like there is a move to replace a lot of expatriates with local consultants. I don’t think that makes sense.” | ||
Improve personal support and respect | Students perceived the need for more support from faculty members, including increased respect | “…if people could appreciate [trainees] more and understand they are qualified.” |
“I think if [the consultants] really encouraged the students and were nice, most people would be willing to do more of their further studies here.” | ||
“Give [trainees] the right environment where they can grow. And also motivate them.” | ||
Improve working conditions and compensation | Students desired improved working conditions, better resources for working and training, and better compensation | “So if something was to change, I think it would be the working conditions. Mostly if the salary was better.” |
“The one thing for me would be the resources. I don’t like to hear about, 'Oh, other countries do this,’ and I can’t even see what that thing looks like. I would rather be there using it and learning how it works.” | ||
Standardize training across Africa | Several students discussed the need for standardization of the training programs across countries within the region | “Even starting, like [College of Surgeons in East, Central and South Africa (COSECSA)], starting the same thing in other departments. As long as the qualification in the end doesn’t require you to specialize further when you go outside the county.” |
Broaden degree recognition | Students would like to be credentialed to work anywhere in the world after completion of their training | “I guess the programs need to be changed so that they’re internationally recognized, at least so that you can work in other countries.” |
Consolidate training in Malawi | Some students saw the benefit in having all of the training provided in Malawi, instead of spending some of the time in South Africa | “If you are planning to work in Malawi, I think you should train here the whole 4 or 5 years.” |
“When they are doing their second half, the department loses registrars and it’s hard on the people that are left behind.” | ||
Expand training in South Africa | Many students saw the benefit of having a portion of their training in South Africa, and some even desired to spend more time there during training | “I think you should have more time experiencing all these other advanced things rather than getting more of your time here in a place with limited resources.” |