“In 1979, “at the instigation” of the WHO, 19 medical schools formed the Network of Community-Oriented Educational Institutions for the Health Sciences. The goal was for institutions to help each other develop training programs that spoke to the health problems of local populations, notably underserved populations, outside the hospital setting. The need to respond to local needs and problems suggested that curricula be problem-based, as was occurring in newer institutions like McMaster University (Canada), Ben Gurion University (Israel), Gezirah University (Sudan) and University of lllorin (Nigeria), all among the founding institutions of the network. In addition to “community-oriented” and “problem based”, terms that were interpreted in assorted ways, there was emphasis on newer “active” pedagogical methods rather than passive rote learning; this included self directed independent study and lifelong learning. By 1990 the network had expanded to 54 member institutions and 80 associated members [43]. The largest groups were in the Americas (45) and Europe (39) with 20-22 institutions in each of the four other regions. A review of published studies on the effects of problem-based and student-centered programs found that their graduates chose careers in primary care in greater numbers than those in conventional programs who did slightly better on traditional measures of academic achievement (examinations). Attempts to measure actual clinical competence were inconclusive [44].”

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The World Health Organization and the global standardization of medical training, a history