Growing the Emergency Medicine Pipeline in Rwanda

Joe Becker, MD, spearheads the development of a groundbreaking clerkship program for medical students, addressing the country’s evolving healthcare needs and fostering interest in emergency medicine careers.

In Rwanda, where the government is working to expand medical training, Becker plays an integral part in shaping the nascent emergency medicine residency and medical student clerkship training for the country.

In 2023, Becker launched the first clerkship in emergency medicine for 30 Rwandan medical students at the University of Global Health Equity (UGHE). The six-week program starts in Butaro, Northern Rwanda with a week-long intensive overview of the specialty and emergency department (ED) protocols, as well as a review of the most common illnesses and procedures in Rwandan EDs, such as intubation, burn treatments, and malaria remedies.

Students then rotate through three hospitals in Kigali for the next five weeks. Faculty from multiple US universities join Stanford faculty in conducting bedside teaching, demonstrating procedures, and delivering didactics every Wednesday. Because Rwandan patients often stay in the ED longer, the teaching faculty are able to conduct rounds with their clerkship students.

Becker, an associate professor of emergency medicine, developed the curriculum based on his previous work on residency training. In 2013, Becker was part of a team that developed the first emergency medicine residency curriculum in Rwanda for the University of Rwanda as part of the Human Resources for Health initiative. The four-year residency program enrolls five to eight general practitioners most years.

According to Becker, emergency medicine has become increasingly vital to Rwanda due to an epidemiologic transformation currently underway. As the country develops more paved roads, accident trauma is on the rise, while some diseases are declining, shifting Rwanda to a Western model of mortality, with increases in traumatic injury, diabetes, and heart disease.

Recruiting US faculty willing to make the journey to Rwanda is not difficult but the adjustment to different care provisions and ED experiences can be challenging. Pathologies are different and patients have fewer resources, requiring physicians to be more judicious in ordering tests. Physicians in Rwanda also encounter a higher incidence of patient death, particularly among younger patients.

Becker’s goal is to increase the number of clerkship students and residents each year. So far, the curriculum has been well received. In Rwanda, medical students typically opt for more lucrative specialties but thirty percent of the clerkship students said they would consider a career in emergency medicine. There is also talk of the second emergency medicine residency program.

May 2024

Spring 2024