Universal health care is essential to ensure that everyone has access to medical treatment without falling into poverty, a challenge that remains acute in Asia and the Pacific where half the population lacks full coverage.

Despite decades of growth, many countries in the region still rely heavily on out-of-pocket spending for health services, leaving millions vulnerable to financial hardship and preventable illness when crises strike.

To help address this, we looked at institutions actively addressing this inequity, including the Ateneo de Zamboanga University School of Medicine in the southern Philippines, which emphasizes socially accountable, community-engaged education.

The school requires students to live and work in poor, rural communities each semester and dedicate ten months in their final year to community projects with local partners.

Its admissions process favors applicants from underserved backgrounds, and outcomes are measured by community impact and graduate trajectories. The approach has produced more than 500 doctors, about 80% of whom remain in the Zamboanga Peninsula, with 31% practicing in small municipalities compared to 7% from a nearby conventional medical school.

There are similar initiatives across Asia and the Pacific. In Thailand, programs such as the One District One Doctor have successfully increased the number of physicians in rural areas.

When medical education is oriented toward community needs and supported by enabling national policies, we can transform healthcare systems and achieve sustainable universal health coverage.

In Nepal, the Patan Academy of Health Sciences recruits students from rural backgrounds, embedding social accountability and espousing a curriculum that involves deep engagement and time spent with rural communities.

Also in the Philippines, the University of Manila School of Health Sciences in the Eastern Visayas offers a step-ladder program from midwifery and nursing to medicine, an approach which has been replicated in three other rural provinces in the country.

These initiatives have led to increased numbers of rural health practitioners and improvements in health metrics such as maternal and infant mortality rates.

What can we learn from these efforts about transforming medical education in Asia and the Pacific to enhance universal health coverage?

First, a single institution can significantly impact its region, carving out a niche as a leading medical and public health institution, producing a substantial proportion of the region's physicians, fostering a professional network, and shaping the healthcare system.

The measurable success of these institutions underscores the importance of tracking, measuring, and publishing outcomes, making a compelling case for investing in institutions, including private ones, to scale up effective models. This should encourage countries to increase the number of medical schools in underserved provinces.

Second, there must be a willingness to rethink and reform medical curricula, even if it means departing from traditional practices. Officials often face skepticism from both medical professionals and government entities, but they persevere. Future physicians need skills to address emerging challenges, including artificial intelligence-assisted care, climate-related health risks, telemedicine, and pandemic preparedness. Curricula must be iterative and responsive to these changing needs.

Third, medical education should align with the objectives of universal health coverage. Medical schools must embrace primary care and community-oriented training. Early curriculum encourages students to reflect on the diverse roles and competencies of physicians, embedding values of community leadership and service throughout the program.

These initiatives can thrive and transform medical education only if supported by robust national policies. Traditional accreditation requirements can hinder innovative curricular reforms. The Philippine government requires the integration of primary care and universal health coverage into medical curricula.

However, educators often encounter barriers, including access to government funded scholarships.

When medical education is oriented toward community needs and supported by enabling national policies, we can transform healthcare systems and achieve sustainable universal health coverage.