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WFME WORLD FEDERATION FOR MEDICAL EDUCATION. VILNIUS CONFERENCE SEPTEMBER 2005.
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WFME WORLD FEDERATION FOR MEDICAL EDUCATION
VILNIUS CONFERENCESEPTEMBER 2005 Second Policy Dialogue in the Baltic Countries on Human Resources for HealthTrends, Initiatives and Challenges Towards Quality Assurance and Mutual Recognition of Professional Qualifications in the EU: An OverviewbyHans Karle, M.D., D.M.Sc.President WFME
OUTLINE OF PRESENTATION • The medical profession • The European dimension • Global perspectives WFME September 2005
BACKGROUND • World Federation for Medical Education (WFME) • WHO/WFME Strategic Partnership • Advisory Committee on Medical Training in EU WFME September 2005
10 ACTUAL TRENDS INHIGHER EDUCATION • Internationalisation • Globalisation • ICT industrialisation • Virtualisation • Commercialisation • Privatisation • Harmonisation • Standardisation • Quality Assurance • Accreditation WFME September 2005
UNESCO: “Global Forum for International Quality Assurance, Accreditation and the Recognition of Qualifications in Higher Education” UNESCO-OECD: “Quality Provision in Cross-border Higher Education” International Association of University Presidents (IAUP): “Quality Register for Quality Assurance and Accreditation Agencies” ACTUAL HIGHER EDUCATIONQUALITY ASSURANCE INITIATIVES WFME September 2005
MAJOR EUROPEAN INITIATIVES • European Commission “Medical Directive 93/16/EEC” • The Bologna Process “European Dimension in Quality Assurance” • European Association for Quality Assurance in Higher Education (ENQA) “Transnational European Evaluation Project II“ • European Commission Thematic Network “MEDINE Project” WFME September 2005
EU SECTORAL DIRECTIVE 93/16/EEC • Objective: to facilitate free movement of doctors and mutual recognition of their diplomas, certificates and other evidence of formal qualifications • Consolidation of 75/362/EEC 75/363/EEC 86/457/EEC WFME September 2005
ARTICLE 23:BASIC MEDICAL EDUCATION • Adequate knowledge of sciences in medicine and good understanding of scientific methods • Sufficient understanding of the structure, functions and behaviour of healthy and sick persons • Adequate knowledge of clinical disciplines and practices • Suitable clinical experiences WFME September 2005
ARTICLE 23:BASIC MEDICAL EDUCATION Specific requirements Six years/5500 hours of theoretical and practical instruction in a university WFME September 2005
ARTICLE 24:SPECIALIST TRAINING • Based on requirements in article 23 • Comprise theoretical and practical instruction • Full time course supervised by competent authority • University centre, teaching hospital and/or other health establishment • Personal involvement of the trainee • Duration : 3-4-5 years WFME September 2005
ARTICLE 30: SPECIFIC TRAINING IN GENERAL MEDICAL PRACTICE • Based on requirements in article 23 • Two years (in the future three years) of training, at least six months (in the future one year) in general medical practice WFME September 2005
THE BOLOGNA PROCESS AND MEDICAL EDUCATION STATEMENT ON THE BOLOGNA PROCESS AND MEDICAL EDUCATION February 2005 WFME September 2005
THEMES OFTHE BOLOGNA PROCESS • Adoption of a system of easily readable and comparable degrees • Establishment of a system of credits such as in the European Credit Transfer System (the ECTS system) • Promotion of mobility by overcoming obstacles to the effective exercise of free movement • Promotion of European co-operation in quality assurance • Promotion of the European dimension in higher education • Lifelong education • Involvement of institutions and students • Promotion of the attractiveness of the European Higher Education Area • Promotion of closer links between the European Higher Education Area and the European Research Area • Two cycle system (bachelor and master) WFME September 2005
THE BOLOGNA PROCESS AND MEDICAL EDUCATION Problems for medical education are primarily related to the following objective: • Adoption of a system essentially based on two main cycles, undergraduate and graduate WFME September 2005
WFME/AMEE STATEMENT ON THE BOLOGNA PROCESS AND MEDICAL EDUCATION • It should be possible to maintain the long, integrated one-tier programme if preferred • If medical education is based on two cycles the undergraduate degree after 3 years (180 ECTS credits) should not be planned for immediate access to employment WFME September 2005
EU THEMATIC NETWORK MEDINE Organisations responsible for Task Force III: • World Federation for Medical Education (WFME). • Association of Medical Schools in Europe (AMSE). WFME September 2005
OBJECTIVE I • Work to enhance overall standards of medical education in Europe through sharing of ideas, dissemination of best practice, and quality assurance, in conjunction with other European agencies such as ENQA and the regional ERA and making use of the work already carried out by the WFME. WFME September 2005
OBJECTIVE II • Analyse how to adapt the WFME standards to the European context of medical education and to the Bologna process in order to establish minimum requirements for accreditation at medical schools in Europe. WFME September 2005
OBJECTIVE III • Produce a set of quality assurance standards for medical education in Europe, building on and adapting existing work such as the WFME Global Standards as framework for institutional self-evaluation and for accreditation of undergraduate medical education programmes. WFME September 2005
HISTORY OF WFME GLOBAL STANDARDS PROGRAMME • Launched by Executive Council 1997 • Position Paper on International Standards Medical Education 1998, 32, 549-58 • Three International Task Forces: BME: 1999 PME: 2001 CPD: 2002 • Trilogy of WFME Global Standards in Medical Education for Quality Improvement. WFME Office, University of Copenhagen, 2003; www.wfme.org. WFME September 2005
Aims of WFME Standard Programme • Medical Education Quality Improvement Tool • Instrument in Safeguarding Internationalisation of Medical Doctors WFME September 2005
TWO LEVELS OF ATTAINMENT • Basic Standards or Minimum Requirements (“musts”) • Standards for Quality Development (“shoulds”) WFME September 2005
WFME Trilogy of Standards: Areas WFME September 2005
USE OF STANDARDS • framework for institutional (voluntary) self-evaluation • external evaluation and counselling from peer review committees, including site visits • combination of these procedures • recognition and accreditation of institutions/programmes WFME September 2005
EVALUATION IN PILOT STUDIES Conclusions: • Standards are realistic and adequately divided between basic and quality development levels • Need for local specification and supplements • Use in institutional self-evaluation a positive event with lasting constructive consequences WFME September 2005
IMPLEMENTATION OFTHE WFME PROGRAMME • Information • Translations of Standards • Validation of Standards in Pilot Studies • Institutional Self-evaluation and Peer Review • WFME Advisor Function • Incorporation in National Standards and Accreditation Procedures • Development of Standards for Accrediting Agencies • World Register of Accredited Educational Institutions WFME September 2005
INCORPORATION IN NATIONAL STANDARDS/ACCREDITATION PROCEDURES (BY REGIONS) WFME September 2005
INCORPORATION IN NATIONAL STANDARDS/ACCREDITATION PROCEDURES (BY REGIONS) WFME September 2005
WFME GLOBAL STANDARDS PROGRAMME WHO/WFME Guidelines for Accreditation of Basic Medical Education Geneva/Copenhagen 2005 WORLD HEALTH ORGANIZATION WFME September 2005
TOWARDS WHO-WFME POLICYON ACCREDITATION • Promotion and review of Regional/National standards • Promotion of institutional self-evaluation • Definition of accreditation guidelines • Promotion and support of accreditation systems • Development of the WHO Directory WFME September 2005
WHO/WFME GUIDELINESPREREQUISITES The WHO/WFME guidelines are: • Non-binding guidelines • Global, but flexible guidelines WFME September 2005
WHO/WFME GUIDELINESCOVERAGE the WHO/WFME guidelines cover: • Fundamental requirements • The legal framework • Organisational structure • Standards or criteria • The process of accreditation • Decisions on accreditation • Public announcement of decisions • Benefits of accreditation WFME September 2005
FUNDAMENTAL REQUIREMENTS The accreditation system: • Must be trustworthy and recognized by all • Must be based on the academic competence, efficiency and fairness of the system • Must be known by the users • Must possess a high degree of transparency WFME September 2005
STANDARDS OR CRITERIA The standards or criteria to be used as the basis for the accreditation process: • Must be predetermined, agreed upon and made public • Must be the WFME global standards with the necessary national and/or regional specifications or a comparable set of standards WFME September 2005
THE PROCESS OF ACCREDITATION The process must include: • A self-evaluation • An external evaluation based on the report of the self-evaluation and including a site visit • A final report by the review or site-visit team after the external evaluation containing recommendations • The decision on accreditation WFME September 2005
THE SELF-EVALUATION Purpose of the self-evaluation is: • To provide the institution’s own description and analysis of the institution and its programme in relation to the predetermined standards and criteria • To give the institution insight in its strengths and weaknesses and point at avenues for quality improvement WFME September 2005
THE SITE VISIT Purpose of the site-visit is: • To provide an external validation of the conclusions of the self-evaluation • To acquire - if necessary - supplementary information WFME September 2005
DECISIONS ON ACCREDITATION Decisions on accreditation: • Must be based solely on compliance with the standards or criteria • Must be valid for a fixed period of time • The duration of full accreditation (5 – 10 years) must be decided in general WFME September 2005
CATEGORIES OF ACCREDITATION DECISIONS 1 • Full accreditation for the maximum period must be conferred if all standards or criteria are fulfilled • Conditional accreditation must be conferred a few or numerous criteria are not fulfilled. the seriousness of the problems should be reflected in specification of conditions WFME September 2005
CATEGORIES OF ACCREDITATION DECISIONS 2 • Denial or withdrawal of accreditation must be the decision if many standards or criteria are not fulfilled signifying severe deficit in the quality of the programme. WFME September 2005
NEW WFME PROJECT PROMOTION OF ACCREDITATION OF BASIC MEDICAL EDUCATION A Programme within the Framework of the WHO/WFME Strategic Partnership to Improve Medical Education WFME September 2005
USE OF WFME STANDARDS BY OTHER HEALTH PROFESSIONS EDUCATIONS • Chiropractics • Dentistry • Nursing • Pharmacy WFME September 2005
CONCLUSIONS • EUROPE IN A GLOBAL PERSPECTIVE • ENDORSEMENT OF THE WFME STANDARD PROGRAMME • WFME GLOBAL STANDARDS AS TEMPLATE FOR REGIONAL/NATIONAL STANDARDS • NEED FOR GUIDANCE OF EDUCATIONAL INSTITUTIONS BY WFME ADVISORS • IMPACT OF THE WHO/WFME STRATEGIC PARTNERSHIP • WHO/WFME GUIDELINES ON ACCREDITATION SYSTEMS • NEED FOR WORLD REGISTER OF ACCREDITED MEDICAL SCHOOLS WFME September 2005
WFME WORLD FEDERATION FOR MEDICAL EDUCATION Web-site: http://www.wfme.org