CLIAREM Model: A novel framework for postgraduate medical education in Sub-Saharan Africa

Authors

  • Taoreed Azeez Department of Medicine, Manor Hospital, Walsall, United Kingdom

DOI:

https://doi.org/10.71637/tnhj.v25i3.1094

Keywords:

medical education, postgraduate training, CLIAREM, Curriculum, sub-saharan Africa

Abstract

Background: An educational model serves as a systematic framework that delineates the structure and execution of an educational program. CLIAREM encompasses Clinical competencies, Leadership abilities, Instructional proficiency, Advocacy capabilities, Research expertise, Entrepreneurial and innovative skills, and Mentoring abilities. This paper intends to explore the elements, significance, and implementation of the innovative CLIAREM model for postgraduate medical education.

Methods: Utilizing suitable terminology, comprehensive searches were conducted in electronic medical databases including PubMed, Google Scholar, SCOPUS, and the African Journal Online (AJOL).

Results: In many countries in Sub-Saharan Africa, the existing postgraduate medical curricula are often derived from foreign sources and fail to address local and current needs, resulting in healthcare providers who may lack critical social skills. This scenario is unsustainable in the modern context, and a comprehensive and adaptable approach, exemplified by the CLIAREM model, presents the most effective and straightforward means to drive this transformation.

Conclusion: CLIAREM is a groundbreaking method that tackles the difficulties encountered in postgraduate medical education, particularly in under-resourced areas like sub-Saharan Africa. It signifies a fundamental change from the earlier notion that a clinician could treat patients but was unable to carry out other vital roles because of insufficient focus in the training curriculum.

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References

. Schneiderhan J, Guetterman TC, Dobson ML. Curriculum development: a how-to primer. Fam Med Community Health. 2019;7(2):e000046.

2. Naidoo K. An Inclusive Learning Environment Is a Partnership Between Learners and Educators. J Phys Ther Educ. 2024;38(3):179–80.

3. Weggemans MM, van Dijk B, van Dooijeweert B, Veenendaal AG, ten Cate O. The postgraduate medical education pathway: an international comparison. GMS J Med Educ. 2017;34(5):63.

4. Schwill S, Kadmon M, Hahn EG, Kunisch R, Berberat PO, Fehr F, et al. The WFME global standards for quality improvement of postgraduate medical education: Which standards are also applicable in Germany? Recommendations for physicians with a license for postgraduate training and training agents.

GMS J Med Educ. 2022;39(4):42.

5. Govender L, Naidoo D. Decolonial insights for transforming the higher education curriculum in South Africa. Curric Perspect. 2023;43(1):59–71.

6. Monekosso GL. A brief history of medical education in Sub-Saharan Africa. Acad Med. 2014;89(8 Suppl):S11-15.

7. Hiatt RA, Engmann NJ, Ahmed M, Amarsi Y, Macharia WM, Macfarlane SB, et al. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa. Acad Med. 2017;92(4):462–7.

8. Wang QS, Hua YF, Tao R, Moldovan NC. Can Health Human Capital Help the Sub-Saharan Africa Out of the Poverty Trap? An ARDL Model Approach. Front Public Health. 2021;9:697826.

9. Africa Development Bank. Africa dominates list of the world’s 20 fastest-growing economies in 2024—African Development Bank says in macroeconomic report [Internet]. African Development Bank Group. African Development Bank Group; 2024 [cited 2025 Apr 2]. Available from: https://www.afdb.org/en/news-and-events/press-releases/africa-dominates-list-worlds-20-fastest-growing-economies-2024-african-development-bank-says-macroeconomic-report-68751

10. McElvaney OJ, McMahon GT. International Medical Graduates and the Physician Workforce. JAMA. 2024;332(6):490–6.

11. Talib Z, Narayan L, Harrod T. Postgraduate Medical Education in Sub-Saharan Africa: A Scoping Review Spanning 26 Years and Lessons Learned. J Grad Med Educ. 2019;11(4 Suppl):34–46.

12. Wu A, Choi E, Diderich M, Shamim A, Rahhal Z, Mitchell M, et al. Internationalization of Medical Education — Motivations and Formats of Current Practices. Med Sci Educ. 2022;32(3):733–45.

13. Sunguya BF, Hinthong W, Jimba M, Yasuoka J. Interprofessional Education for Whom? — Challenges and Lessons Learned from Its Implementation in Developed Countries and Their Application to Developing Countries: A Systematic Review. PLoS One. 2014;9(5):e96724.

14. Shakhman LM, Al Omari O, Arulappan J, Wynaden D. Interprofessional Education and Collaboration: Strategies for Implementation. Oman Med J. 2020 Jul;35(4):e160.

15. Singh P, Singh S, Kumari V, Tiwari M. Navigating healthcare leadership: Theories, challenges, and practical insights for the future. J Postgrad Med. 2024;70(4):232–41.

16. MIR MM, MIR GM, RAINA NT, MIR SM, MIR SM, MISKEEN E, et al. Application of Artificial Intelligence in Medical Education: Current Scenario and Future Perspectives. J Adv Med Educ Prof. 2023;11(3):133–40.

17. Johnson O, Begg K, Kelly AH, Sevdalis N. Interventions to strengthen the leadership capabilities of health professionals in Sub-Saharan Africa: a scoping review. Health Policy and Planning. 2021;36(1):117–33.

18. Gonzalo JD, Dekhtyar M, Caverzagie KJ, Grant BK, Herrine SK, Nussbaum AM, et al. The triple helix of clinical, research, and education missions in academic health centers: A qualitative study of diverse stakeholder perspectives. Learn Health Syst. 2020;5(4):e10250.

19. Khan RA, Spruijt A, Mahboob U, van Merrienboer JJG. Determining ‘curriculum viability’ through standards and inhibitors of curriculum quality: a scoping review. BMC Med Educ. 2019;19:336.

20. Heber S, Grasl MC, Volf I. A successful intervention to improve conceptual knowledge of medical students who rely on memorization of disclosed items. Front Physiol. 2023;14:1258149.

21. Changiz T, Amouzeshi Z, Najimi A, Adibi P. A narrative review of psychomotor abilities in medical sciences: Definition, categorization, tests, and training. J Res Med Sci. 2021;26:69.

22. Hahn A, Judd CM, Hirsh HK, Blair IV. Awareness of Implicit Attitudes. J Exp Psychol Gen. 2014;143(3):1369–92.

23. Varkey B. Principles of Clinical Ethics and Their Application to Practice. Med Princ Pract. 2021;30(1):17–28.

24. Azeez TA. Healthcare delivery in Sub-Saharan Africa: exploring the impact of leadership theories and styles. Rwanda medical journal. 2023;80(2):69–87.

25. Spanos S, Leask E, Patel R, Datyner M, Loh E, Braithwaite J. Healthcare leaders navigating complexity: a scoping review of key trends in future roles and competencies. BMC Med Educ. 2024;24:720.

26. Gupta AK, Neely J, Wilkinson C. Clinical leadership training: a clinician’s perspective. Clin Radiol. 2021;76(4):241–6.

27. Toh RQE, Koh KK, Lua JK, Wong RSM, Quah ELY, Panda A, et al. The role of mentoring, supervision, coaching, teaching and instruction on professional identity formation: a systematic scoping review. BMC Med Educ. 2022;22:531.

28. Srinivasan M, Li STT, Meyers FJ, Pratt DD, Collins JB, Braddock C, et al. “Teaching as a Competency”: competencies for medical educators. Acad Med. 2011;86(10):1211–20.

29. Dong H, Lio J, Sherer R, Jiang I. Some Learning Theories for Medical Educators. Med Sci Educ. 2021;31(3):1157–72.

30. van Diggele C, Burgess A, Mellis C. Planning, preparing and structuring a small group teaching session. BMC Med Educ. 2020;20(Suppl 2):462.

31. Sethi A, Schofield S, McAleer S, Ajjawi R. The influence of postgraduate qualifications on educational identity formation of healthcare professionals. Adv in Health Sci Educ. 2018;23(3):567–85.

32. Robbrecht M, Van Winckel M, Norga K, Embo M. Exploring residents and supervisors’ workplace learning needs during postgraduate medical education. Int J Med Educ. 2023;14:65–74.

33. Earnest M, Wong SL, Federico S, Cervantes L. A Model of Advocacy to Inform Action. J Gen Intern Med. 2023;38(1):208–12.

34. Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, et al. Communication in healthcare: a narrative review of the literature and practical recommendations. Int J Clin Pract. 2015;69(11):1257–67.

35. Richard C, Lussier MT, Millette B, Tanoubi I. Healthcare providers and patients: an essay on the importance of professional assertiveness in healthcare today. Med Educ Online. 28(1):2200586.

6. Kristensen N, Nymann C, Konradsen H. Implementing research results in clinical practice- the experiences of healthcare professionals. BMC Health Serv Res. 2016;16:48.

37. Arkoudis NA, Efthymiou E, Moschovaki-Zeiger O, Koutserimpas C. The challenges of balancing clinical and research responsibilities. Radiol Bras. 57:e20230119.

38. Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context – global shortages and international migration. Glob Health Action. 2014;7:10.3402/gha.v7.23611.

39. Clemens MA, Pettersson G. New data on African health professionals abroad. Human Resources for Health. 2008;6(1):1.

40. Diaconu K, Falconer J, Verbel A, Fretheim A, Witter S. Paying for performance to improve the delivery of health interventions in low‐ and middle‐income countries. Cochrane Database Syst Rev. 2021;2021(5):CD007899.

41. Li Y, Cao K, Jenatabadi HS. Effect of entrepreneurial education and creativity on entrepreneurial intention in college students: mediating entrepreneurial inspiration, mindset, and self-efficiency. Front Psychol. 2023;14:1240910.

42. Greenblatt WH. Proportion, Type, and Characteristics of Physician Entrepreneurship in Massachusetts. JAMA Netw Open. 2021;4(1):e2026938.

43. Teo MYK, Ibrahim H, Lin CKR, Hamid NABA, Govindasamy R, Somasundaram N, et al. Mentoring as a complex adaptive system – a systematic scoping review of prevailing mentoring theories in medical education. BMC Med Educ. 2024;24:726.

44. Dusin J, Melanson A, Mische-Lawson L. Evidence-based practice models and frameworks in the healthcare setting: a scoping review. BMJ Open. 2023;13(5):e071188.

45. Oliver R, Kersten H, Vinkka-Puhakka H, Alpasan G, Bearn D, Cema I, et al. Curriculum structure: principles and strategy. Eur J Dent Educ. 2008;12 Suppl 1:74–84.

46. Jeyakumar T, McClure S, Lowe M, Hodges B, Fur K, Javier-Brozo M, et al. An Education Framework for Effective Implementation of a Health Information System: Scoping Review. J Med Internet Res. 2021;23(2):e24691.

47. Romanelli F, Bird E, Ryan M. Learning Styles: A Review of Theory, Application, and Best Practices. Am J Pharm Educ. 2009;73(1):09.

48. Elendu C, Amaechi DC, Okatta AU, Amaechi EC, Elendu TC, Ezeh CP, et al. The impact of simulation-based training in medical education: A review. Medicine (Baltimore). 2024;103(27):e38813.

49. Müller C, Mildenberger T, Steingruber D. Learning effectiveness of a flexible learning study programme in a blended learning design: why are some courses more effective than others? Int J Educ Technol High Educ. 2023;20(1):10.

50. Liu C, Ren M, Luo C, Asfandyar K, Dai H, Yang J, et al. The application effect of the segmented teaching method in training medical students on clinical practice skills. BMC Medical Education. 2024;24(1):1090.

51. Khanpoor H, Amerzadeh M, Alizadeh A, Khosravizadeh O, Rafiei S. Developing a responsive model to societal needs in medical education. BMC Med Educ. 2024;24:370.

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Published

2025-10-13

Issue

Section

Review Articles

How to Cite

CLIAREM Model: A novel framework for postgraduate medical education in Sub-Saharan Africa. (2025). The Nigerian Health Journal, 25(3), 973-989. https://doi.org/10.71637/tnhj.v25i3.1094

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