Medical Education Reform in Sub-Saharan Africa: The Case for Rehabilitation Integration in Cameroon

Background The World Health Organization's Rehabilitation 2030 initiative recognizes rehabilitation as an essential component of universal health coverage. However, medical education in Cameroon systematically excludes physical medicine and rehabilitation training, creating significant gaps in professional competency and healthcare delivery. Purpose This study examines the consequences of rehabilitation education absence in Cameroonian medical curricula and proposes an evidence-based integration model aligned with international standards and regional best practices. Methods We conducted a qualitative study (2023–2025) involving systematic discussions with academic leaders (n = 12) from major Cameroonian medical institutions including Universities of Yaoundé I, Douala, and Garoua. We analyzed the pioneering rehabilitation education experience at University of Dschang, which introduced experimental rehabilitation teaching in 2021 Results Academic leaders explicitly acknowledged rehabilitation as non-priority, stating "it doesn't exist in our national curriculum, why should we teach what isn't prescribed?" This educational deficit generates delayed rehabilitation referrals, inappropriate physician-therapist financial arrangements involving 30–50% revenue sharing, and over-reliance on diagnostic imaging rather than functional assessment. Conversely, Dschang's minimal 4-hour rehabilitation exposure generated unexpected student enthusiasm for Physical Medicine and Rehabilitation specialization, demonstrating integration feasibility and unmet educational demand. Conclusions Rehabilitation integration into medical education represents a critical health system strengthening opportunity for Cameroon. We propose a structured 100-hour curriculum distributed over three academic years with mandatory clinical rotations. This model addresses current professional marginalization while aligning with WHO recommendations and could serve as a template for other Sub-Saharan African countries facing similar educational gaps and professional recognition challenges. What was already known on this topic: Prior research has documented severe shortages of rehabilitation professionals across Sub-Saharan Africa and identified educational gaps as key barriers to workforce development. Several African countries, including South Africa, Ghana, Rwanda, and francophone nations like Côte d'Ivoire and Senegal, have successfully integrated rehabilitation training into medical curricula with measurable improvements in referral patterns and professional recognition. However, systematic analysis of the institutional mechanisms that perpetuate educational exclusion and their downstream effects on clinical practice patterns, particularly the documentation of commercial arrangements between physicians and rehabilitation professionals, remained limited in the literature. What this study adds: This study provides the first comprehensive analysis of rehabilitation education exclusion in Cameroon, documenting specific institutional resistance patterns and their consequences including quantified physician-therapist commission arrangements (30–50% revenue sharing) that compromise care quality. It presents novel evidence from the University of Dschang's pioneering experience, demonstrating that minimal educational exposure (4 hours) generates substantial student interest in rehabilitation specialization, contradicting assumptions about low demand. The study contributes a detailed, evidence-based 100-hour integration model aligned with WHO recommendations and regional best practices, offering a practical template for other African countries facing similar educational gaps and professional marginalization challenges.