Learning from low income countries

Editor—Richards and Tumwine ask for discussion on the subject of poor countries making the best teachers.¹ When will the postgraduate tutors and royal colleges recognise that medical experience in developing countries should be counted towards specialist registrar training?

I recently spoke to a specialist registrar whose 12 months in the main teaching hospital in Malawi counted for nothing towards his training. As a specialist registrar training in chest medicine, he will have seen more tuberculosis than most chest physicians working in provincial England will see in a lifetime. This is particularly frustrating as the numbers of cases of tuberculosis are rising progressively in the United Kingdom, and training in the diagnosis and management of this disease needs to be improved as much as possible.

An argument could be made for making training in the developing world compulsory for any doctor who might encounter tuberculosis in his or her clinical practice as a consultant in the United Kingdom. Instead, the powers that decide what is and what is not medical training ignore it completely.