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About SCOME
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Contents

History

Medical Education should be a concern of every medical student as it shapes not only the quality future doctors, but also the quality of healthcare. IFMSA has a dedicated organ which aims to implement an optimal learning environment for all medical students around the world- the Standing Committee on Medical Education (SCOME). It was one of the IFMSA's first three standing committees from the beginning of its foundation in 1951. IFMSA SCOME acts as a discussion forum for students interested in the different aspects of medical education in the hope of pursuing and achieving its aim.

Mission

Health Care is changing at an unprecedented rate and at multiple fronts. Technology has revolutionized archaic diagnostic and therapeutic procedures. Medical science has increased our understanding of the body and created an explosion of new information. Patients are increasingly questioning and less trusting their doctors. But medical schools are not or only slowly introducing changes in their curriculum. Teachers at many medical faculties are not educated to teach, they are doctors and mostly lack knowledge of how to show their skills to their students.

We question that students educated in a so-called traditional curriculum are able to face the needs of healthcare in a modern society. Scientific data show that modern medical curricula are a lot more likely to teach students in an appropriate way in order to create doctors equipped with various skills and knowledge. Although there are a number of innovative approaches to teaching medicine, partly based on findings of cognitive science, change in medical curricula occurs slowly and at few medical schools. The need for change is either not recognized or ignored in many universities.

As medical students are directly exposed to medical curricula, they should rightfully be assumed to be experts on their educational system, and should therefore have an influence on the creation of new curricula. From IFMSA experience, it is often the medical students who are the strongest proponents for adapting their education to the needs of their community.

Here SCOME comes into the game. We try to promote modern medical education. Convinced by many positive examples we go on that mission by teaching and training students and professors, exchanging experiences and spreading information.

As a global grassroots organization of medical students locally active in more than 90 countries worldwide, IFMSA has made meaningful contributions to improve medical education over the last decades.

On our way to improve medical education

In most of the cases it is rather hard to improve our educational system. In most of the countries there is no tradition of integrating students in faculty development. Sometimes they even are not member of decision-making bodies within the schools or they are only a minority in those. So statements and proposals of students do not have a high value for stakeholders. This situation is well known to most of us. Why would you write this here? Rather: We must be aware of this well-known situation causing multiple problems. Our strategy has to be adapted to these circumstances. How?

In the last years we worked mainly in three fields:

a) Locally

The most promising strategy for change is a local approach. Even if students do not have a majority within the faculty boards students could convince deans, professors, teachers and stakeholders to develop their education. In a constructive and cooperative way one can find many small solutions to make life easier. To get some ideas of how to approach see "concrete suggestion" below and exchange experiences with other NOMEs.

To enable NOMEs and LOMEs to facilitate improvement on the local level one of the main activities within SCOME are trainings. These trainings cover all fields within medical education, like assessments and exams, evaluation, teaching and learning systems, problem-based-learning, community-based-learning, computer-based-learning, policies of government and ministries, …). It is important to provide as many trainings as possible. These trainings will be held on general assemblies, as pre-GA-Workshops, on regional and national meetings and on special international training workshops.

b) International projects

(Check Project-Section to learn more about the recent projects)

We have different types of international projects:

Database projects
The main objective of these projects is to collect information (e.g. about curricula, residencies, …) and to provide it to all, mainly on behalf the internet.
 
Research in Medical Education
We support and encourage students to do research on the field of Medical Education. Therefore we work together with the scientific student conferences, where we initiate medical education sessions and provide workshops. Furthermore we have our own research projects.
Courses
After students found a lack of a special topic in their curriculum they initiate courses. Students also invite guest speakers and experts themselves. If these courses lead to a success and the interest of the students is high enough, the medical school will accept to integrate them in the curriculum eventually. There are many courses run by students.
 
Trainings
To improve our knowledge and skills we organize training workshops.

c)  International lobby

There are some international organizations dealing with medical education. We try to co-operate with them and to represent the students´ thoughts and wishes on the international level. In some cases these ideas find their way back to the national and local level. Actually we are working together with World Federation on Medical Education to define, disseminate and implement global standards in basic medical education. It is the task of the NOMEs to find out which possibilities they have to work in a similar way on the national level.

Policy statements

"First policy statement of IFMSA" (1951-1970)
"Declaration on Primary Health Care and Medical Education" (1979)
"Policy declaration on Primary Health Care" (1980)
"Policy Declaration on Medical Education" (1980)
"Resolution on Medical Education" (1983)
"Students Assessment"
"IFMSA Recommendations on Implementation of the Continuous Medical Education in Medical Curricula" (1999)
"Impact of Technology on Health Education" (2001)
"Implementing International Standards in Basic Medical Education" (2001)

"The Bologna Declaration and Medical Education"
 

First policy statement of IFMSA: 1951-1970 - Impact of Technology on Health Education

Health

Considering the WHO definition of health, a condition of complete, mental and social well being, considering the fact that IFMSA members are the world's future doctors, two items will be stated:

  1. The medical students, as future doctors, should have one central aim: to serve the people.
  2. The medical students' association should have one central aim: to fight for better health of all people in the world and to mobilize, involve and motivate the student.

As an important issue it should be emphasized that any health care system in a country should be in accordance with the needs and wishes of its people. In accordance with the laws set by the World Declaration of Human Rights, there shall be no distinctions in the treatment of patients and the provision of basic health care needs made on financial, political, social or religious grounds. Therefore all patients are equal.

Professional interest

IFMSA studies and promotes the professional interest of medical students throughout the world in the accordance with the above principles. Accordingly IFMSA will, within its capabilities and constitution, support the following principles:

  1. It is the right of medical students to participate actively in the discussions and decisions concerning medical education and general universities problems as well as other problems.
  2. Students should all actively through students' union or through elected representatives be able to participate and vote in student-relevant decision-making bodies, faculties and universities.
  3. The rights of the students' representatives attending such decision-making bodies should be equal to that of the academic and nonacademic staff.
  4. Student representatives must be entitled to discuss with the student population on matters dealt within such decision-making bodies.
  5. Admittance to universities should be free of charge and the necessary books and instruments should be provided for free. In addition all needy students should be financially supported.

Right to study

It is the right of every student irrespective of his race, his political or religious believes, or his socio-economic conditions to be allowed to begin the medical courses within limits of the national health plan, and to accomplish his studies.

Medical education

IFMSA states the great efforts must be made  to improve the standards of medical education in accordance with the principles mentioned in article 10, by investigating and introducing better teaching and examination methods, as well as by investigating other aspects and by promoting a wide discussion and publicity of the subject. Medical education in developing countries should be in accordance with the medical needs of the people. Foreign systems should not be forced upon them.

Medical research

IFMSA states the it is the duty of any present or future doctor to participate in the further development of medicine within his/her capabilities, and that this participation should be in accordance with the principles stated in article 10. In case it consists in biomedical research, the principles of the World Medical Association Declaration of Helsinki, as revised in Tokyo, are to be followed.

Professional exchange

IFMSA aims at strengthening the relations among students by a scheme of professional exchange of medical students among various countries and by promoting an organization of medical schools.

Activities

IFMSA is to promote activities that encourage medical students to contribute constructively and critically at an early stage towards the solving of health care problems, i.e. in serving people.

Publications

IFMSA publications comprise a journal, a news bulletin and reports. IFMSA shall keep in close contact with the press and shall encourage the publishing of news of interest to and concerning medical students' associations and other interested bodies.

International organizations

IFMSA can act as link between, and co-operate with, international and other organizations, the Federation shares similar interests with.

Declaration on PRIMARY HEALTH CARE AND MEDICAL EDUCATION

Adopted by the IFMSA - 28th General Assembly Kiljava (Finland ), August 1979

 

The IFMSA affirms the basic inalienable right of every human being to proper medical health care.

 

The medical care services and practices involve care of women and men through successive stages of their lives from conception to death including fetal life, birth, childhood, adolescence, reproduction, middle age, old age and dying Ð as individuals, in families, at home, at work, in health and in mental   and physical illness.

 

Medical Education is not an aim in itself. It should be an aim-oriented endeavor, which trains the perspective medical personnel to meet the health needs of their societies.

 

The IFMSA notes that the education of medical students in the countries which it represents is mainly structured on the technological mode of hospital based medicine. The doctors thus produced are often inappropriately trained to serve the needs of their community. In the developing world this results in the concentration of health personnel in centers of technological excellence, often at the expense of the needs of the majority of the population especially in the rural areas.

 

While in the industrialized nations it is exemplified by the failure to actually eliminate the major causes of morbidity paying too little attention to the part that may be amenable to preventive medicine in its various forms.

The doctors in their present training remain alien to the communities they serve not able to alleviate much of the pain and suffering connected with disease.

 

The IFMSA believes that practical training and teaching in PHC must be central to medical curricula. This should concentrate on the principle of prevention and therapy in the community including health education and total care of the persons from conception to death with an increasing emphasis on the emotional, psychological and social factors of human health and disease.

Instructions and demands

In the light of the discussion and the definition above, we instruct the EB of IFMSA and SCOME to collect and circulate information on PHC systems and teaching in all countries.

We instruct the IFMSA NMOs to press for development of PHC systems in their countries and changes in medical school curricula to prepare doctors for work in this field.

This should include:

  1. Development of effective PHC teaching based around centers where it is practiced and taught by those professionals involved in it.
  2. More emphasis on selection of medical students highly motivated to serve the community. The students should be truly representative of the social structure in their country.
  3. Encouragement and participation in PHC research.
  4. The IFMSA calls upon NMOs to join with students in health related fields in their countries to work together in order to defend and promote the interests of the patients in the context of a fully comprehensive health service.

The NMOs are to report to the SCOME on their activities in PHC related areas both academically and practically.

 

We instruct the  SCOME to co-ordinate in conjunction with WHO the dissemination of information concerning curricula, national and community programs, and PHC, as well as the distribution of the reports of the NMAs and to encourage the cooperation between students of the various health-related professions; doctors, nurses, physiotherapists, psychologists, social workers, etc. forming  a team dedicated to the abolition of pain and suffering through prevention, primary care and other means.

 

We suggest that in the next GA in 1980 a seminar should be held on the topic of PHC which should include education curricula and national health care programs.

 

We instruct the EB to distribute this declaration to all medical faculty deans in countries affiliated to the IFMSA as well as the AMEE and WHO, and the major news agencies.

Policy declaration on PRIMARY HEALTH CARE

Adopted by the IFMSA -29th General Assembly
Cairo ( Egypt ), August 1980

 

In consideration of the Declaration of Kiljava on PHC and ME, made at the 28th GA of the IFMSA, the 29th GA makes the following resolutions:

 

  1. There should be a department of ÈPrimary careÇ or ÈCommunity MedicineÇ in every medical school. Students should be taught in these areas from their first year of study. Particular emphasis needs to be placed on communication skills both to facilitate personal interactions and to allow and to allow doctors to teach their communities about PHC. Teaching in these departments should be done by professionals from all these disciplines that are involved in the delivery of PHC. The departments should also ensure a continuing emphasis to PHC in all traditional medical specialties. Whenever possible those teaching the specialties should also have personal experience in the PHC area. The use of a patient oriented approach to health problems as distinct from a purely technological or medical orientation should foster at all levels of student teaching.
  1. Selection: Procedures only on marks obtained at high school level do not select medical students highly motivated to serve the community. Alternative selection procedures have been successfully developed, medical schools should adopt these methods or develop others suited to the needs their community.
  1. National member associations should press the responsible authorities to provide ways of improving the attraction and status of PHC work to practicing doctors. The present law status of PHC can be seen to reflect back directly to the low levels of interest and motivation for this area of training shown by medical students. Measures to be taken could include the prevention of direct financial incentive for PHC work, but should also involve the provision of extended educational opportunities, professional links to other doctors and hospitals and the opportunity to participate in some ongoing research. Research in the area of PHC itself would be particularly appropriate.
  1. Field trips and direct PHC experience followed by the appropriate theoretical introduction, discussion and critical evaluation, should be the essential basis of the teaching of PHC. Students need however to be aware of the problems of generating and maintaining such contacts with the area, be they physical (such as transportation), cultural (such as language or social class differences), or political such as maintaining access to, say, a factory).
  1. National Member Associations are urged to pursue activities that will improve students' awareness of PHC issues, and foster a positive attitude towards work in this area. This could be by student-generated projects that work within the community or by the organization of seminars and discussion papers on the subject. All such undertakings should be reported to SCOME, which can act as a resource centre for ideas in the area.

Policy Declaration on MEDICAL EDUCATION

Adopted by the IFMSA - 29th General Assembly
Cairo (Egypt), August 1980

 

As the future doctors of the world, we view with great concern the present state of our medical education.

The aim of medical education (ME) must be to prepare the medical students to meet with professional excellence the health needs of the population they serve.

 

Medical education today is largely based on traditional models and employs inadequate methods that are not conductive to the achievement of professional excellence. In order to improve the ME in accordance with its aims the following topics must be addressed:

  1. ME goals
  2. ME, curriculum planning and evaluation
  3. The selection of medical students
  4. The size of the medical class
  5. Teaching quality
  6. Examinations
  1. ME Goals Medical schools must clearly define the goals of their educational activities. Educational goals must reflect the health needs of the population for which the doctors are trained. Educational goals must be defined jointly by health care planners, who are ware of health needs, medical school educators and representatives of population. We call upon all medical schools to undertake the establishment of such stated goals.
  1. ME, Curriculum Planning and Evaluation The medical school curriculum must serve to meet the stated goals. Curriculum planning must be undertaken jointly by medical school educators and health care planners. There must be a permanent committee to assess continually the relevance of course work with regards to its effectiveness in achieving the stated aims of the medical school. We demand that the medical schools establish such committees, consisting of educators, planners and students, where decisions will result from equal participation of these three groups.
  1. The selection of Medical Students The admission process of medical students must be aimed at accepting those students that are motivated capable of achieving the stated goals of the medical school. We feel that under no circumstances full reliance on academic record in the selection of medical students is adequate. We call upon medical schools to establish selection procedures that also take into account the human qualities that are necessary for production of a competent medical practitioner.
  1. Size of Medical Class The size of medical class has great influence on the quality of medical education. There must be continuous efforts to decrease the size of medical classes.
  1. Teaching Quality Teaching staff should be selected, promoted and reviewed on the basis of their demonstrated ability to teach and not only on the basis of the quality of their research. Student feedback must be an important component in the assessment of the teaching competence. Medical faculties should offer the framework for teachers to improve their teaching through seminars, consultations and other necessary means. Stated aims of course content should be available to the medical students. Methods and structure of teaching should be selected in a way that can maximize the learning effectiveness of the medical students in accordance with the stated aims of the course content.
  1. Examinations The main aim of medical school exams is to ensure the competence of the tested students in the particular subject. Students should be tested on clearly defined subject matters. Choice of testing methods shall not be influenced by the personal bias of the teaching staff.

Resolution on MEDICAL EDUCATION

Adopted by the IFMSA - 32nd General Assembly L'Aquila (Italy), August 1983

 

Due to the growing concern about the tendency in the world's medical education system towards increasing the duration of the period required to train fully competent medical doctors:

  1. Considering that the constant increase in health-related scientific knowledge necessitates a selection of what may comprise the basic curriculum of medical school, and that the selection criteria should be based on the skills needed to improve the health of society.
  1. Considering that at medical schools there is no explicit definition of the medical doctors' professional profile.
  1. Considering that in general, medical examinations are not adequately measuring whether or not the competence corresponding to the solid professional profile has been reached.
  1. Considering that a valid evaluation of an acceptable level of professional competence enabling a medical doctor to function independently must measure solid competence and not the length of a medical education program.
  1. Recognizing that a medical doctor must acquire lifelong learning skills and that these skills must be learned in the basic medical education program.
  1. Recognizing the needs for the availability of educational programs in all medical fields after licensure for practicing independently.
  1. Noting that a postgraduate education program should not be used to compensate for a basically ineffective undergraduate education or poor quality health manpower plan.

The IFMSA resolves that before decisions be taken to increase the length of time before which licensure to practice independently can be granted, the cost effectiveness of the present basic medical education programs must be thoroughly evaluated in the professional competency profile which would respond to the health needs of the society so as to reach the goals of Health for all by the year 2000.

IFMSA position paper on student assessment

This IFMSA statement seeks to delineate the problems medical students are facing on an international level regarding assessment in/of medical education.

Objectives:

  1. To outline the skills a medical student should acquire during his or her medical studies in order to become a good physician.
  2. To outline the problems in assessment of medical students that hinder the acquisition of such abilities.
  3. To define the pedagogical role of assessment in medical education.
  4. To find alternative methods or improve the ones already existing in order to overcome problems of objective 2) above.
  5. To support any other proposals that would help to achieve improvements in student assessment.

1. IFMSA considers it necessary for a medical student to acquire the following skills during his or her medical education:

  • to be able to assimilate, integrate and apply medical information in the manner most profitable for the patient and the society.
  • to be able to bear in mind the humanitarian and ethical aspects of any his or her decisions.
  • to be able to perform a meticulous clinical examination.
  • to be able to attach the due importance to the patient-doctor-relationship.
  • to be able to undertake efficient interaction with other members of the medical professions.

2. The traditional methods of assessment in medical education confront us with the following problems:

  • They do not allow enough space for the development of the full individual in each medical student.
  • Instead of promoting the students´ ability to learn actively and solve problems, some assessment methods rather induce a passive attitude in the student. Reproduction or, even worse, recognition of information is given more importance than analysis and problem solving (MCQ).
  • On the other hand assessment methods with direct teacher-student-contact can never guarantee full objectiveness.
    Furthermore we find that the lack of standardization between medical faculties in different countries limits the mobility of students.

3. IFMSA believes that student assessment should transcend its present dimension of solely passing or failing students to one that is more pedagogically oriented. This should mean that the assessment would be a platform for motivation without undue competition: The student have the possibility to see that what will be required from him or her in any kind of exam is of relevance to his or her future work as a physician. Moreover there should be a feedback for both students and medical teachers providing both with information on the level the student has reached in his or her medical education. Assessment should allow the student to view the patient in his or her entirety (i.e. without labels of medicine, surgery, etc.).

4. IFMSA considers the following as possible solutions to the above problems:

IMPROVING EXISTING METHODS OF ASSESSMENT:

  1. Oral exams should be performed as comprehensive exams, viewing the patient in his or her entirety. Objectivity should be increased by using exam commissions instead of single examiners and keeping minutes of each exam.
  2. Essays should be corrected according to a standardized answer sheet. They should be patient-centered.
  3. Practical exams should comprise basic clinical skills.
  4. MCQs should never be used as the sole method of assessment. They should only be used provided there is continuous evaluation and feedback.
  5. Assessment should always be based on a variety of methods. All these methods should follow a standardized protocol in an effort to maximize the objectivity of the method. Anonymity should be safeguard as far as possible. Students should receive feedback about their performance in all exams undertaken.

INTRODUCING ALTERNATIVE METHODS OF ASSESSMENT

IFMSA is of the opinion that alternative ways of assessment in medical education should play a much larger role than they have so far had. Among the methods to be taken into consideration should be:

  1. OSCE (objective structured clinical examination), involving the testing of various practical skills via a number of stations, each having a checklist to assess the performance of the student.
  2. continuous assessment and feedback on wards, contributed by all members of the team.
  3. continuous assessment using the same set of questions throughout the whole curriculum (students from different semesters would expected reach different levels)
  4. paper cases with several steps (each subsequent page would give further information on the "paper patient")
  5. assessment of communication skills using video cameras
  6. utilization of the group process in tutorial groups as a means of assessment in order to strengthen collaboration and reduce competition among students.
  7. introducing quality assessment of curricula and medical teaching staff by the medical students themselves that has official and substantial bearing on the rewarding of teaching posts.
  8. rotation of examiners in a regional group of medical schools or presence of external examiners, so as to improve objectivity.

GENERAL COMMENTS

Preparation for medical assessment should allow enough free time to develop the full social and cultural potential in each medical student. Students should be provided with guidelines and a framework of studying. The methods of assessment and the minimum requirements for passing should be made available to the students at the beginning of the course of studies. Flexibility concerning the sitting for exam sessions should be guaranteed.

Assessment should lead to one universal degree for medical doctors.

The better the assessment of medical students is, the better is the quality of future medical care to be provided for the whole society.

IFMSA Recommendations on Implementation of the Continuous Medical Education in Medical Curricula

Adopted by the participants of the 5th IFMSA Workshop on Medical Education: Life Long Learning, The Former Yugoslav Republic of Macedonia, October 1999

Definition of Continuous Medical Education (CME)

Medical education never ends. It doesn't stop upon graduation from medical school. The needs of the society in which we live are changing, and so is the information available for medical education. Our ultimate goal is to produce better and more competent doctors who are able to adapt themselves to the needs that the future brings. It is not possible to acquire all the necessary medical knowledge in the short period of university studies. That means that the medical schools' most important task is to prepare future doctors to work in any kind of changing environment. The principal is to learn how to learn.

Task Description

At this moment, the reality is that medical schools all over the world to give their students all of the knowledge available in the medical field during their undergraduate studies. This fact, however, does not guarantee that future doctors will be competent enough to approach a patient after graduation. The result of this kind of teaching are overloaded curricula, which still cannot teach ALL of the knowledge and skills needed. The problem that medical schools today do not prepare students with adequate skills on how to continuously learn, how to find and select and judge the newest available medical information, how to cope with new technologies, how to deal with the changing environment concerning communication skills, law, community needs and so forth. The question to ask, then, is how to balance the importance of theoretical medical knowledge with the clinical skills needed to be a doctor.

IFMSA's Wishes and Recommendations

IFMSA specifically recommends the fostering of self-directing learning skills, critical thinking skills, interviewing skills and communication skills. These communication skills should emphasize not only strong doctor-patient but also strong doctor-doctor and doctor-community relationships. Teamwork in this world is a growing need, as is peer-education and evaluation. Other important goals that we should strive to promote include the knowledge to use new technologies, management skills, practical skills, basic research skills (knowledge about scientific methods and research), and skills how to use all available information services (including the internet and libraries).

Medical students need to learn how to select and judge the available information. Future doctors can only set good priorities if they have the goals of the community in mind. We should specifically be educated on how to listen to society. In developing the core curricula, we must realize that it is and must be dynamic. What is "core" today may not be what is "core" in 20 years or more.

Policy/Position on the Impact of Technology on Health Education

following a round table discussion

50th General Assembly Meeting, 2001 Aalborg

We recognize that technology impacts health care education, research, and science educators in the areas of research, classroom teaching and distance education. While the overall effect is not yet fully assessable, the presence of technology in so many different aspects of the profession makes it important to more clearly recognize and appreciate its current and potential role.

 

IFMSA recognizes the following things:

  • While there is no assessing body to monitor the presence of technology in this field, and information technology is fast creating an affect IFMSA feels that the sense of direction of the impact it creates has not been spared from the chaos and distress that accompanies this unprecedented era.

  • Biomedical knowledge and clinical information about patients are essentially unmanageable by traditional paper-based methods, and to a growing conviction that the processes of knowledge retrieval and expert decision making are as important to modern biomedicine as the fact base on which clinical decisions or research plans are made.

  • Information Technologies can be educators' tools in finding creative ways that encourage students to self-test, self-question, and self-regulate learning in helping them to create solutions to complex problems.

  • Information Technologies are providing new opportunities for linking medical schools around the world for sharing computer-based learning materials. Information technologies open a wide horizon for acquiring and expending medical knowledge originated in any part of the world without limitations of time, space or distance.

  • Information Technologies have lead to the improvement of evidence-based medicine.

IFMSA urges for a creation of an international independent monitoring board by international organization such as the World Health Organization (WHO) and the World Federation of Medical Education (WFME) to lead the sense of direction of technology in the right path.

 

IFMSA stresses that the use of computers and information technology in medical education should be regarded as an additional tool and must never be a goal in itself but part of flexible learning. On the contrary clinical medical education should always be centered on direct patient contact and bedside education. While we urge for direct patient contact we believe that using of stimulations would also benefit the student in training.

 

IFMSA will work with different organizations and institutions world wide in developing a comprehensive online resource that wouldn't contain an overload of information and that can be monitored for content following international standards.

 

IFMSA understands the advantages produced by information technologies in data retrieval and research management and urges that this be geared to serve the needs at the international level.

 

IFMSA will communicate to all international organizations, national organizations and local organizations urging to ensure that the best possible training is given to the students by the educators while they integrate the use of computers into the system as different teaching methods need different approaches. Traditional methods in some cases are proven to be more effective and these methods shouldn't be replaced in order to just keep abreast of the technology and careful consideration and study should be done before replacing traditional methods. IFMSA also urges strongly the integration of the technology as part into the education.

 

IFMSA would like all the educators to take the students into consideration while developing or planning for new information technology, as students are the best resources. Students worldwide are thereby requested to take an active role while any developments to this effect come in place.

 

IFMSA will through its network work on linking medical schools and organizations for sharing computer based learning material but would like an international organization to be a part of it to monitor the standards thus creating an International self study resource with no boundaries in information and which will provide equal opportunity to countries that cant afford or keep abreast with the technologies.

 

IFMSA while recognizing that information technologies have improved the evidence-based study strictly urges that Technologies should not estrange us from our humanity or the noble profession. We believe that medicine is an art by itself.

 

IFMSA believes that information technology is educating the patient and urges for the creation of a course in the medical curriculum of how to handle a patient who has obtained his knowledge good or bad through the technology.

 

IFMSA stresses and urges all students and everyone in this profession to ensure that the ethical and moral aspects are safeguarded.

 

ALL IN ALL, IFMSA RECOGNIZES THE IMPORTANCE OF IMPACT OF TECHNOLOGY ON HEALTH EDUCATION AND ENCOURAGES MEDICAL STUDENTS, EDUCATORS AND INTERNATIONAL MONITORING ORGANIZATIONS TO TAKE THE INITIATIVE TO TAKE ROLE IN THE CURRENT PHASE TO DIRECT TECHNOLOGY IN THE RIGHT PATH AS WE DO NOT KNOW HOW THIS WOULD BE IN THE FUTURE.

Policy/Position on IMPLEMENTING INTERNATIONAL STANDARDS IN BASIC MEDICAL EDUCATION

following a round table discussion

50th General Assembly Meeting, Aalborg 2001

We recognize that to have quality development in basic medical education implementing international standards is vital.

 

IFMSA views the current situation in medical education as follows:

  • Basic Medical Education courses conducted in about 1600 medical schools worldwide varies from one school to another.But only a little number of these medical schools worldwide are subject to external evaluation and accreditation procedures.

  • These result in a very different level of medical knowledge,skills and behaviour acquired by graduates of medical schools.

  • Globalization is helping to produce a new vision of cooperation for common goals and spesific advantages without precluding the local culture,language and various requirements responsive to local realities.

  • Medicine itself is universal and requires a universal identity to work on it.We will be doctors for all.

  • There is clearly no global system that provides the implementation of international standards.

IFMSA describes international standards in basic medical education as follows:

  • IFMSA defines the word "standards as both a goal (what should be done ) and a measure of progress toward that goal ( how well it was done).

  • IFMSA keeps in mind that "'implementing international standards'does not imply uniformity of medical schools or a threat to the fundemental principles that medical education has to address the specific needs in a given social and cultural context."

  • IFMSA describes the report of World federation For Medical Education (WFME) on Defining International Standards in Basic Medical Education as a reference point for international standardization.

  • IFMSA states that providing globalization by collabrating with international organizations such as WFME is a must in medical education.

  • IFMSA urges all medical students to do their best for their own education.

  • IFMSA describes taking role in implementation of intenational standards in basic medical education as one of the ways to achieve the best in medical education.

IFMSA urges medical students all around the world to take the initiative to reach international standards locally, nationally and internationally as follows:

  • IFMSA aims to take a step further for the implementation of the international standards in basic medical education by,

  • helping professionals on medical education to investigate problems associated with implementation of international standards in basic medical educations and adapt strategies.

  • helping to raise awareness on the international standards in collaboration with international organizations.

  • IFMSA urges medical students focus more on the international standards by organizing forums,workshops and training programs where recomendations of the professionals for the stage of implementation locally, nationally and internationally be presented.

  • IFMSA suggests that the report of WFME On Defining International Standards in Basic medical Education be translated into different languages making it possible for everyone involved in medical education to understand

  • IFMSA urges medical students to work in collaboration with International organizations to introduce the report on international standards to local,national and international authorities.

IFMSA advocates all national and local authorities in medical education to get involved in the stage of implementing international standards in basic medical education as follows:

  • IFMSA calls upon all national and local authorities in medical education to view these standards as a way for individual faculties to get integrated with international recomendations and as a method to measure themselves.

  • IFMSA calls upon all national and local authorities in medical education to implement international standards in their own curriculum in synthesis with their regional needs.

ALL IN ALL, IFMSA RECOGNIZES THE IMPORTANCE OF IMPLEMENTING INTERNATIONAL STANDARDS IN BASIC MEDICAL EDUCATION AND ENCOURAGES MEDICAL STUDENTS TO TAKE THE INITIATIVE TO TAKE ROLE IN THE IMPLEMENTATION PHASE AS THEY ARE THE ONES TO CONTINUE THIS IN THE FUTURE.

The Bologna Declaration and Medical Education

A Policy Statement from the Medical Students of Europe Megève, France July 4th 2004

 

Outcome of the third workshop on the Bologna process organized by the International Federation of Medical Students' Associations (IFMSA) and European Medical Students' Association (EMSA)

 

Adopted by the IFMSA General Assembly in August 2004

 

Summary

Most points of the Bologna process are welcomed by the medical students of Europe. Medical education is in many ways in a special position when it comes to implementing the changes, and we would like to emphasize the importance of three points:

 

  1. A common system for quality assurance of medical education in Europe would increase mobility and improve the quality of tomorrow's physicians.
  2. We are concerned about the negative implications of a two-cycle structure on medical education. Harmonization of medical education in Europe is crucial whatever system exists.
  3. Student involvement is essential at all levels of the process.

 

Background

 

The Bologna Declaration[1] of June 1999 established the following objectives:

 

  1. Adoption of a system of easily readable and comparable degrees
  2. Adoption of a system essentially based on two main cycles, undergraduate and graduate.
  3. Establishment of a system of credits - such as the ECTS system
  4. Promotion of mobility by overcoming obstacles to the effective exercise of free movement
  5. Promotion of European co-operation in quality assurance
  6. Promotion of the necessary European dimensions in higher education

 

These objectives are, according to the Declaration, to be attained "within the framework of our institutional competencies and taking full respect of the diversity of cultures, languages, national education systems and of University autonomy."

 

Two subsequent meeting were held where additional points were added:

 

Prague communiqué[2] May 19th 2001:

 

  1. Integrate life long learning into the overall strategy
  2. Higher education institutions and students
  3. Promoting the attractiveness of the European Higher Education Area

 

Berlin communiqué[3] September 19th 2003:

  1. Establish a European research area


 

Our Viewpoint

 

1. Adoption of a system of easily readable and comparable degrees

The medical degree is already easily readable and comparable within the EU through the Medical Education Directive EC 93/16. This can further be improved through implementation of the Diploma supplement.

 

2. Adoption of a system essentially based on two main cycles, undergraduate and graduate

We are concerned about negative consequences in implementing a two-cycle structure in medical education. Current efforts to update the medical curriculum recognise that the early integration of basic and clinical science is essential to produce better doctors. This provides a meaningful context in which to integrate current research with basic care. It is also supported by adult learning theory, which acknowledges the difference between having factual knowledge and being able to apply it to a real-life situation. The implementation of a two-cycle structure must not be allowed to cement the traditional division between the basic sciences and clinical sciences, as described in the Flexner Report of 1910[4]. 

 

In those countries with a two-cycle structure for medicine, students should be required to have a Bachelor of Medicine or bachelor degree with academic equivalence to enter the Master of Medicine, to ensure the quality of those who graduate as physicians.

 

Without a European consensus on implementing the two-cycle structure in medicine, two degree systems will result, seriously hampering easy readability and mobility.

 

Some medical curricula teach subjects over several years.  The implementation of the two cycle structure in such curricula will lead to an artificial separation of these subjects, limiting mobility. This must be avoided by introducing guidelines for bachelor and master content. One model for this is described in the idea of a European Core Curriculum in medical education, as mentioned by the British General Medical Council in 1993 and defined by AMEE Education Guide no 5[5].

 

At the same time, we recognise the value of having a unified degree structure for higher education in Europe. For medical education, we recognize potential improvements in flexibility and mobility, and more opportunities to choose a master degree.

 

3. Establishment of a system of credits - such as the ECTS system

Establishment of ECTS can easily be done in most European countries, and has already been implemented at several European medical schools. We require that a European grading system must be researched and evidence-based to determine the most appropriate manner in which to asses medical students. A correct and consistent implementation of ECTS and the grading system is of great importance for mobility and quality of assessment throughout Europe. 

 

4. Promotion of mobility

Mobility is desirable on all levels of medical studies, from individual courses or clinical clerkships, as in today's Erasmus program, to entire degrees. The recognition of common guidelines for the content in the degrees would increase mobility. The Lisbon Convention[6] has established a means to get degrees and courses recognized, and this is an important step to increase mobility.

 

5.  Promotion of European co-operation in quality assurance

We urge the ministers to agree on a system for quality assurance in Europe. The task of creating this system should be given to independent experts. For medical education this could, for example, be AMEE. Student involvement in this process is absolutely necessary. Quality Assurance can be achieved through the establishment of common guidelines for the content of the degrees and an adoption of, for instance, the WFME Global Standards for Quality Improvement[7]. A common European system for accreditation of medical schools would establish and maintain high educational quality and provide a means for comparison between different medical schools. We welcome harmonization, but preserving the diversity of the individual medical schools in Europe is of utmost importance.

 

6. Promotion of the necessary European dimensions in higher education

We recognise that the cultural diversity of Europe is currently reflected in the way medicine is taught in different countries.  We hope that the future European medical education is based on a holistic view of the complex world we are living in and reflects the fast changing environment and growing knowledge base of tomorrow's physicians.  More focus on language learning would enhance communication in the profession and improve mobility.

 

7. Integrate life long learning into the overall strategy

The healthcare environment is rapidly changing making continuous professional development essential after graduation. The role of medical schools in preparing their graduates for this process cannot be stressed enough. We see the utilization of modern teaching methods and self-directed learning as setting the foundation for life long learning.

 

8. Higher education institutions and students

The recognition of students as "competent, active and constructive partners[8]" is a step forward in increasing the quality of medical education. We welcome this invitation of the ministers for more active student participation which we hope will be welcomed and implemented at all levels. We feel strongly about our education and that of the generations to come. We are the key to shaping tomorrow's education. We will, after all, be tomorrow's teachers.

 

9. Promoting the attractiveness of the European Higher Education Area

Through establishing a common European system for quality assurance and safe-guarding easily readable and comparable degrees, Europe will be more attractive for both European and non-European students.

 

10. Establish a European research area

In our knowledge-based society, research is one of the pillars of the modern university. We see the potential benefits of the establishment of a European research area and appreciate its importance in academia.

 

In conclusion, we strongly welcome most points of the Bologna process, which encourages flexibility, mobility and quality assurance. We are concerned about the negative implications of the two-cycle structure on medical education.  However, not implementing the two-cycle structure should not be an excuse not to implement the rest of the Bologna process.  We emphasise the importance of common European guidelines for the content of medical degrees.  The integration of the basic sciences and clinical worlds from day one is paramount to our success as future physicians. 

 

We look forward to active participation in Europe's drive towards the highest quality medical education possible.

 

References:

1http://www.bologna-bergen2005.no/PDF/00-Main_doc/990719BOLOGNA_DECLARATION.PDF

2http://www.bologna-bergen2005.no/PDF/00-Main_doc/010519PRAGUE_COMMUNIQUE.PDF

3http://www.bologna-bergen2005.no/PDF/00-Main_doc/030919Berlin_Communique.PDF

4 Abaham Flexner, Medical education in the United States and Canada, The Carnegie Foundation for the Advancement of the Teaching Bulletin Number Four,1910 www.carnegiefoundation.org/elibrary/docs/flexner_report.pdf.

5  AMEE Education Guide no 5, R M Harden & M Davis: The Core Curriculum with Options or Special StudyModules. www.amee.org

6http://www.bologna-bergen2005.no/PDF/02-CoE/970411Lisbon_con_165.pdf

7 WFME Global Standards for Quality Improvement, Basic Medical Education, WFME Office: University ofCopenhagen, Denmark 2003 www.wfme.org

8 http://www.bologna-berlin2003.de/pdf/Prague_communiquTheta.pdf


 

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Global Courses in the Medical Curriculum - Examples from Different Countries
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Global Standards - Mind the Gap!
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