Table 5 Examples of cooperative international medical relationships developed in the GCC countries

International scholarships.

Example: Dubai Harvard Foundation for Medical Research [53]

Selected students from the GCC sent to host country to obtain medial training.

Minimal expenditure on support structures and faculty. Flexible and integrated.

Students may endeavor to stay in host country. Limited overall improvement to existing health profile.

Premedical programs for undergraduate students.

Example: New York University Abu Dhabi [54]

Students in existing or new university can take premedical course.

Avoids expensive costs of maintaining a full medical school. Integrated and innovative.

Students may face problems selecting and entering an approved medical school.

Partial institutional link at a program level.

Johns Hopkins Medicine International and Al Rahda Hospital [56, 63]

University of Pittsburgh Medical Center and Hamad Medical Corporation [57]

Donor school agrees to establish and supervise a particular program in recipient institution.

Works well when recipient institution has well-organized facilities but lacks a specific program. Flexible, integrative, and innovative.

Country-specific cultural differences can impair program effectiveness.

Consulting agreement between two institutions.

Example: collaborative project between medical schools of Aberdeen University and the UAE University [58]

Donor institution signs agreement covering agreed-upon deliverables to upgrade recipient institution.

Recipient institution can benefit from organizational skills and experience of donor organization without committing to long-term investment in personnel with requisite skills. Flexible, integrative, and innovative.

Resentment from personnel in recipient institution may interfere with agreed-upon objectives.

Establishment of new, completely affiliated health educational school in recipient country

Example: Weill Cornell Medicine - Qatar [64] and The Royal College of Surgeons in Ireland – Bahrain [60]

Donor institution agrees to develop a completely integrated satellite school with same standards and courses as the existing school in the donor country.

Offers high quality education to selected students. Provides unique opportunity to strengthen the foundation of the recipient country’s health system. Integrated and innovative.

Expensive. Both institutions must make a long-term commitment (not flexible).

Physician exchange programs at institutional level.

Example: GCC countries and Children’s National Hospital [55]

Physicians with special skills travel and work in distant schools or hospitals.

Method for rapid, cost-effective knowledge and skill transfer. Especially effective if there is a two-way physician exchange (flexible, integrative, and innovative).

Logistical problems such as language and cultural differences. Immediate benefit, but duration of improvement unsure.