The introduction of medical relicensing in Egypt signifies a significant shift in how the medical profession is regulated, sparking extensive debate among healthcare professionals. However, details regarding the implementation process, assessment methods, and involvement of stakeholders remain unclear since its announcement in 2017. This PhD study aims to provide context-specific recommendations for Egyptian medical relicensing, addressing gaps in policy, education, and practice.
Using a realist-informed approach, this multi-method study explores the impact of regulatory interventions on healthcare workforce performance, investigates mechanisms and contextual factors influencing relicensing in the Egyptian context, and proposes a tailored relicensing model for Egypt. Drawing on literature from various fields such as health policy, human resources for health, pedagogy, performance, and behaviour change, the research comprises four main studies: a scoping review on relicensure, a systematic review on primary care physician performance, semi-structured interviews, and a modified Delphi study.
Findings underscore the complex interplay between doctors, regulators, and contextual factors in physician performance regulation. It emphasizes the need for a customized approach that considers local needs and cultures, the value of incorporating evaluation criteria like knowledge, skills, safety, communication, and teamwork into the relicensing process, advocates for fostering a growth mindset, continuous learning, reflective practices among physicians, and highlights assessment for learning and empowering physicians to drive improvement.
While medical relicensing holds promise for enhancing professional accountability in Egypt, current plans may fall short of realizing this potential. Proposing a model for medical relicensing in Egypt, the study provides a framework to support national-level efforts in improving physician performance. This evidence-informed framework, supplemented with recommendations for the relicensing portfolio, performance measurements, and context-specific considerations, offers a standardized yet adaptable approach. It can assist policymakers in monitoring and evaluating relicensing initiatives, aligning with both national and global health objectives.