Ugandan doctors visit Yale in first steps of collaboration on medical education

In 2002 Majid Sadigh, M.D., associate clinical professor of medicine, made the first of three trips to the Makerere University Medical School in Uganda. “I am stunned,” he said on his return, “by the level of scientific elegance in that institution.” On his second visit two years later, Sadigh taught Ugandan medical students and residents. On his third trip, in the fall of 2005, he was joined by Asghar Rastegar, M.D., associate chair of medicine. Their goal this time went beyond simply teaching. “Makerere was a gold mine for some sort of collaboration,” Sadigh said, noting the enthusiasm for a partnership on both sides.

In March three ranking members of Makerere’s medical faculty spent a week at Yale to pursue that collaboration. “The major areas of interest are medical education and the importance of clinical care,” said Samuel Luboga, M.D., deputy dean of the medical school at Makerere. “Under that umbrella there will be specific programs.”

The largest university in Uganda, Makerere is the alma mater of several presidents of African nations. The medical school was recently selected by the Academic Alliance for AIDS Care and Prevention in Africa, an international public-private partnership, as the site of the Infectious Diseases Institute, a regional center of excellence for HIV/AIDS care, training, research and prevention in East Africa. To be sure, HIV/AIDS is the country’s leading health problem, but not the only one. Infectious diseases, malaria and maternal morbidity and mortality also rank high. Then there is the shortage of doctors.

In the best of circumstances, Luboga said, there is one physician per 18,000 people. In the countryside, though, only one doctor may be available for 35,000 to 50,000 people. “If I had my way,” Luboga said, “it would be one per thousand.”

While at Yale, Luboga, Harriet Mayanga, M.D., chair of medicine, and Samuel Kaggwa, M.D., chair of surgery, visited colleagues in surgery, infectious diseases and medical education.

As envisioned, the collaboration would see a year-round presence by Yale attendings, who would rotate through the 1,600-bed Mulaga Hospital in Uganda. Students and residents would also do rotations there. Ugandan faculty, residents and attendings would come to Yale for training.

The program fits into Yale’s vision of its mission as a global university and would offer Yale physicians, residents and students experience with diseases not usually seen in the United States. Funding is being sought in Uganda and the United States. Ideally, the program would be sustainable for the long term.

David L. Coleman, M.D., HS ’80, professor and interim chair of medicine, said the department is also seeking a partnership with a facility in an underserved community in Connecticut. “We have taken the responsibility to improve public health and health care in communities, particularly communities that are underserved or have resource constraints.” He hopes to have the Ugandan exchange in place by the end of the 2006-07 academic year. “We want to help improve the health of the citizens of Uganda by assisting the leadership of Makerere University to improve medical education. We hope to make an enduring contribution while also learning from our colleagues in Uganda.”