Roundtable: revisiting innovative leaders in medical education

In the fall of 2008, MEDICC Review published a roundtable discussion with six of eight deans representing schools of health sciences with a strong social accountability mandate, who had just founded a new collaborative: the Training for Health Equity Network (THEnet). The topic was the changing paradigm of medical education. MEDICC Review returns to hear their perspectives on how their schools contribute to universal coverage, the theme of this issue. An appropriate health workforce is a critical component of universal health coverage. Discussions until now have focused mostly on managing supply and demand. Yet, it has become increasingly clear that what is needed is a fundamental shift in approach: different types of health workers employed in different ways in different health systems to meet the needs of all. Because the traditional “ivory tower” model of medical education is failing to meet the health and social needs of the underserved, THEnet schools are pioneering innovative models to improve access to and quality of health services in disadvantaged communities. Through THEnet, voices of the underserved are being heard—challenging the policies, institutions, and orthodoxies that have systematically failed these populations. THEnet schools measure their success, not by how many graduates they produce or how many of their articles have been published, but by whether their graduates have the right competencies to meet the needs of their reference populations and whether a large proportion of them stay and work in regions where they are most needed. They also measure whether their research and services positively affect health policies and practice and improve health in vulnerable communities. Community engagement is hardwired into the schools’ activities, a cornerstone of their mission to impact health service provision and health workforce retention in disadvantaged areas. THEnet schools view the public as a vital component of the health system, and of any effort to expand health coverage. In their experience, communities can be mobilized and supported to take responsibility for their own health and promote health-seeking behavior, becoming partners in developing solutions to their health challenges. THEnet is scaling up its research and capacity development activities to examine the return on investment in communityengaged socially accountable education, and to better support schools through evidence-based strategies, peer learning environments, and practical tools. The aim is to demonstrate that health equity is a realistic and actionable goal for sustainable health workforce development.