Allocating scarce resources to competing sectors has always been a major challenge for policy-makers, planners and administrators. As the cost of healthcare continues to escalate and the burden of diseases make faster demands on the budget, there has been greater recourse to public debate on the issue. A major underpinning of this debate focusses on the ethical issues inherent in the decision-making process as they affect life, living and death – all in the context of “quality of life”.

Access to an adequate level of healthcare is a function of affordability to both providers and users including the indigent. The primary healthcare strategy was envisaged as a holistic approach to improve the population’s quality of life. The more recent Millennium Development Goals are a further initiative with the same objective.

There is a trend towards the use of complementary/alternative medical care practices by persons in both developed and developing countries. Surveys have shown that patients expect their physicians to provide them with advice on which of these methods might be useful to complement the conventional medical practices. Medical schools at present are not offering enough information to undergraduates in order for them to carry out this important function.

Creative thinking and entrepreneurship were the driving forces which opened new opportunities for medical training to be available and accessible to persons previously denied because of “artificial” barriers. The concept of offshore medical schools was born out of these circumstances and an attempt to challenge the status quo of the privileged few.