1. PIHOA55 Meetings Summary – Kiribati Pre-Internship Program Assessment Palikir, Pohnpei State, FSM – 13 March 2014

2. Emerging issues e.g. Growing emphasis on medical workforce and training outside the region 2 974 25 7 19 31 98 Ability to back- fill large proportion of vacant MO positions and short-fall 6 6 10 ~50 %

4. Background: 14 ELAM graduates returned to Kiribati 10 graduates of FNU working in Kiribati who need Internship Training WHO and FNU working with Kiribati MHMS to develop Internship Program Need to assess 14 ELAM graduates Pre-Intern Assessment Process -Seasoned medical educator staff from FNU CMNHS -Exam: 1) Multiple Choice Questions (MCQ) & Modified Essay Questions (MEQs), 2) Objective Structured Clinical Exam (OSCE): practical exam stations, 3) Objective Structured Practical Exams (OSPE): selected patients & wards rounds

5. Pre-Intern Assessment Results: -Gaps in the interns’ knowledge base in the basic and clinical sciences -Overall deficiency in knowledge of certain basic concepts -Little hands-on patient experience during their medical school training, instead training residents (registrars) on the wards of the hospitals in Cuba

6. Recommendations: -Transform Kiribati Hospital and its branches into a teaching hospital system -Visiting specialty individuals and teams should have Interns assigned to them -Adopt a two tier registration process: Part I a provisional registration which allows them to practice as Interns under close supervision, and Part 2 full registration -Extend the Internship to two years and include a transition “training internship” up to six months with entrance into the full Internship Program to be individualized depending upon knowledge and skills -Regarding posting after Internship Program: develop a set of criteria as to knowledge base and competencies as to clinical and practical skills needed for next posting

8. PIHOA55 Meetings Palikir, Pohnpei State, FSM – 13 March 2014 Thank you Greg Dever, MD Regional HRH Coordinator gregd@pihoa.org