Global Standards - Mind the Gap!
World Conference on Medical Education
Copenhagen/Lund 2003
Nikola Borojevic
Director on Medical Education 01/02

Nikola: "Ladies and Gentleman,
this is a presentation in behalf of IFMSA – International Federation of Medical Students Associations. Twice a year, we meet and exchange our experiences and ideas on various topics, one of which is Medical Education. From year to year in our 50 years of existence we conclude that students think that their medical education can be better: regardless weather students come from "developing"; or "developed"; world. Most of the students see that there is room for improvement, and I guess all of us here would agree as well: there is always room for improvement."

Nikola:" WE NEED STANDARDS!
THEY ARE COOL!
What does this mean and why do students need standards? I can speak about this for hours because discussion among students involved in IFMSA took a long time, but trying to keep it short and simple, I would mention most important points:
- We need standards because we can use them in negotiations with our deans for improvement of education
- We get better view of expectations, aims and objectives of our own education. I guess we could say that more transparency of the learning process means that student can understand better WHY he is learning particular subject, and understanding "why"; can lead to increase in motivation of students.
However, as we are global Organization with around 90 countries and representatives from all continents, the message I would like to present here is not why students need standards, but students’ concerns about understanding the global standards."

Nikola: "MIND THE GAP
Most of you recognized picture of the floor from the London Tube, and inspiration for the title of this presentation comes exactly from there. In early October last year, first Executive Board meeting took place in London, We decided that our top priority for this year is regionalisation of our organization. Consequently, discussion about strategic plan to achieve best possible shape of the process took place in Tunisia.
Once again we agreed that the message, not only for our regionalisation, but for International Health and Education is: Mind The Gap."

Nikola: "The "Gaps"; we are referring to are: * different starting points
- cultural differences
- resources
- infrastructure
- social differences / opportunities
Levels of education are different not only throughout the world but within many countries themselves. Looking at the Global Standards and these differences, most apparent feeling arising is fear. Fear from forcing global values without regarding the needs of the communities. However, we don’t fear of misuse of the Standards. We don’t see them as a facilitating tool for encouraging brain drain, but as a tool for enhancement of medical education that would lead to better health of the community. With fears set aside, what we see as challenge is."

Nikola: "Implementation of the Standards with respect to the diversity"

Possible ways of addressing this challenge that we’ve come up with would be understanding of Global Standards as a guideline for creating more detailed regional standards. Regional standards could serve as a core for even more specific and detailed national standards that would take into consideration not only resources but also needs of the community on local level: people whose health we want to improve as a consequence of improvement of medical education,
Another point in consideration should be measurement tools adapted to the regional/national needs, and of course, appropriate consequences of not following the standards. (In a country with 40 medical schools, it might make sense to close down school that doesn’t follow the standards, but in a country with only one medical school that does not seem appropriate.)