Medical education in Syria at a time of crisis: Analysis of the results of the knowledge‐based National Medical Examination

Abstract

ObjectiveThis study explored how the Syrian crisis, training conditions, and relocation influenced the National Medical Examination (NME) scores of final‐year medical students.MethodsResults of the NME were used to denote the performance of final‐year medical students between 2014 and 2021. The NME is a mandatory standardised test that measures the knowledge and competence of students in various clinical subjects. We categorised the data into two periods: period‐I (2014–2018) and period‐II (2019–2021). Period‐I represents students who trained under hostile circumstances, which refer to the devastating effects of a decade‐long Syrian crisis. Period‐II represents post‐hostilities phase, which is marked by a deepening economic crisis.ResultsCollected data included test scores for a total of 18 312 final‐year medical students from nine medical schools (from six public and three private universities). NME scores improved significantly in period‐II compared with period‐I tests (p < 0.0001). Campus location or relocation during the crisis affected the results significantly, with higher scores from students of medical schools located in lower‐risk regions compared with those from medical schools located in high‐risk regions (p < 0.0001), both during and in the post‐hostilities phases. Also, students of medical schools re‐located to lesser‐risk regions scored significantly less than those of medical schools located in high‐risk regions (p < 0.0001), but their scores remained inferior to that of students of medical schools that were originally located in lower‐risk regions (p < 0.0001).ConclusionAcademic performance of final year medical students can be adversely affected by crises and conflicts, with a clear tendency to recovery upon crises resolution. The study underscores the importance of maintaining and safeguarding the infrastructure of educational institutions, especially during times of crisis. Governments and educational authorities should prioritise resource allocation to ensure that medical schools have access to essential services, learning resources, and teaching personnel.

Translation, cultural adaptation and linguistic validation of the postgraduate hospital educational environment measure into Arabic

“…Therefore, the authors recommend the addition of two domains: the perception of available resources which should be designed to measure the available hospital resources and investigate how it affects working and learning; secondly, the perception of psychological support which should be designed to evaluate the psychological burden of working in under-resourced and chaotic hospital setting in a war-ravaged country like Syria. Availability of resources affects residents ability to practice medicine effectively and henceforth learning on the job especially in an age where medical technology and equipment are fundamental for everyday practice; although literature of the effect of lack of resources on teaching hospitals in Syria are scarce, recent papers has highlighted the effect of war and resource availability on medical students’ performance [ 37 ] and their perception of the learning environment [ 21 , 38 , 39 ]; some residents can miss out the chance to practice essential procedural skills for this reason [ 34 ]. As for the psychological health domain, studies have numerously showed the negative effect of war on psychological health of residents and having items to address, assess and bring forward this important area in our vulnerable context is very important from an educational perspective as well as wellbeing perspective [ 20 , 40 , 41 ].…”