Transforming Ghana’s Healthcare: The Impact of Graduate Entry Medical Programmes

The World Health Organization estimates that Ghana had 1.4 physicians per 1,000 population, well below the African and Global averages of 2.6 and 17.2. Why should we care? First, more doctors mean more people can see a doctor when they need to. Next, with more doctors, patients might wait less time to be seen.

Importantly, having more doctors can lead to better health results for the whole population. To bolster the number of physicians per capita, a multifaceted approach encompassing training, recruitment, and retirement strategies is necessary. Traditionally, Ghanaian medical doctors undergo six-year programs following their senior high school education.

However, the healthcare system faces challenges in retaining physicians, with a significant outflow of medical professionals from rural to urban areas and from Ghana to high-income countries. Despite rising life expectancy, retirement ages in the health sector have not been adjusted accordingly.

In response to these issues, the Ghanaian medical community has proposed solutions. First, the training landscape has evolved with the introduction of graduate medical entry programs (GEMP) and physician assistantship programs – two interventions that I have experience with. When I first donned my white coat as a physician assistant, I felt a surge of pride and a sense of accomplishment. Yet, as I navigated the corridors of Enyiresi Government Hospital, I realized that my journey in healthcare was far from complete. I found myself limited by the scope of practice for physician assistants. This realization led me to the GEMP at the University of Ghana Medical School (UGMS), a decision that has profoundly reshaped my career and perspective.

My journey began at the University of Health and Allied Sciences (UHAS) in Ho, where I pursued a degree in Physician Assistantship. UHAS is renowned for its rigorous training, exceptional faculty, and comprehensive clinical skills development. Graduating in 2019, I embarked on my national service at Enyiresi Government Hospital, where I had the privilege of learning from skilled medical officers, particularly Dr. Hammond Moore, my mentor.

While my time as a physician assistant was undoubtedly rewarding, I observed notable differences in the dynamics between medical doctors and nurses compared to my own interactions. These experiences, combined with occasional restrictions to my actions and to be frank a lack of respect, prompted me to reflect on my career path. I recognized the value of my role but also identified a desire for further medical training – I wanted to be able to do more for my patients. This realization ultimately inspired me to pursue a medical degree.

In 2022, I set my sights on GEMP at UGMS. The program, designed for graduates from various backgrounds, offers a fast-tracked path to becoming a medical doctor. It spans 4.5 years, with the first 1.5 years dedicated to basic sciences such as cell biology, anatomy, physiology, embryology, pharmacology, and pathology. The remaining three years focus on clinical courses and clerkships, integrating GEMP students with those from the regular six-year program. Other medical schools offer GEMP admission including the University of Cape Coast School of Medical Sciences and Family Health University Medical School.

Admission into GEMP is competitive and involves an access course, an entrance examination, and a selection interview. Fortunately, there are numerous resources available to prospective applicants. Successfully navigating this process, I found myself immersed in a curriculum that dwarfs the scope of my previous training. The depth and breadth of information in medical school are akin to viewing an object under a microscope at 100x magnification compared to the naked eye. I have found every course within the GEMP program engaging, but anatomy stands out as a particular highlight.

The combination of hands-on dissections and advanced technology, such as the Anatomage, provided a truly comprehensive learning experience. With my aspirations of becoming a neurosurgeon, the neuroscience courses were especially stimulating. Without reservation, enrolling in GEMP was one of the best choices I’ve made.

GEMP is not without its challenges. The volume of information is immense, and the pace is relentless. Students must be prepared for regular evaluations, including interim assessments, viva voce, Objective Structured Practical Examinations (OSPEs), final exams, and lab reports. Financially, the program is demanding, and I am deeply grateful to my aunt, Mrs. Faustina Amuzu, for her unwavering support.

Financial constraints can pose a significant challenge for many aspiring medical students. While scholarships, such as those provided by the Ghana National Petroleum Corporation, can offer invaluable support, most become available only after admission. This means students often need to secure funding for at least the initial semesters. This financial hurdle presents a unique opportunity for corporations seeking to implement impactful Corporate Social Responsibility initiatives. By investing in promising medical students, businesses can contribute meaningfully to healthcare development.

Despite these challenges, GEMP is immensely rewarding. It closely mirrors medical education in North America and graduate medicine programs in the UK, providing a robust foundation for a career in medicine. For those considering this path, the benefits are manifold. The program’s success is underscored by recent achievements, such as a GEMP student being named the top graduate of UGMS, surpassing even their counterparts in the traditional six-year program. One of GEMP’s greatest strengths lies in its student profile. Our prior healthcare experience brings a unique perspective to the classroom and the wards.

Lecturers regularly revel in class discussions as my colleagues, and I share our experiences. I equally find that GEMP students learn with purpose because they have a better understanding of the clinical implications of the concepts the lecturers emphasize. There is no surprise here since we have seen firsthand the challenges patients face, fostering empathy and clinical acumen. This practical grounding complements the theoretical knowledge acquired in medical school.

In conclusion, GEMP can help increase Ghana’s physician workforce density in shorter timeframes than the regular medicine programme without impacting the quality of training. Additionally, GEMP is a transformative journey that equips students with the knowledge and skills to excel in the medical field. It is a rigorous but rewarding path, and I encourage all graduates to consider furthering their careers through this program. This goes without saying but my colleagues and I are always ready to assist anyone interested in embarking on this remarkable journey.

Israel Addo is a dedicated medical student enrolled in the Graduate Entry Medical Programme at the University of Ghana Medical School, Korle Bu. With a previous degree in Physician Assistantship, he brings a unique perspective to his medical studies. Passionate about neurosurgery and medical education, he is committed to sharing his experiences and insights to inspire others considering a career in medicine.

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