The ACGME and Global Health: Insights from Abu Dhabi on the Local View of Glocalization
“It’s not necessarily about a difference in practice, nor a difference in standards, but really about ensuring that whatever is coming out of that educational system actually fits the health needs of the nation or of the local community or whatever context in which you practice,” said Sawsan Abdel-Razig, MD, MEHP, addressing the local perspective on glocalization.
Dr. Abdel-Razig, currently the chief academic officer at Cleveland Clinic Abu Dhabi, played a key role in the development of post-graduate medical education (PGME) in Abu Dhabi, most notably overseeing medical education regulations. ACGME Global Services recently spoke with Dr. Abdel-Razig to get her unique perspective as a builder and leader of Abu Dhabi’s PGME system.
Making the Most of Globalization
Few places have benefitted from as significantly as the United Arab Emirates (UAE), from rapid economic expansion to infrastructure development. However, growth comes with unique challenges that must be addressed to fully harness the opportunities presented – including providing health care for a rapidly growing population.
Dr. Abdel-Razig plays a significant role in crafting the PGME system in Abu Dhabi, including how it aligns with the entire health care sector. “It’s a balancing act that we make when looking at how medical education practices or standards align with the sociocultural needs of the context in which we in which we practice,” she said. “A family physician’s scope of practice in Abu Dhabi looks very different from a family physician in the US, which looks very different from a family physician in China.”
In pursuing outcomes-based PGME in Abu Dhabi, educational leaders addressed their needs in steps. First, they aimed to ensure whatever measures they adopted made sense for ’s population health needs, then “aligned the regulators with the operators” in the medical education space. Most importantly, “they had their eye on the workforce,” said Dr. Abdel-Razig, which she noted “in many parts of the world… is not the case, where you’ve got the accreditors doing something, the hospitals doing something else, and the patients having different expectations.”
Abu Dhabi chose a deliberate approach by creating alignment “from all the way up at the regulator level down to the frontline level,” Dr. Abdul-Razig added. “I think that’s what made the difference.”
“Glocalization” for Abu Dhabi
One of the most unique dilemmas facing not just medical educators, but the entire health care sector of Abu Dhabi, is directly the result of globalization: With a vibrant, and extremely diverse community experiencing exponential growth, defining “local” for the UAE is moving target. Dr. Abdel-Razig noted that “when you think about glocalizing, you’re trying to meet the needs of the local population of today and tomorrow, except that tomorrow can be so different from today.”
An additional challenge facing Abu Dhabi is that the vast majority of PGME faculty members are often not from the UAE. Coming from their own local contexts, Dr. Abdel-Razig noted, “there’s no inherent sense of community issues,” because both patients and care practitioners are often transitory. This means there is a need for significant focus on local needs and context, which may take these physicians time and effort to harmonize from their own experience. “You’re not just teaching the residents; you’re actually also supporting faculty [members] as they learn about the local context in which we practice.”
On the flip side, these dynamics also present significant strengths in PGME. Diverse faculty members bring diverse approaches to education and patient care. Additionally, being at the forefront of a worldwide phenomenon of increasing mobile patient populations and health care workers provides a unique opportunity for the UAE to pioneer health professions’ education strategies and approaches that leverage glocalization practices while employing benchmarked frameworks and practices toward those goals.
With the continuing growth in Abu Dhabi, ensuring the workforce is equipped to address the health needs of the community remains a top priority. Dr. Abdel-Razig noted newer opportunities – and challenges – have been presented by the most recent advances in artificial intelligence and technology toward more personalized approaches to care. As PGME educators worldwide brace to take these on, she emphasized the importance of keeping eyes on the relevance and responsiveness of the skills, knowledge, and behavioral outcomes of competency-based education systems in addressing patient needs wherever they are. Essentially, she said, this is “meeting the patient where the patient is.”
Through this series, The ACGME and Global Health seeks to engage the global medical and health care communities in conversations on challenges facing global health that transcends borders. The goal of this content series is to provoke discussion about issues that concern the global PGME community, enabling critical conversation that engages with stakeholders across borders, disciplines, and perspectives. This post includes input from ACGME and public health leaders from recent interviews and presentations.
ACGME Global Services, a department of the ACGME, was created to advance the ACGME Mission by working with global entities to enhance the quality of resident and fellow physicians' education. We invite comments by email (global@acgme.org) and through Twitter and LinkedIn (with the hashtag #ACGMEGlobalServices). We also seek external voices in future posts in the ACGME and Global Health Blog series; email us if you would like to participate.