gms | German Medical Science

Project description: The partnership project supports speciality training for Malawian registrars (MRs) in Malawi and South Africa (SA) to mitigate the country’s severe shortage of paediatricians. In addition, German registrars (GRs) undergo six months of training in Malawi, eligible for accreditation by their German regional medical council.

Research questions: This qualitative study examines the views of registrars and stakeholders about the training in Malawi with the following questions:

1.

What are the expectations of MRs and GRs participating in the training?

2.

What are the perceived benefits of the project?

3.

What are the respondents’ views about the quality of the partnership and the opportunities for improvement?

Methods: Between Apr 2023 and Jan 2024, we conducted in-depth interviews online or in-person with 5 MRs, 7 GRs, and 7 key informants who were involved in implementing the project and supervising the registrars. Thematic analysis identified key themes corresponding to the research questions.

Findings: MRs expected diverse learning experiences in SA, aiming to gain exposure to patients and health workers from various backgrounds, different disease patterns, diagnostics and subspecialties. However, concerns arose about xenophobia in SA and about applying advanced skills upon returning. GRs anticipated new learning opportunities in a resource-limited setting and aspired to work in global health in future. They noted improved clinical skills without relying on lab results and experienced perspective shifts in professional and personal interests through multicultural exposure. Key informant interviews emphasized mutual learning by MRs and GRs and potential for long- term capacity building by contributing to increasing the number of specialists. Better support measures for GRs and providing bonding opportunities for MRs and GRs were areas for improvement. Consideration for a bilateral exchange emerged but doubts about its effectiveness arose, concerning language and legal barriers. Overall, participants rated the partnership positively, leveraging long- established relationships and effective communication to be able to navigate unanticipated events.

Discussion: Not all MRs traveled to SA. Therefore, findings are incomplete, and the richness of the interview skewed towards GRs. Despite this, the preliminary analysis indicates the project’s contribution to all registrars’ professional and personal growth. Overarching themes suggest the need for accessible preparation sessions for GRs and a focus on nurturing peer-relations among registrars to magnify the project’s outcome.