Social Accountability and Health Professions Education for Equitable Quality Healthcare Delivery: Dr. Tomlin Paul
The University of Global Health Equity (UGHE) is an innovative and ground-breaking health sciences university dedicated to training a new generation of well-rounded medical doctors in Africa. One of the University’s central tenets is that medical practice should place a premium on the social aspects of health and healthcare. Thus, the humanities and social sciences cannot be overstated in medical education. They are disciplines that enable us to develop a thorough and nuanced understanding of health and healthcare issues across a range of historical and contemporary societies and local contexts. Set high in the hills of Butaro Sector, Burera District, the location of UGHE’s Campus is intentional; to facilitate meaningful partnership with the surrounding community and to provide students with a holistic understanding of the unique challenges faced by communities living in rural and remote settings, as well as how to address those inequities through research thinking and collaboration.
Dr. Tomlin Paul, a Health Professions Education Specialist at UGHE, emphasizes the importance of socially accountable institutions such as UGHE in order to achieve high-quality, equitable healthcare delivery.
He grew up as the last of nine children of a subsistence farmer and housewife in the rural community of Morne Diablo, Trinidad and Tobago, Southern Caribbean. Life in this low-income community was challenging but his parents worked hard and sacrificed to ensure that he and his siblings gained access to good quality education as a means of improving their life chances. This has inspired him to become a physician and medical educator who is now able to provide service in a university that is somewhat connected to his childhood village. Reflecting on his early childhood he says, “It was extremely difficult for farmers like my father, who had to work very hard to afford our basic needs and schooling because we needed to promote access and equity within our village. My father would always tell us that a good education is better than gold and would serve as a springboard for development and social transformation. I believed that the best way to rise above the challenges of life in the village was that good education.”
Dr. Tomlin’s vision for education and equity was strengthened when he joined UGHE. Prior to joining this team, he spent over two decades working as a medical educator including serving as Dean of the Faculty of Medical Sciences at The University of the West Indies, Mona, Jamaica. During his tenure as Dean, he focused on promoting social accountability in medical education. He explains that “the essence of the medical school is not only seen in training doctors or nurses or pharmacists, for the market but in responding to the health needs of the population. He is of the view that medical training, must be oriented to the population, the community, and the needs of society to make it relevant.” Dr. Tomlin noted that he was drawn to the UGHE given his commitment to social responsibility and its intriguing name. He said he thought it was really fascinating to have a university with the name “global health equity”. “The name is interesting and inspiring, but more than the name, the location is deep in the heart of the rural Butaro community much like his childhood village.” Now at the UGHE and working in the Education, Development, and Quality Center (EDQC), Dr. Tomlin is excited by the UGHE’s focus on high quality, equity, and its big heart for the community. He noted how impressed he was by the UGHE’s model. For him, the UGHE’s willingness to “roll up its sleeves and take its mission and high-quality operation into the heart of the community where there is a great need for medical education is commendable”. He further marveled at how the UGHE as an organization prides itself on working side by side with the community noting how enamored he is by the staff’s willingness to enter the heart of the community and connect and work with the residents.
UGHE’s MBBS program mission is to educate well-rounded medical doctors who will have a holistic understanding of health and healthcare. Considering this, the UGHE student is conversant with a range of humanities and social sciences. “They get that perspective of their profession that has roots and arms which stretch all over with the goal and principle of caring for mankind in Rwanda, Africa, USA, Trinidad and Tobago, Jamaica or any part of the globe.” These principles are universal and ingrained within the medical education program at UGHE. Being a member of the team Dr. Tomlin plays a very important role in developing the whole student given his experience in curriculum development. Within the UGHE setting, Dr. Tomlin has worked with other members of the team to support a partnership with the Butaro District Hospital to facilitate students’ clinical training and has had inputs in the development of the clinical curriculum. He is also working within partnerships created with faculty at both Harvard and California University of Science and Medicine among other universities. He said, “these partnerships have enabled us to enrich the program and ensure that students develop the necessary competencies, as the MBBS program is competency-based”.
Dr. Tomlin emphasizes that UGHE’s MBBS students get exposure to the humanities, and they are exposed to the bigger picture of global health understanding where health is delivered, how it is delivered, looking at the context, even looking back at colonial medicine to now and its impact and how the health sector can be improved. He says, “A medical student will get the impression which is important, that this is not only science in the traditional sense of clinical science and medical sciences, but what they’re getting into prioritizes care for the community, and has connections with not only Rwanda and Butaro but with the world. The UGHE student is offered a global experience. The program allows students to interact and engage with other health professional students outside Rwanda. Currently, there are some students who have been collaborating with their counterparts at the University of Virginia, School of Medicine and other universities outside of Rwanda as they take the core medical courses.”
Dr. Tomlin discusses how students are being prepared for problem solving and humanistic research. “MBBS students are conducting research on community issues, and we will bring our students to address community issues through human-centered research, looking at the real issues of people. We hope that after graduation, they will continue to provide clinical care while also asking, “How can I improve the health of not just the patient in front of me, but of the community from which this patient is coming?” And to do so, they will need to think like researchers and apply their clinical and public health skills in that context.” The UGHE students receive consolidated training and will leave with tremendous skills. It is not inaccurate to assert that UGHE is part of a small minority of medical schools that are producing physicians who have highly developed clinical and public health skills, and an orientation to a global community.
He strongly believes that medical education institutions should be socially accountable and lead the way by engaging the communities in which they operate to help tackle the challenges they are facing and not just train doctors who have the know-how. Dr. Tomlin says that “UGHE is a socially accountable global health educational institution because it continues to respond to the priority health needs of the population and more importantly, they see this as an obligation”.