Shaping the future doctor: evaluating clinical competence, professionalism, and social accountability among the inaugural medical graduates of the university of global health equity, Rwanda.
4 affiliations
- 1University of Global Health Equity, Butaro, Rwanda. [email protected].
- 2University of Global Health Equity, Butaro, Rwanda.
- 3Ministry of Health, Kigali, Rwanda.
- 4Harvard Medical School, Boston, USA.
Abstract
Background
Globally, medical education is shifting toward competency-based and socially accountable models that emphasize not only clinical proficiency but also ethical behavior and responsiveness to community needs. This shift must also address systemic challenges such as uneven supervision and limited clinical exposure. This study examined self-reported procedural confidence, stakeholder perceptions of clinical competence, professionalism, communication, and social accountability among the University of Global Health (UGHE) first cohort (2025) of medical graduates, who were trained under a competency-based, socially accountable curriculum.Methods
A mixed-methods cross-sectional study was conducted among interns, supervisors, nurses, and hospital directors at five hospitals representing both urban and rural contexts. A structured survey captured interns' self-reported procedural confidence across 48 core procedures, while 16 focus group discussions (≈22 h) explored stakeholder perceptions of interns' clinical performance, professionalism, teamwork, communication, and social accountability. Quantitative and qualitative data were analyzed through descriptive statistics and thematic analysis, respectively, and integrated through triangulation.Results
Interns reported moderate to high self-reported confidence in common routine and emergency procedures, including intravenous line insertion, wound care, infection prevention, oxygen administration, and patient stabilization. Lower confidence was reported for more complex or less frequently performed procedures, including lumbar puncture, pleural tap, fracture reduction, and vacuum-assisted delivery. Qualitative analysis generated four key themes: supervised clinical exposure as the foundation for procedural confidence; professionalism, humility, and respectful teamwork as markers of workplace readiness; socially accountable care through patient advocacy and adaptation to resource constraints; and interns' contribution to service delivery through improved communication, workflow, and team coordination. Across sites, supervisors and nursing leaders described interns as respectful, reliable, collaborative, ethical, and willing to seek guidance when faced with uncertainty. Limited exposure to advanced procedures and variability in supervision remained important challenges.Conclusions
The study suggests that competency-based, socially accountable medical education can produce graduates who are perceived by colleagues and supervisors as clinically capable, ethically grounded, and able to contribute meaningfully to patient care and health-system functioning in resource-constrained settings. However, strengthening procedural confidence requires increased clinical exposure, structured supervision, timely feedback, and supportive workplace-based learning environments.
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BibTeX
@article{ewnte2026shaping,
title = {{Shaping the future doctor: evaluating clinical competence, professionalism, and social accountability among the inaugural medical graduates of the university of global health equity, Rwanda.}},
author = {Biniam Ewnte and Natalie McCall and Menelas Nkeshimana and Joseph Rhatigan and Abebe Bekele and Marie Elise Ngabire and Placide Sesonga},
journal = {BMC medical education},
year = {2026},
month = aug,
doi = {10.1186/s12909-026-10074-4},
url = {https://europepmc.org/article/MED/42968111},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Shaping the future doctor: evaluating clinical competence, professionalism, and social accountability among the inaugural medical graduates of the university of global health equity, Rwanda.
AU - Biniam Ewnte
AU - Natalie McCall
AU - Menelas Nkeshimana
AU - Joseph Rhatigan
AU - Abebe Bekele
AU - Marie Elise Ngabire
AU - Placide Sesonga
PY - 2026
DA - 2026/08/01
JO - BMC medical education
DO - 10.1186/s12909-026-10074-4
UR - https://europepmc.org/article/MED/42968111
AB - Background Globally, medical education is shifting toward competency-based and socially accountable models that emphasize not only clinical proficiency but also ethical behavior and responsiveness to community needs. This shift must also address systemic challenges such as uneven supervision and limited clinical exposure. This study examined self-reported procedural confidence, stakeholder perceptions of clinical competence, professionalism, communication, and social accountability among the University of Global Health (UGHE) first cohort (2025) of medical graduates, who were trained under a competency-based, socially accountable curriculum.Methods A mixed-methods cross-sectional study was conducted among interns, supervisors, nurses, and hospital directors at five hospitals representing both urban and rural contexts. A structured survey captured interns' self-reported procedural confidence across 48 core procedures, while 16 focus group discussions (≈22 h) explored stakeholder perceptions of interns' clinical performance, professionalism, teamwork, communication, and social accountability. Quantitative and qualitative data were analyzed through descriptive statistics and thematic analysis, respectively, and integrated through triangulation.Results Interns reported moderate to high self-reported confidence in common routine and emergency procedures, including intravenous line insertion, wound care, infection prevention, oxygen administration, and patient stabilization. Lower confidence was reported for more complex or less frequently performed procedures, including lumbar puncture, pleural tap, fracture reduction, and vacuum-assisted delivery. Qualitative analysis generated four key themes: supervised clinical exposure as the foundation for procedural confidence; professionalism, humility, and respectful teamwork as markers of workplace readiness; socially accountable care through patient advocacy and adaptation to resource constraints; and interns' contribution to service delivery through improved communication, workflow, and team coordination. Across sites, supervisors and nursing leaders described interns as respectful, reliable, collaborative, ethical, and willing to seek guidance when faced with uncertainty. Limited exposure to advanced procedures and variability in supervision remained important challenges.Conclusions The study suggests that competency-based, socially accountable medical education can produce graduates who are perceived by colleagues and supervisors as clinically capable, ethically grounded, and able to contribute meaningfully to patient care and health-system functioning in resource-constrained settings. However, strengthening procedural confidence requires increased clinical exposure, structured supervision, timely feedback, and supportive workplace-based learning environments.
SN - 1472-6920
ER -