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IMPLEMENTING A COMPREHENSIVE PRIMARY CARE CONTINUING MEDICAL EDUCATION PROGRAM IN RURAL NEPAL

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Problem Fostering a culture of continued learning at healthcare facilities is a global priority for health systems performance, patient safety, and quality improvement. In low- and middle-income countries, continuing medical education activities are almost non-existent. National professional academies tend to be focused almost exclusively at major teaching hospitals in urban centers. In addition to playing a central role in healthcare provision, rural district-level hospitals are formative for many young healthcare professionals who are posted there for mandatory government service. The district hospital thus represents an important missed opportunity to be a center for learning. Approach We describe a comprehensive primary care and inpatient-based continuing medical education program at a district hospital in rural Nepal. The program aims to create a build the hospital as a regional center for healthcare worker training and professional development, to enhance healthcare worker recruitment and retention, to foster a culture of inter-professional learning and collaboration, and to facilitate quality improvement initiatives. The particular modalities of continuing medical education include didactic lectures, morbidity and mortality conferences, and case presentations by junior staff physicians and mid-level providers. Outcomes Bayalpata Hospital leadership conducted 155 didactic lectures since beginning the continuing medical education program in July 2014. Ongoing challenges critical to long-term success include identifying a dedicated staff member to champion continuing medical education at Bayalpata Hospital, engaging all clinicians in relevant content, and building formal training in quality improvement into the continuing medical education programming.