Halder J Abozait1 and Liwar M Ahmed2
1MBChB, Junior House Officer, Department of Medicine, College of Medicine, University of Duhok, Duhok, Iraq
2MBChB, Junior House Officer, Department of Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
Email: Halder J Abozait (halder01jamal@gmail.com)
Date submitted: 17-June-2025
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Citation: Abozait H, Ahmed L. Supporting transition to a two-year internship: next steps. Educ Health 2025;38:310.
Online access: www.educationforhealthjournal.org
DOI: 10.62694/efh.2025.375
Published by The Network: Towards Unity for Health
Dear Editor,
We read with great interest the article by Hamed et al. titled, “Development of a systems-based framework for transition from a one-to two-year medical internship program”.1 The authors provide a timely and comprehensive evaluation of faculty perspectives on this significant reform in Egypt’s medical education system. As practitioners ourselves, we commend the application of a systems-thinking framework and the integration of both qualitative and quantitative insights to guide the transition.
The findings reflect the reality many institutions face: while the benefits of extended internships are widely acknowledged, the infrastructure and supervision challenges remain formidable. Notably, the 98% absence of effective information systems and 90% concern over ethical safeguards highlight structural deficiencies that cannot be addressed solely by increasing internship duration. Instead, they require deliberate investments in faculty development, digital infrastructure, and learner well-being.
We wish to underscore the critical need for involving interns and recent graduates in future studies and implementation strategies. While the faculty perspective is indispensable, the lived experiences of interns navigating this transition—especially regarding workload, mentorship quality, and competency tracking—would enrich the proposed framework and identify blind spots in policy design.
Additionally, the proposed macro–meso–micro systems approach offers a strong conceptual base but should be accompanied by costed action plans and institutional accountability metrics. We suggest that pilot implementation with regular feedback loops may be more feasible than full-scale national rollout, allowing policymakers to adapt and refine strategies in real time.
Lastly, this work sets a precedent for other countries contemplating similar reforms. The proposed integration of ethical guidelines, equity mechanisms, and continuous quality assurance into the training ecosystem aligns with best practices in global medical education. However, translating these ideals into practice requires unwavering political will and inter-sectoral collaboration.
1. Hamed O, Wasfy N, Saleh R, Rizk M. Development of a systems-based framework for transition from a one-to two-year medical internship program. Education for Health. 2025;38(1):31–45. https://doi.org/10.62694/efh.2025.204.
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Education for Health | Volume 38, No. 3, July-September 2025