One of the main factors that demoralize health workers in rural PNG is the lack of continuing professional development and continuing medical education. It is because either they are not interested or simply they are forgotten! More often it is the later.

Usually a rural health worker will attend a formal workshop or short training of some kind because of their own persistance to look for these opportunities and by word of mouth from friends or relatives. If they just wait for someone to remember them and call them up and say “John, you must attend this workshop on malnutrition as it is in the health department policy”, then they can wait for years with nothing happening in-between.

So what should we do? I do not want to go about whose responsibility it is or who should push for this.

I just want to share my experience at Immanuel Lutheran Rural Hospital. We have now started our own continuing medical education (CME) program. The sessions are held every 2 weeks. The topics for discussion are chosen by the staff. It is usually an area of deficiency or an area with conflicting theories on patient care. I also choose some topics and these are based on common illnesses presenting to the hospital.

Some of the sessions we have had so far were on:

• Basic Life Support
•  Advanced Life Support
• Approach to women with abnormal PV bleeding
• Approach to patients who are anaemic

These are some of the topics. The response was slow initially but picking up now. The life support sessions were in high demand so we will be having more sessions just to re-enforce what we discussed in the first session.

So when I think of the issue of CME and continuing professional development for rural health workers in PNG, I think it begins with the worker firstly. They must be motivated to seek opportunities and ask around. Secondly the employing agency should have some plan for their staff to undergo some form of formal CME or continuing professional development courses at least once a year. Thirdly, the health workers themselves can organise in-house CME sessions to update their medical knowledge. It would be difficult for those working solo in remote health centres to be aware of workshops or training opportunities but the employing agency should make it their responsibility to make sure this aspect of their employee’s career is taken care of.