The main difficulty of our study was the collection of the teachers filled out questionnaire with 67.2% of the response. This rate is lower compared to a similar Algerian study in the French department with 100% return [5]. It be explained by our survey method (mail). It is well known that the response rate of online surveys without financial incentives is generally between 6% and 15% lower than traditional methods as hand by hand [6,7]. In addition, it is not excluded that teachers had being reserved to judge LMD reform which is newest. The majority (64.5%) of medical school’s teachers had not received training on LMD reform since its introduction. This could limit its understanding by them in applying. The absence of training before the introduction of the LMD reform in African universities was pointed out by HUGON [8]. In Algeria [5] several university partners (teachers, students, and administrative staff) complained that the LMD reform was hasty, specifically the problem of teacher’s training. However, 56.6% of Lomé’s teachers had being trained in new ICTs. In Mali, Fomba and collaborators in 2011, found that only 22% of teachers had sufficient skills about computing and its use [9]. The mostly methods of teaching used were handout (89.5%) and power-points (82.9%). Only 60.5% of teachers provided digital version of their courses to students. In a previous study including all the faculties of University of Lomé, the medical school was the rare faculty where new technologies had more being used for teaching [4]. Our results are similar to Bachir’s [10]. This study shows that teachers are making efforts in adapting to the core of LMD system, namely using new technologies. No course provided in medical school as in other faculties of Lomé University was online [4].
According to the teachers, one of the strong points of the LMD reform in medical school was the best system of evaluation. The evaluation in the LMD reform requires 3 examinations: one test in the middle, one in the end of semester and one for the resit. As all students of university are mixed during the evaluation, that’s limiting cheating. Most of teachers (28.6%) recognized also that the LMD reform upgrade the university of Lomé to be on international standards. It will be facilitating the recognition of the diplomas delivered and the transhumance of students worldwide [11–13]. The organization of education in the teaching units has been the core of the LMD reform in several African universities [9, 10, 14,15].. The ICTs have revolutionized many aspects of educational lives, including teaching and learning and become inevitable in higher education [16–18]. But it is a big challenge for most developing countries due to many socio-economic and technological circumstances [19]. The LMD fostering their using then, it is better thing provided (23.8%).
The absence of intermediate diploma (29.3%) and pathways between different study branches of medical and paramedical training were the main weakness of LMD reform since its introduction. Indeed, in accordance with the principles of the LMD system, the first purpose of the introduction of this reform in the medical schools in Togo was to combine the license of all branches of health studies. The orientation in Master of each study should be done by merit order: the best students in research master for medical school and others in professional master for paramedical training according to a numerus clausus. The first application of this principle led to a successful claim of all the students whose had validated the license. Therefore, all students had continued medical school instead of some being oriented in the paramedical schools. This situation was responsible of plethoric number of students and has forced to reintroduce the numerus clausus in the first year. Finally, there is no intermediate diploma and pathways of students up today as hoped. This organization has been very successful in France with more than 6 common studies in licence and orientation according the merit [20].
The others aspects for improving LMD reform were: increase human and material resources, putting all the courses online, organize more practice and workshops, foster students’s presentation and homeworks This is a general situation in others African universities
Despite these difficulties, the LMD system is not a choice for our universities, but a necessity to upgrade the training [21].
Limitation
The main limitation of our study is related to the unwillingness of some teachers to give their opinion on the LMD reform.