Medical education needs to adapt to globalization with equity

Letter to the World Health Organization – WHO

Dr. Kerstin Vesna Petric
Chair and Officers of the Executive Board
World Health Organization – WHO
Avenue Appia 201211
Geneve – Switzerland

Washington D.C., 03/04/2023

Summary: Suggests the elaboration of studies aimed at the global standardization of the curricula of medical courses, ensuring the recognition of valid professional training for equal medical performance and for greater effectiveness of professional care. 

Every human being deserves the best medical care, leveled by the state-of-the-art technology available and free from any kind of privileged treatment deriving from socioeconomic and ethno-racial inequalities, which is not decent, ethical, or fair. The global standardization of medical courses, as suggested here, would eliminate the need for developed countries to require doctors from less advanced nations to undertake further training, in order to better serve their people. Doctors trained in Cuba or Bolivia would no longer be discriminated against or constrained by the lack of immediate equivalence of their training, due to the inexistence of a globalized teaching standard. The same applies to doctors trained in Brazil, for example, who are prevented from serving the huge Brazilian community in the U.S., formed by more than a million immigrants, many undocumented and without health insurance. This issue would be easily solved if the parity of the curricula was established. Numerous immigrant communities, established in several nations, would benefit from being delivered from bureaucratic obstacles and narrow interests that are imposed over and above humanitarian issues. 

The global standardization of medical courses will obviously require a full revision of the curricula, which in no way should harm the inclusion of disciplines that provide specialized training regarding the most pressing diseases in different regions of the world, or regarding the assistance to the underprivileged population. The proposal would allow the elimination of curricular discrepancies between the medical courses provided in developed and developing countries, boosting humanitarian care in an unrestricted way, by prioritizing it over political-ideological systems and geopolitical barriers. Doctors deserve to be considered international health agents with no restrictions, since they’re indispensable to human life and welfare. Likewise, the world population deserves egalitarian care, based on respect for the life and the dignity of human beings. 

It is imperative that we expand cooperation with the poorest countries in the area of healthcare, through treaties that develop mechanisms to prevent medicine from being ruthlessly trampled by the financial interests of the large pharmaceutical and medical supply industries. Surely, this important UN body will not allow itself to be subjugated by the economic power of multibillionaire groups that usually pay no attention to the needy population. I believe that, if there is political will, the proposal can be examined in the light of reason and will reveal merits that justify being supported by the World Health Organization (WHO), which has broad representation and the responsibility to seek solutions based on the foreseen needs of the coming decades. Respecting the different health systems of each nation, the new generation of doctors who graduate from medical school with a universal academic curriculum would be prepared to work in different geographic regions of the planet, as they would also have additional training focused on the particular health issues of each country.

The economic cost of the global standardization of medical courses is justified by the advantages of its implementation, especially regarding the elimination of boundaries for medical practice, with the objective of saving human lives with greater speed and efficiency, as is the noble mission of health professionals. The global curricular standardization would also be a response to the increasingly evident distortions in medical education. Among the multiple benefits that could result from ensuring parity of knowledge among physicians who are trained in dissimilar countries—for example, Afghanistan, Brazil, India, China and the USA—would be the facilitated referral of patients to the necessary exams, especially the most sophisticated ones. Knowledge of state-of-the-art technology is increasingly demanded by societies worldwide, and this is directly related to the powerful pharmaceutical and medical supply industries. The project to standardize medical education worldwide may reduce the abysmal differences that currently exist between professionals from different countries; it is a structural project, with a strategic nature and requiring long-term consolidation; its advancement will depend greatly on the engagement of the international media, whose influence can foster the notion that the prioritization of human healthcare can be harmonized with corporate interests.

The project would require a full revision of the curricula of the medical courses and their adaptation to the global standardization program, incorporating all the advances achieved by developed countries. As a natural consequence, thousands of young doctors who work in poor countries would receive an improved education, beneficial to a significant portion of humanity that needs better assistance and less bureaucratic obstacles derived from counterproductive policies that lack empathy and respect for the human being.

The majority of humanity is waiting for this natural advance, which must begin to be debated now so that humanity can start preparing for other phases of globalization, in a fair and solidary way. Instead of taking heed of the early discouragement of the nay-sayers, who lead classist organizations, we must give our attention to the positive aspects of the proposition, which would lead to excellence the medical training in developing countries. A doctor trained in Brazil, for example, would receive the same training as a German, English, Japanese, or American doctor. Those who wish to establish themselves in a developed country would no longer need to take several years to revalidate the course taken in their home countries.

The world needs visionary leaders and citizens, willing to circumscribe divergences and promote convergences for the implementation of feasible proposals that allow true human needs to be met. The process of globalization has been limping along due to the difficulties imposed by sectarianism, especially of a political-ideological nature, but it is something necessary and inevitable. Whether we like it or not, technological evolution does not stop, and the demand for an egalitarian service is legitimate, fair, and cannot be postponed.

It is time for us to reflect and act, with the objective of stimulating the necessary paradigm shift for the welfare of all sentient beings on the planet. A global action plan will be necessary, engaging the opinion-forming mass media in information campaigns. The current distribution model of medical education needs to be rethought and reformulated to fit the new planetary reality. The fair distribution of medical education, improving public health systems on a global scale, will benefit the needy populations, treated with visible inequality in relation to the citizens of developed countries. The advances in science must be shared with all people so that the dignity and well-being of humanity can prevail over the economic interests that interfere detrimentally in health systems all over the world, as democratic values get trampled by the pursuit of maximum profit, while the burden over the population increases. Knowledge and new technologies must reach the entire population of the Earth, in order to foster a more egalitarian and fairer world, as advocated in this proposal. It seems unethical that, while in some countries medicine begins to benefit from artificial intelligence, in other countries medical training and care are still precarious. The elimination of this immense abyss that separates nations demands a shared global knowledge base for the benefit of humanity itself; we are all on the same boat, sailing on the ocean of difficulties.

The advances of science should be regarded as advances of civilization itself, not a privilege of a few nations. Given the practical, historical, and ethical grounds of this proposition, aimed at preparing us for the future, I earnestly request its examination with the seriousness and rationality that the issue demands. I also take this opportunity to express in advance my sincere gratitude to the WHO, such an important multilateral organization, for its eventual manifestation.

Samuel Sales Saraiva

An Earthling with American and Brazilian citizenship


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