Local areas of impact Achievements
1. The educational aspirations of the UMCG and SEHOS The UMCG elective program has resulted in an educational infrastructure that effectively caters for the exposure of Dutch medical students to the practice of medicine in a resource limited environment. This resulted in a concomitant need and opportunity to offer training electives in internal medicine, pediatrics, neurology, general surgery and emergency medicine to Dutch and Belgian residents.[@26049] The opportunities for clinical and educational scientific research among residents and local specialists have resulted in several PhD dissertations and scientific publications.[@26046; @26047; @26048] These results have further strengthened the educational setting on the island with several long term research and concomitant educational programs on (locally) relevant topics like clinical leadership, HIV and emerging infectious diseases in collaboration with UMCG and other international institutes.
2. Continuous professional development of local health care providers One of the objectives of SEHOS is ensuring that the professional competencies of their staff is maintained in their chosen domains of expertise. Participation in continuous professional development is therefore mandatory. The continuous and steady influx of trainees to the hospital also helps sustain this process of ongoing professional development in teaching faculty through the vibrant educational climate and the stimulating academic discussions that emerge from the challenging questions the young and eager students pose to the teaching faculty. Hence, local faculty (medical specialists) have had to be trained in the new and current forms of educational practices, while keeping their knowledge of discipline up to date in a critical and learning environment. This has resulted in the development of a specific curricular framework in SEHOS that aligns with the educational objectives of the Dutch and UMCG medical curriculum.[@26041; @26050] Teacher training programs designed in collaboration with the UMCG are provided annually to local medical professionals to improve the quality of teaching and supervision of trainees. (e.g. Teaching on the run).[@26051] Furthermore a Dutch accredited post-graduate educational program on varying medical topics is provided by the NASKHO on a monthly basis (see www. NASKHO.org).
3. Transformation of the local health care delivery process, The collaborative efforts between the UMCG and SEHOS over the years have fostered extensive academic networks between local and Dutch medical professionals. A couple of health care projects that have been jointly initiated and realized include departmental quality improvement audits, staff support initiatives through modern communication technologies (e.g. electronic patient rounds, video conferences) and improved patient care through referral services to tertiary centers in the Netherlands (e.g. pediatrics with UMCG and Academic Medical Center Amsterdam, hematology with Erasmus Medical Center, Rotterdam). This network has also facilitated various continuous professional education initiatives[@26051], which have been expanded to include UMCG supported postgraduate training programs for nurses.
4. Provision of improved health services to the inhabitants of the island The presence of a residency program in Curaçao has had positive effects on the hospitals clinical infrastructure (e.g. the opportunity to offer tertiary health care services to vulnerable and premature children in a NICU) as well as, impetus for national healthcare reform in Curaçao (i.e. the development of a reference document for the implementation of competency based health care delivery on the island)[@26049]. These developments align with the aspirations of global health as well as the principles of transformational learning i.e. developing a continuous learning organizational environment that can even serve as a structural basis for health care reform in a resource limited setting.[@26033; @26041]