The Postgraduate Fellowship in Migrant and Refugee Health
Non-governmental organization (NGO)
The Postgraduate Fellowship in Refugee and Migrant Health (PGF) is a medical capacity building programme for local healthcare workers serving in humanitarian settings to improve their clinical practice. It targets those who have not received training to meet the healthcare needs of a refugee population and is centered around the delivery of 8 independent humanitarian medicine modules, alongside clinical mentoring. The PGF was launched in response to the Rohingya crisis in 2017, where newly qualified doctors were being recruited by local/international agencies to respond to the health needs of nearly 1 million Rohingya patients.
Project activities to date have included the following: - In total, over 900,000 patient consultations benefited and the doctors trained spanned most areas of the entire camp geography - Training nearly half of all the doctors working in the Rohingya camp setting from 36 NGOs, iNGOs and GOs represented across trained cohorts. - Collaborating with 51 medical content developers/doctors to develop internationally recognised and contextually relevant modules. - 26 expert faculty of doctors deployed from DWW including primary care, emergency medicine, paediatrics, maternal health, gender-based violence and mental health. Their role served to share knowledge and skills with PGF doctors while simultaneously mentoring them on an individual basis. - Conducted over 1,500 workplace-based assessments recorded in personal logbooks including case-based discussions, directly observed procedural skills, mini-clinical evaluation exercises, and reflective practice by DWW medical faculty. - Completed 201 sessions (787 hours) of clinical shadowing and mentorship directly in camp clinics. - Completed 138 sessions (423 hours) of teaching conducted by DWW medical faculty. - Distributed over 594 additional professional certificates achieved including MISP for Reproductive Health (IWAG), ETAT, BLS, and the LSHTM Health in Humanitarian Crises online course.
In total, over 900,000 patient consultations were benefited and the doctors trained spanned most areas of the camp geography. We witnessed increased skills and knowledge from baseline measurements demonstrated by each participant, on average, in addition to new skills learned. Participants reported that they were able to apply PGF learnings in their clinical settings, for example, applying multiple life-saving techniques learned in the PGF to patients, and screening specialised cases such as mental and psychosocial health from a primary care perspective. One sustainable impact is through the PGF, was how it built a stronger community of Bangladeshi medical doctors due to its duration and practical aspects. More than 30-40% of participants are now in clinical management roles representing UN and international agencies, local agencies and playing a crucial role in wider surveillance, policy and system strengthening activities despite joining the crisis as junior doctors 3 years ago.
Enabling factors include DWW’s understanding of cultural sensitivity and our diverse team. We bring 19 years of medical humanitarian experience through a localised model, which is one of the fundamental values of the PGF. DWW had previously implemented programmes in Rakhine State in Myanmar and as such has a strong contextual understanding of the crisis. Constraints include implementing an intensive educational programme in a humanitarian context and the need to adapt continually to changing environments. To our knowledge, this programme is the longest and most comprehensive training offered to medical doctors in the Rohingya camps since 2017 until today.
The nature of the PGF as a capacity-building training programme ensures its sustainability. Using a localised approach, DWW builds the capacity of the local healthforce to better manage primary care cases in a refugee setting. The programme is designed to be adapted for other settings, including in refugee camps in other locations, to support the 2030 agenda of achieving good health and well-being for all. The PGF has proven to be a sustainable and innovative programme providing long-term investment to local health systems to improve the health outcomes of the communities they serve. One of the greatest impacts is on the healthcare workforce whom we trained, who indicated that the PGF was a direct result of the leadership and management positions they now hold [see journal report]. These doctors will go on to be the future clinical leaders in the country thus supporting the wider health system and creating a sustainable approach that builds back better.
https://www.tandfonline.com/eprint/7YHETTP6U8ZKWR8BSE64/full?target=10.1080%2F14739879.2020.1864782& https://www.doctorsworldwide.org/doctors-worldwide-successfully-strengthens-the-health-response-for-the-rohingya-crisis-in-bangladesh-through-the-postgraduate-fellowship-in-migrant-and-refugee-health-pgf/ https://www.youtube.com/watch?v=zWp51wDSjk4 https://www.doctorsworldwide.org/project/postgraduate-fellowship/
The PGF curriculum and content has been adapted to incorporate best practice and learning in managing covid patients, which helps to ‘build back better’ by providing doctors with essential skills and knowledge to provide better clinical care during the pandemic. By improving doctor confidence, doctors feel better prepared to respond to crises. All covid-19 precautions are in place for the clinical shadowing and teaching aspects of the project to ensure safety of all involved.
SDGS & Targets
Deliverables & Timeline
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The PGF directly benefits the Bangladeshi health workforce. Through our 4 cohorts, we have trained 99 doctors representing nearly half of the doctors who work in the refugee camps. The indirect beneficiaries are the Rohingya people and host communities, with 900,000 patient consultations positively impacted in total. Key stakeholders include IOM who funded Doctors Worldwide to continue delivering the project.