Future of Medical Education – Students Expectations
World Conference on Medical Education
Copenhagen, 17.03.03
Özgür Onur
Director on Medical Education 02/03

Dear Excellencies,
Dear Director General of WHO,
Dear President,
Dear colleagues and friends,
Ladies and Gentlemen,

My Name is Özgür Onur, I am student in Germany, but as you can see from my dark hair and brown eyes, I have a Turkish origin.
I am the Director on Medical Education of the International Federation of Medical Students´ Associations and I am the student representative in the Executive Council of the World Federation for Medical Education.

The IFMSA is:

The topic of my speech today is:
"The expectations of students on their future";
One approach to find out the expectations is to look, what students are dreaming off. It is worth to look in the world of Literature, Media, Television, … There are many examples where expectations and dreams are shown and shaped, like "Chicago Hope";, "Emergency Room";, "House of God"; etc.
I would like to focus on one novel, which is dealing a lot with the aspect of Medical Education. It is "The Physician"; by Noah Gordon.

Thousands of students read this fantastic book, mostly pretty much in the beginning of their studies.
The story is about a young boy becoming a physician in the Middle Ages. He is first in London, after a long and exhausting journey he studies in a medical school in Persia. In this part of the story Noah Gordon describes in a very comprehensive way the education this student gets. The different aspects he is touching are:

There is one expectation, which stands on all of these: Becoming a good physician.
Perhaps this sounds a little bit childish or naïve in your eyes, but I think this is a good picture of what students expect when they start to study.

Then the students start in med school and very soon they face a big disappointment.
WHY THAT?
Because something changed from the Middle Ages to today.

The industrialisation in Medical Education, the mass production of students.
The picture shows, how this looks in practice. Actually this is the university hospital in Aachen in Germany.

Has anyone of you visited this place?
Actually this is the school where I am studying. After a while you are starting to love this building, believe me.
So what went wrong in development of our medical education?

Our objectives, our learning goals lost the idea of SMART.
What is SMART?

Most of our learning goals do not fulfil these requirements. Now, some of you would say, our learning goals are SMART!!! My school isfulfilling this! You are right. A couple of schools started to reform their curriculum and many of them are fulfilling the whole SMART-concept.
It gets quite interesting, if you compare the educational tools from the reformed schools with the ones I mentioned before from the Middle Ages, you will see many similarities (except of "New technologies"; of course). So it looks like that the Future of Medical Education lies in the past. "Back to the roots"; fits pretty well here.
I could go into details now. I could analyze the different approaches. I think there are still many aspects to improve.
On the last General Assembly of the international medical students in Estonia we had a long discussion on this. Very soon we got to the point that analyzing the different aspects in the reformed curricula would be more or less a luxury debate. In the best case it would lead to an improvement of already good education.

We decided that our aim is not primarily to work on the top of the iceberg, which is already glittering in the shiny sun.
We should focus on what is under the surface. Unfortunately the majority of students are facing every day teachers in medical schools with no interest for improvement. Education plays the smallest role in their job:
Research, patients care, personal career, financial income are much more important then education young students and doctors.
We believe that this has to be changed. But who could do this???
Now we could start to pinpoint on different organizations and institutions who should be responsible. But this does not help much. We, as we are all here, we, as we are all involved in improvement in medical education, have to take responsibility. It is not enough that we work for a better education in our own schools, in our own departments. Nooo, we are also responsible for all other schools in our surrounding. Everyone of us has to take initiative, everyone of us have to be proactive.
If we are serious with the vision "For a better health care"; and if we believe that better education can lead to this goal, than we have to change the education for the mass of students and not just for a couple of students.

Of course, you have to test new developments on smaller groups first to see if it is working. But we believe that we learned and tested a lot in the past 20 years. We have now to go a step further: the wider implementation of our experience!
Let us dive into the water and bring up the ice!
We as international medical students would like to thank WFME for the initiative taken in the past years. The global standards could become a tool for a wide improvement. The first could be finalized on this consensus conference, with your help of course. After a solid foundation it will be from biggest importance what we do out of it. We cannot rely on others. Assisted by international bodies WE have to implement these standards. We as medical students already prepare a project on disseminating and implementing the standards. Nergiz from Turkey will have a presentation later today.
We are also very satisfied that Dr. Karle told us in his opening speech that WFME is aware of the cultural varieties and that WFME has the wish to keep them. We think WFME proofed its awareness in the formulation of the standards. Now it will be important how the next steps will be taken. Nikola will present our position on this tomorrow.

Thank you for listening to me until now. There is one final point I want to make. If a student is talking in front of so many experts he will usually take the chance to tell something about students involvement. I do not want to be an exception:

I do not need to explain why student involvement is important, I guess. Otherwise I would not been invited to talk to you here and you would not listened to me. But why are we facing such difficulties always. Continuity is the major problem in my eyes. I do not want to start to blame anyone. I think there are faults on both sides, but how can we overcome this.
I believe that one strategy could be to rely on the persons in this system who work for many years in this field. There are many of you here who could take the role of a advocate for students. I know that many of you got disappointed by students once a while. I know that these are happening, but I am sure you made positive experience, too. So I would like to encourage both students and teachers to stop to complain, but to see the positive examples in this field and In would like to encourage you to work on a proper cooperation.