Global Communities

A School of Medicine began in Lao in 1957, and this single government funded institution has evolved over time to become the University of Health Sciences, Lao PDR. UHS was officially established in 2007 and is administrated by the Ministry of Health. It has seven faculties including Basic Sciences, Medicine, Nursing, Dentistry, Pharmacy, Medical Technology, and Postgraduate Studies.

The University of Calgary began collaborating with the Lao Ministry of Health and what was then named the University of Medical Science. Lao health care and medical education leaders asked the University of Calgary to collaborate with them on medical education reform to address the Lao health issues particularly in rural areas. Our first Memorandum of Understanding (MOU) began in 2004 as the Lao Human Resource for Community Health Project. In this initial project (2004 – 2010), faculty of the UofC collaborated to:

• Assess rural health care needs
• Revise undergraduate medical education curriculum, teaching methods and learning resources to address rural health care needs,
• Develop postgraduate generalist training to meet rural community / primary health care needs

In the last decade, the University of Calgary has continued to work with UHS, particularly in support of their Family Medicine Specialist Program. The training is community focused and is a distributed learning model (all outside of Vientiane, the capital city). We have also assisted in finding funding to support annual continuing professional development for family medicine graduates and to aid graduates to write and publish a Family Medicine Textbook in Lao language.

Family Medicine Resident Teaching

The Lao Family Medicine training model is to train a 5-Star doctor, meaning that a family medicine graduates is able to be a clinician, educator, community leader, manager, and researcher.

Numerous faculty members from the University of Calgary have worked with UHS and provincial teachers to provide teaching to family medicine residents. Our collaboration in teaching has been and continues to be in three main areas.

• Clinical Skills
  • University of Calgary worked with Lao faculty and family medicine graduates to:
    • Develop a clinical skills manual that covers history-taking and physical examination skills for all systems in Lao language
    • Develop on-line videos of physical examination in Lao language
• Specific courses in clinical management and clinical decision-making
  • Curricular material has been developed in Lao language that covers some fundamental knowledge and skill in maternal and child health, trauma care, and adult chronic disease management.
  • Some specific courses that University of Calgary faculty have helped create or have utilized pre-existing curriculum include:
    • Helping Babies Breathe and Helping Babies Survive
    • Using the WHO Pediatric manual for Pediatric Emergencies
    • Pre-eclampsia and Eclampsia
    • Bleeding After Birth
    • Primary Trauma Course
    • Reading ECG’s and Cardiac Emergencies
    • Managing Common Adult Chronic Diseases
    • Diagnosis and Management of Common Mental Health Presentations
• Skills for community-based and health facility quality improvement projects
  • University of Calgary worked with Lao faculty and family medicine graduates to:
    • Develop Community Project Manual in Lao language for family medicine community-based quality improvement projects
    • Develop Community project orientation module for family medicine residents
    • Develop quality improvement (QI) workshops and cultivate QI projects amongst family medicine graduates

We continue to work with UHS and family medicine graduates to develop a cadre of clinicians who can organize, teach, and assess family medicine residents in these skills.

Continuing Professional Development (CPD) for Family Medicine Graduates:

There are now over 200 graduates from the Family Medicine Specialist Program in Lao PDR and over 70% continue to work outside of the capital city. These graduates are scattered across the country in almost all of the provinces in Lao. This has resulted in the need for Continuing Professional Development (CPD) for these graduates, many of who work in remote communities.

Faculty from the University of Calgary have worked with family medicine graduates and UHS to develop CPD events for the Family Medicine graduates that include clinical care topics, but also other topics such as professionalism, teaching, management, etc. These CPD events have been made possible through a grant from Rotary International.

CPD content has been based upon feedback from family medicine graduates regarding their educational needs. Regular CPD events include:

• Annual 3-day CPD in Vientiane
• Site visits to district hospitals where family graduates are working

Competency-Based Medical Education

Faculty members from the University of Calgary have started working with the Dean at UHS and the PGME office to introduce Competency-Based Medical Education (CBME). Lao faculty and family medicine graduates will jointly design Competencies and Entrustable Professional Activities (EPA’s). Faculty from the University of Calgary are working to assist the process. UHS would like to implement CBME across their PGME program, but wish to first pilot this within the Family Medicine Specialist Program.

International Institute for Medical Education Leadership (IIMEL)

Medical education leaders at the University of Health Sciences, Lao PDR have been participants in IIMEL since its inception. To highlight the distributed learning model and community quality improvement projects at UHS, we may organize an Asian Regional IIMEL in the future. Learn more about this project here (link to the IIMEL project page).

The Patan Academy of Health Sciences is dedicated to improving Nepal’s rural health by training health workers for rural Nepal (http://www.pahs.edu.np). PAHS is an institutional member of THEnet (https://thenetcommunity.org), a community of educators that contribute to health equity through health workforce education, research, and service, based on the principles of social accountability and community engagement.

PAHS is in the city of Patan, which is adjacent to the capital city of Kathmandu. PAHS is based at Patan Hospital, which is the major teaching hospital for the academy. They began the school of medicine in 2010 and have since expanded with programs in nursing and public health.

The University of Calgary first became involved in Nepal in the late 1970s, providing teaching within Nepal’s first medical school, the Institute of Medicine under Tribhuvan University.  Some Nepali graduates in the 1980’s, who received teaching from University of Calgary faculty during their medical school, reconnected in 2007 as they began planning a new community oriented medical school. With this, the collaboration between the University of Calgary and PAHS began.

The Ateneo de Zamboanga University: School of Medicine (ADZU-SOM) started in 1993 as a dream when a group of local physicians and community leaders came together to establish the Zamboanga Medical School Foundation, a non-profit foundation within the Ateneo de Zamboanga University. They were seeking to be an innovative medical school that could respond to the social, cultural, and health realities of Southwestern Mindanao, Philippines.  There was no medical school in the region and local students who wanted to pursue medicine had to relocate to other parts of the Philippines. Typically they did not return to the region after graduation, remaining in the bigger cities or migrating overseas. 

Over 3 million people live scattered across islands and mountains in Southwestern Mindanao. When ADZU-SOM began, this region had 7 of the poorest provinces in the Philippines and 80% of their towns and municipalities had no doctors.

When they started, ADZU-SOM had no classrooms, no books, no experienced teachers, no curriculum and no admissions policies. Faculty members from the University of Calgary (Canada) agreed to participate and contribute as invited. Many other institutional and educational leaders and teachers from Canada volunteered to join the team in Zamboanga or served as academic hosts for Zamboanga teachers and trainees to study in Canada.

Now, over 25 years later, ADZU-SOM is a respected medical school, part of the Ateneo, with a good reputation in the Philippines. Many of their graduates have an MD-MPH degree and more than 95% continue to work in the Philippines with the majority working in previously underserved communities.

Ateneo de Zamboanga University’s School of Medicine (ADZU-SOM) received the Charles Boelen International Social Accountability Award from the Association of Faculties of Medicine of Canada (AFMC) in 2017. The award is given to organizations in recognition of their professional accomplishments exemplary of the principles of social accountability. The school is also a member of the Training for Health Equity Network (https://thenetcommunity.org), a network working to transform how health workers are educated and the way education institutions are held accountable to their community health needs.

The Mongolia National University of Medical Sciences (MNUMS) visited University of Calgary in 2014 and expressed interest in medical education support.  Since 2015, University of Calgary Medicine and English Language Training have visited MNUMS. Medicine has conducted three competency based medical education training and assessment workshop programs in Ulaan Bataar. English language program training-of-trainers (TOT) was offered in 2016 on site. As well, exploratory discussions are underway for medical trainee international placements.

The Cumming School of Medicine also led a UNICEF nutrition project in 2018/2019 to help develop, integrate and expand of nutrition curricula at MNUMS in select undergraduate programs: traditional medicine, medicine, nursing, pharmacy, public health and bio-medical sciences.  UCalgary supports capacity building within its global health partnerships and so UCalgary facilitated curricula development at MNUMS and acted in an advisory capacity to support MNUMS faculty to develop their own curriculum, in Mongolian language, adapted to the local context, diet, and educational programs. The curriculum was developed within a competency-based model. Developing nutrition curriculum using this methodology provides an opportunity for MNUMS to pilot competency-based curriculum design in a small format, which will position MNUMS for future competency-based curriculum reform across programs, if desired. It also assures that the curricula target the greatest needs, particularly rural-urban nutritional outcome gaps as identified by UNICEF.

University of Guyana: The University of Guyana and its associate partner the Georgetown Public Hospital Corporation and Ministry of Health have developed and implemented dedicated a cardiac care unit to support cardiac health for the people of Guyana as well as the Caribbean. The partnership has involved exchange of faculty, training of postdoctoral fellows from both universities. 

The University of Calgary has had a longstanding collaboration with the Catholic University of Health and Applied Sciences (CUHAS), Mwanza Tanzania. The medical education focus began with a request from leadership at CUHAS and since 2012 Dr. Heather Baxter has been delivering needs-based faculty development to the pre-clinical and clinical faculty annually. As CUHAS is transitioning to competency based medical education and increasing the utilisation of simulation in their medical education,  a regional IIMEL (International Institute for Medical Education Leadership) conference was held in 2019 with partners from Mbarara University for Science and Technology to share innovations and educational processes. This conference helped to strengthen collaborations within the 2 East African partners.

The medical education focus to this long-standing collaboration began in 2017 with annual needs-based faculty development co-delivered with medical education experts locally. The simulation center and their local experts have been valuable in leading and assisting with faculty development workshops. Mbarara University of Science and Technology faculty attended the 2019 Regional IIMEL held in Mwanza Tanzania to share their knowledge and expertise and learn alongside their East African colleagues.

UNAN (Universidad Nacional Autonoma De Nicaragua), Managua: UCalgary has implemented a research and educational partnership in medicine in the Faculty of Medical Sciences at UNAN- Managua (Nicaragua). The partnership included staff and student exchanges between both institutions and the Emerging Leaders in Americas Program (ELAP) scholars visit to UCalgary. The areas covered include Biotechnology, Molecular Diagnostics (Genetics & Infectious Diseases), Bioinformatics, Oncology, Cardiology, Medical Imaging Health Informatics. 

UCalgary has conducted joint education and research, visiting scholar exchange and scholarly work, and undergraduate and graduate students exchange program, hands-on molecular biology and bioinformatics workshops at five Ethiopian institutions since 2005 with a “train the trainer” model that focused on priority needs including research and educational capacity building and the formation of Armauer Hansen Research Institute in Addis Ababa. This has expanded into new domains including molecular biology, biotechnology, veterinary medicine, One Health, environmental microbiology, zoonotic infectious disease, sustainable energy and sustainable design and other faculties including the Faculty of Veterinary Medicine, the Schulich School of Engineering and the School of Architecture, and Planning and Landscape Architecture. Ethiopian partner institutions that the Cumming School of Medicine directly interacts with are:

1. Armauer Hansen Research Institute, Addis Ababa
2. Ethiopian Biotechnology Institute (EBTI), Addis Ababa
3. Addis Ababa University, Institute of Biotechnology (AAU – IoB), Addis Ababa
4. Jimma University, Jimma and University of Gondar.