<br>From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote"><br>
















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<h1 style="margin-right:0in;margin-bottom:5.0pt;margin-left:.5in;line-height:15.0pt"><b><font size="4" color="maroon" face="Arial"><span style="font-size:14.0pt;font-family:Arial;color:maroon">Health professionals
for a new century: <br>
transforming education to strengthen health systems in an interdependent world<br>
<br>
</span></font></b></h1>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">Prof Julio Frenk a, Dr
Lincoln Chen b ‡  , Prof Zulfiqar A Bhutta c, Prof Jordan Cohen d, Nigel Crisp e,
Prof Timothy Evans f, Harvey Fineberg g, Prof Patricia Garcia h, Prof Yang Ke i,
Patrick Kelley g, Barry Kistnasamy j, Prof Afaf Meleis k, Prof David Naylor l,
Ariel Pablos-Mendez m, Prof Srinath Reddy n, Susan Scrimshaw o, Jaime Sepulveda p, Prof David Serwadda q, Prof Huda
Zurayk</span></font><font size="2" color="navy" face="Trebuchet MS"><span style="font-size:10.0pt;font-family:"Trebuchet MS";color:navy"> r<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">Available online at: <a href="http://bit.ly/edUAoJ" target="_blank"><font color="navy"><span style="color:navy">http://bit.ly/edUAoJ</span></font></a>
<br>
<br>
</span></font><font size="2" color="navy" face="Trebuchet MS"><span style="font-size:10.0pt;font-family:"Trebuchet MS";color:navy"></span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">“…..A Lancet Commission
highlights a call from 20 professional and academic leaders for major reform in
the training of doctors and other healthcare professionals for the 21st
century. Changes are needed because of fragmented, outdated, and static
curricula that produce ill-equipped graduates. The Commission argues for major
reform across the entire medical education system, in order to produce
competency-led curricula for the future…”</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy"> </span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">“…..100 years ago, a
series of studies about the education of health professionals, led by the 1910
Flexner report, sparked groundbreaking reforms. Through integration of modern
science into the curricula at university-based schools, the reforms equipped
health professionals with the knowledge that contributed to the doubling of
life span during the 20th century.<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">By the beginning of the
21st century, however, all is not well. Glaring gaps and inequities in health
persist both within and between countries, underscoring our collective failure
to share the dramatic health advances equitably. At the same time, fresh health
challenges loom. New infectious, environmental, and behavioural risks, at a
time of rapid demographic and epidemiological transitions, threaten health
security of all. Health systems worldwide are struggling to keep up, as they
become more complex and costly, placing additional demands on health workers.<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">Professional education
has not kept pace with these challenges, largely because of fragmented,
outdated, and static curricula that produce ill-equipped graduates. The
problems are systemic: mismatch of competencies to patient and population
needs; poor teamwork; persistent gender stratification of professional status;
narrow technical focus without broader contextual understanding; episodic
encounters rather than continuous care; predominant hospital orientation at the
expense of primary care; quantitative and qualitative imbalances in the
professional labour market; and weak leadership to improve health-system
performance. Laudable efforts to address these deficiencies have mostly
floundered, partly because of the so-called tribalism of the professions—ie,
the tendency of the various professions to act in isolation from or even in
competition with each other.<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">Redesign of professional
health education is necessary and timely, in view of the opportunities for
mutual learning and joint solutions offered by global interdependence due to
acceleration of flows of knowledge, technologies, and financing across borders,
and the migration of both professionals and patients. What is clearly needed is
a thorough and authoritative re-examination of health professional education,
matching the ambitious work of a century ago.<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">That is why this
Commission, consisting of 20 professional and academic leaders from diverse
countries, came together to develop a shared vision and a common strategy for
postsecondary education in medicine, nursing, and public health that reaches
beyond the confines of national borders and the silos of individual
professions. </span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy"> </span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy">The Commission adopted a
global outlook, a multiprofessional perspective, and a systems approach. This
comprehensive framework considers the connections between education and health
systems. It is centred on people as co-producers and as drivers of needs and
demands in both systems. By interaction through the labour market, the
provision of educational services generates the supply of an educated workforce
to meet the demand for professionals to work in the health system. To have a
positive effect on health outcomes, the professional education subsystem must
design new instructional and institutional strategies…..”<br>
<br>
</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy"> </span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:navy"> </span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">a Harvard School of Public Health,
Boston, MA,
 USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">b China Medical Board, Cambridge, MA, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">c Aga
 Khan University, Karachi, Pakistan</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">d George
 Washington University Medical Center, Washington,
DC, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">e Independent member of
House of Lords, London, UK</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">f James
P Grant
School of Public Health, Dhaka, Bangladesh</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">g US Institute of
Medicine, Washington, DC, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">h School of Public Health
Universidad Peruana Cayetano, Heredia, Lima,
 Peru</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">i Peking
University Health Science Centre, Beijing, China</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">j National Health
Laboratory Service, Johannesburg,
 South Africa</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">k School
of Nursing, University
of Pennsylvania, Philadelphia, PA, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">l University
of Toronto, Toronto, ON, Canada</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">m The Rockefeller
Foundation, New York, NY, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">n Public Health Foundation
of India, New Delhi, India</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">o The Sage Colleges, Troy, MI,
 USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">p Bill & Melinda Gates
Foundation, Seattle, WA, USA</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">q Makarere University
School of Public Health, Kampala,
 Uganda</span></font></p>

<p class="MsoNormal" style="margin-left:.5in"><font size="1" color="navy" face="Arial"><span style="font-size:8.0pt;font-family:Arial;color:navy">r Centre for Research on
Population and Health, Faculty of Health Sciences, American
University of Beirut,
Beirut, Lebanon<br>
<br>
</span></font></p>

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