Table 2.
Comparing contexts in which medical education takes place for the sites of this study and countries in the global North with prolific outputs of HPE research1: Crude measures of healthcare system efficiency and disease burdens (WHO, 2020)
| Indicators | USA | Canada | UK | Nether-lands | Aus-tralia | South Africa | Mexico |
|---|---|---|---|---|---|---|---|
| Economic and educational indicators, where schooling takes place | |||||||
| PIRLS: international achievement in reading (2016)2 | 549 | – | 559 | 545 | 544 | 320 | – |
| TIMMS: countries average mathematics and science achievement (2019) 2 | 528 | 518 | 523 | 528 | 524 | 364 | – |
| GINI co-efficient (2022) 3 | 41.1 | 33.3 | 35.1 | 28.1 | 34.1 | 63.0 | 45.4 |
| Per capita GDP (USD) | 63.6 | 43.3 | 41.1 | 53.4 | 51.7 | 5.7 | 8.3 |
| Resourcing and staffing of healthcare, where medical education takes place | |||||||
| Per capita health expenditure (USD) | 10 921.01 | 5048.31 | 4312.89 | 5335.30 | 5427.46 | 546.69 | 540.37 |
| Density of medical doctors (per 10 000 population) | 26.1 | 23.1 | 28.1 | 36.1 | 36.8 | 9.1 | 23.8 |
| Density of nursing and midwifery personnel (per 10,000 population) | 145.5 | 99.4 | 81.7 | 111.8 | 125.5 | 13.1 | 24.0 |
| Burden of disease, that clinician educators in medical education contend with | |||||||
| Maternal mortality ratio (per 100 000 live births) | 19 | 10 | 7 | 5 | 6 | 119 | 33 |
| Under-five mortality ratio (per 1000 live births) | 7 | 5 | 4 | 4 | 4 | 34 | 13 |
| Neonatal mortality rate (per 1000 live births) | 4 | 3 | 3 | 2 | 2 | 11 | 8 |
| New HIV infections (per 1000 uninfected population) | 0 | 0 | 0 | 0 | 0.04 | 4.94 | 0.08 |
| Tuberculosis incidence (per 100,000 population) | 3 | 5.6 | 8 | 5.3 | 6.6 | 520 | 23 |
| Life expectancy at birth (both sexes; years) | 78.6 | 82.8 | 81.4 | 81.6 | 82.9 | 63.6 | 76.6 |
1To illustrate the health professional education (HPE) North–South gap; the vast majority of HPE outputs were produced by “Northern” countries, with the USA, UK, Canada, Australia and Netherlands accounting for the top 5 country affiliations for medical education publications (Doja et al., 2014; Maggio et al., 2022; Rotgans, 2011; Tutarel, 2002)
2Trends in International Mathematics and Science Study (TIMMS) and Progress in International Reading Literacy Study (PIRLS) are international assessments, currently taken in 70 countries since 1995, that monitor trends in student achievement in mathematics, science and reading, and are used as an indicator of the quality of basic education systems; with lower scores representing poorer academic performance
3The Gini co-efficient, index or ratio, a measure of statistical dispersion, measures income or wealth inequality; with lower values as more equal and higher values as less equal (e.g. a Gini co-efficient of 60.0 means that the richest 20% of a population holds 80% of all income)