April 23rd, 2019 by Galit Rudelson

Title: Medical School In Ghana
Figured I’d give this one a title, since all I plan on talking about is the path to becoming a doctor in Ghana.
First, a quick summary of medical school in the US, for my non-medical friends. After college you go to 4 years of medical school. Traditionally the first 2 years are studying in books, and the next 2 are in the hospital. After that you graduate you go to residency, which can last between 3 and 7 years, depending on the specialty. After residency you either finally start practicing on your own, or choose to specialize even more within your specialty, and do a fellowship for several years.
Now onto Ghana. First of all, this is information I gathered to the best of my ability from talking to many different people. So my fair disclaimer is that I believe it all to be accurate, but I might have misunderstood parts of it.
Primary education (or our equivalent of K-8th) can be found for free. Of course, as can be expected, free education is often times not as good as paid for education. Furthermore, someone has to motivate the children to go to school. In households where both parents leave for work before school (such as farmers, as a majority of the community is), it is up to the children to get motivated enough to go to school. So just imagine convincing a 6 year old to walk to school on their own volition. Rather difficult.
Secondary school (or our equivalent of highschool) is much of the same. But almost all high schools are boarding schools. The children go for 3 terms, and come home between each term, and for a couple of months during the equivalent of “summer vacation.” No matter what school you go to in Ghana, everyone takes the same standardized high school exams. As I talked about in my previous post, I have met a truly impressive man that studied for these exams all on his own, and did very well. But I am assured that they are fairly difficult.
From secondary school future doctors apply right into medical school (none of this college then medical school like in the states). I heard from one person that you must have had the highest grade in all 6 subjects to be considered into medical school. The number of medical schools in the country are in the single digits.
School itself is 7 years. The first 4 are in the books, and the next 3 are clinical. During my time here there were three 6th year students here. Their knowledge level seemed very comparable to where a 3rd year med student would be expected to be in the States. I was also surprised to learn that they use a lot of the same resources, including Sketchy Micro!
Following medical school all graduated doctors become “House Officers” for 3 years. This is a twist on our residency program. The House Officers act as interns would, learning the ropes of the hospital, gaining responsibility as time goes on. But they rotate through all of the different specialties. This means that every House Officer learns how to do a c-section, abdominal surgery, pediatric care, and emergency care, for example. After House Officer my understanding becomes a little murky. They choose the specialty they go into, and I believe they start working under a specialist for a year, and then are on their own. Don’t hold me to that, it was confusing.
What comes out of this system is that no matter what specialty a doctor is in, he is able to be on call at night. He should be able to handle any emergency room patient that comes through, and any obstetrical emergency. They can all step in at any time to perform a c-section for example. The general medicine doctor I worked with today was tired because last night he had to come in to repair a ruptured uterus. To my non-medical friends, only OBGYNs would handle such an emergency, and aside from surgeons, nobody would know the first thing about performing surgery outside of their specialty.
This system also has some interesting consequences. Much of the grunt work is done by House Officers, like much of the grunt work is done by residents in teaching hospitals in the US. But in more rural areas, where any sort of specialist is a rare finding, House Officers maybe the only doctor a patient would be able to see. The doctor I worked with told me about how he managed chemotherapy for an ovarian cancer as a House Officer. He said “I like how Americans do everything because research proves that it helps. Here we try to copy the Americans. But then you end up in situations like that, where someone with no training in ovarian cancer is giving you your chemotherapy. And it becomes much more guesswork than research based.” In that story, his patient had come from 9 hours away to be seen by a doctor.
As interesting as this whole system is, I have made this far too long, so I will stop here for now! Thanks for reading