By Sabrina Bakeera-Kitaka; Joseph Rujumba; Peninah Julianne Nattimba; Kizza Lubega; Nicolette Nabukeera-Barungi, Elizabeth Najjingo and Victor Musiime

Adolescence is a transformative period of physical, cognitive, and psychosocial development, yet health systems across the globe consistently struggle to meet the unique healthcare needs of this age group. While paediatric training traditionally focuses on early childhood survival and acute illness, young people transitioning into adulthood face distinct challenges—ranging from mental health concerns and reproductive health needs to managing chronic conditions independently. Uganda has a very young population with more than 70% of our 48.8 million people is less than 30 years, and yet our century old Makerere University College of Health Sciences, the oldest medical training institution in the country did not have a dedicated Adolescent health program for the Residents in Paediatrics.

To bridge this gap, our department recently, in the academic year 2024/25  integrated formal adolescent health training directly into the Master of Medicine (MMed) in Paediatrics and Child Health curriculum. To-date we have successfully trained 58 residents and the 3rd cohort has 27 students currently in their 2nd year of 3.Further more, the Mbarara University of Science and Technology has also started this integration this Academic Year 2026/27 and trained their 1st Cohort of Residents.

The primary objective of this curricular integration was to equip postgraduates with both the clinical competencies and communication strategies required to engage adolescents effectively. Key components of the integration include:

• Structured Clinical Rotations: Dedicated clinical exposure in adolescent-friendly clinics, focusing on standard psychosocial assessments (such as the HEADSSS framework), subspecialty transitions, and mental health screening. Our Adolescent Clinic at Makerere/Mulago was started in May 2013 and has seen over 12,000 individual clients.
• Student-led Expert Resource Sessions: These are delivered in collaboration with public health specialists, adolescent mental health professionals, and community health organizations to emphasize holistic care.
• Core Competency Workshops: Interactive seminars addressing sensitive communication, medical ethics, confidentiality laws, and chronic disease self-management strategies tailored to teenagers.

Core Focus Areas of Training

• Adolescent Development: Understanding biological puberty, brain maturation, and psychosocial transitions.
• Sexual and Reproductive Health (SRH): Managing contraception, menstrual health, STIs, HIV prevention, and safe abortion care guidelines.
• Mental Health & Substance Use: Identifying early signs of anxiety, depression, eating disorders, and substance abuse (alcohol, tobacco, and local drugs).
• Adolescent-Friendly Health Services (AFHS): Creating safe, confidential, non-judgmental, and accessible clinical environments.
• Communication & Counseling: Using frameworks like HEEADSSS (Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety)
• and Motivational Interviewing.

Early observations indicate a significant shift in postgraduate confidence and approach. Residents demonstrate improved proficiency in taking confidential histories, identifying psychosocial risk factors early, and managing complex adolescent presentations with a patient-centered approach. Furthermore, feedback from young patients highlights an increased feeling of trust and understanding during clinical encounters. More Residents are taking on Adolescent-focussed research topics as part of their Masters.

Preparing future leaders in child health requires evolving our educational frameworks to reflect the changing burden of disease and demographic realities. Integrating adolescent medicine into master’s-level paediatric training is not merely an educational upgrade; it is an essential public health intervention. We hope our experience encourages other training institutions to systematically incorporate adolescent health into their postgraduate medical education programs.