Title:Existing barriers with Health Care Workers who work in the Emergency Medical Services from Low-Income and Middle-Income Countries Accessing Affordable Continuous Medical Education due to their Low Rated Currency When Converted to the United States Dollar

According to Thibault1 there have been many changes in health professions education over the last five decades, as for the first four decades the pace of healthcare delivery reform far exceeded the pace of health care professions education reform, where once a professional completed their training, they had reached their final sign off which was known as the finished product. However, at this present time health care workers must comply with their  professional licensure laws and follow the health system standards, where they are required to maintain some form of continuing medical education, which can be provided by academic institutions, professional  associations, delivery systems and private entities where there is no finished product or final sign off, as the healthcare professional is in a state of always becoming and continuously learning to help maintain their practice at a high and effective standard1. Okoroafor et al2 highlighted one of the United Nations Sustainable Development Goals (SDG’s) is to achieve universal health coverage (UHC) by 2030. Unfortunately, there remains to be lower investments made in the continuous education of healthcare workers along with a gross mismatch of with disease burden and population needs2. Hill et al3 highlights there are several discrepancies that exist between standards healthcare provision and high income and low- and middle-income countries, resulting in a poor infrastructure and under-resourced education on healthcare Systems. Azad et al4 completed a systematic review on continued nursing education in low income and middle-income countries between 2007 and 2017 where the results gathered showed the main models utilised included train the trainer models, low dose/high frequency models, multiple media training models. In addition to strong international partnerships with an increased integration of cultural context provided a stronger level of education in terms of knowledge base and improving the patient’s quality of care4.