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MEDICAL EDUCATION IN LITHUANIA

MEDICAL EDUCATION IN LITHUANIA. Algimantas Tamelis Faculty (School) of Medicine Kaunas University of Medicine. Lithuania. Membership: EU ( 1 May 2004 ) , NATO ( 29 March 2004 ) Capital: Vilnius Language: Lithuanian Population: 3,39 mln. Area: 65,300 km²

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MEDICAL EDUCATION IN LITHUANIA

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  1. MEDICAL EDUCATION IN LITHUANIA Algimantas Tamelis Faculty (School) of Medicine Kaunas University of Medicine

  2. Lithuania • Membership: • EU (1 May 2004), • NATO (29 March 2004) • Capital: Vilnius • Language: Lithuanian • Population: 3,39 mln. • Area: 65,300 km² • Political system: Parliamentarydemocracy

  3. Largest cities: Vilnius (553,200), Kaunas (373,700), Klaipėda (191,600), Šiauliai (132,700), Panevėžys (118,800). Ethnic composition: Lithuanians: 83.5%, Poles: 6.7%, Russians: 6.3%, Belorussians: 1.2%, other: 2.3%. Lithuania

  4. ACADEMIC COUNCIL SENATE STUDENTS COUNCIL GENERALINFRASTRUCTURE SERVICES GENERAL SERVICES FOR EDUCATION AND RESEARCH RECTOR’S OFFICE UNIVERSITY HOSPITAL COUNCILS FACULTIES’ COUNCILS RESEARCH INSTITUTES’ COUNCILS • UNIVERSITY HOSPITAL • DIRECTOR GENERAL • OBSERVER’S COUNCIL • MEDICAL COUNCIL • NURSING COUNCIL • FACULTIES • MEDICINE • ODONTOLOGY • PHARMACY • NURSING • PUBLIC HEALTH • RESEARCH INSTITUTES • BIOMEDICAL RESEARCH • CARDIOLOGY • ENDOCRINOLOGY • PSYCHOPHYSIOLOGY & REHABILITATION UNIVERSITY HOSPITAL OF ONCOLOGY • DEPARTMENTS • UNITS • THEORETICAL AND CLINICAL DEPARTMENTS LABORATORIES

  5. THE COMMUNITY

  6. Undergraduate Students

  7. Pedagogic Units 10 theoretical departments 30 clinical departments Administrative staff Dean 3 Vice Deans 2 Dean Assistants 3 Technical personnel School of Medicine: Human Resources

  8. Professors

  9. Challenge • COUNCIL DIRECTIVE 93/16/EEC “To facilitate the free movement of doctors and the mutual recognition of their diplomas, certificates and other evidence of formal qualifications”

  10. Basic Principles of Education • State regulated profession • Law of High Education • Three levels (cycles) of education • Bachelour • Master • Doctor • Principles and basic structure of undergraduate education • Internship and Residency training

  11. Regulation of Postgraduate Training • Decision of the Government • Training of Doctors • Structure of training • Undergraduate studies 6 years • Internship – 1 year • Residency training • Regulations • Duration

  12. Medical Education Specialist General (Family) 3 - 6 years Medicine 3 years Internship 1 year Basic Medical Education Undergraduate studies 6 years

  13. Enrolment • Completed secondary education • No entrance examinations • Concerted enrolment procedure: • Ranking on Matura examinations • school-level • national-level (National Examination Centre) • This year – joined 310 students

  14. Requirements For the Training • Order of Ministers of Health Care and Education and Science: • “Minimal requirements for the training of doctors, odontologists, nurses, midwifes and pharmacists” • Duration • Structure • Principles • CPD • Transposition of EU directives

  15. Requirements for the medical training • 6 years or at least 5 500 hours of teaching: • adequate knowledge of the sciences on which medicine is based and a good understanding of the scientific methods including the principles of measuring biological functions, the evaluation of scientifically established facts and the analysis of data; • sufficient understanding of the structure, functions and behaviour of healthy and sick persons, as well as relations between the state of health and physical and social surroundings of the human being;

  16. Requirements for the medical training • adequate knowledge of clinical disciplines and practices, providing him with a coherent picture of mental and physical diseases, of medicine from the points of view of prophylaxis, diagnosis and therapy and of human reproduction; • suitable clinical experience in hospitals under appropriate supervision.

  17. Undergraduate Training • Universities • Kaunas University of Medicine • Vilnius University • Programs in High (University) Education • “Medicine” – 6 years • “Odontology” – 5 years • “Pharmacy” – 5 years • “Nursing” – 4 + 2 years • “Public Health” – 4 + 2 years

  18. Study credit • To measure student workload • 1 week – 40 hours • Every activity to achieve learning outcomes • Lectures • Classes • Laboratory • Practical training • Library • At home • Ets.

  19. KMU Curriculum • 6 years (12 semesters) • 240 national credits – 360 ECTS credits • contact time – 6965 hours (72,5 % of study time) • independent studies – 2635 hours (27,5 %) • 62 subjects • 52 compulsory • 10 elective (could be chosen from the list of more than 60 subject).

  20. KMU Curriculum • Study blocks (according Lithuanian law): • university background knowledge • 34 credits (14,2%) • program basis • 60 credits (25%) • special medicine subjects • 146 credits (60,8%) • Elective courses – 38 credits (15,8%) – through all blocks

  21. Traditional curriculum • 1st and 2nd years • Courses in the university background knowledge and the programs basis • 3rd year • Courses in special medicine are started • 4th, 5th and 6th years • Courses in special medicine prevails • Some courses in university background knowledge

  22. Teaching Methods • Proportion of lectures (overall) – 20% • Variations according subject • Practical clinical training • Contact with the patient • The first - the 1st year – “Fundamentals and Practice of Nursing” • As a doctor – the 3rd year – “Basics of Medical Diagnosis” and “Basics of General Surgery” • All working day in the clinical department • Small groups • Bedside teaching

  23. Student Assessment • Study results – discussed every semester • Dean office • Rector Board • Percentage of failing students per teaching year • Temporary – 5 – 20 % • Repeated studies • Delays • Drop outs – 1 – 2

  24. Survey Anonymous Conducted every second year. Special questionnaire Effectiveness of course unites, Value of lectures and practical classes, Aspects of teachers’ work and other. Results of survey by the Office of Students Representatives and administration of the Faculty Discussed at: Faculty Council, University commission on Study quality assurance Rector Board. Are presented to the all subdivisions of the Faculty Quality Assessment

  25. Development • Problem based learning – from academic year 2006/2007 • Support from EU structural funds

  26. Problem based curriculum • 1st year – traditional studies • Main principles of cell and tissue structure (Citology, Histology) • Main principles of human anatomy • Related courses • Physiscs • Chemistry • Informatics • Etc.

  27. Problem based curriculum • 2nd and 3rd year – problem based learning • According to main functions of human body • Homeostasis • Respiration • Blood circulation • Sensation and consciousness • Infection • Immune responce • Ets. • Preclinical and clinical departments involved • 6 problems per module • 2 turorial seminars per problem

  28. Problem based curriculum • 4 – 5 year • Integrated clinical trainig(internal medicine, surgery, radiology, biochemistry, rehabilitation) • Cardiovascular system • Chest and lungs • Gastrointestinal disorders • Kidneys and urinary tract • Endocrine • Etc.

  29. Problem based curriculum • 6 year • Reseach project • Elective couses • Practical placement in regional hospitals • Internal medicine • Surgery • Obstetrics • Pediatry • Final examination • Practical • Theoretical

  30. SOCRATES / ERASMUS PARTNERS Lulea Oulu Kuopio Tampere Kotka Bergen Helsinki Tartu Linkoping Riga Vaxjo Aarhus Kristianstad Naestved Gdansk Groningen Greifswald Kiel Cardiff Berlin Magdeburg Leipzig Gent Halle Wroclav HradekKralove Praha Lille Brno Rennes Lyon Geneve Grenoble Santiago de Compostela Parma Oviedo Montpellier Perugia Plovdiv Porto Dicle Roma Lleida Madrid Coimbra Beja

  31. Number of foreign students2002-2007

  32. Citizenship of students,2007, n=282

  33. Reform of Postgraduate Studies • Structure – more streamline • Duration – according EU directive • Programs • Structure • Training log-book

  34. Medicine - Internship • Established since 1993 • Regulated by Universities • Clinical experience in regional hospitals and out-patient departments selected by University • Internal medicine • Surgery • Obstetrics • Paediatrics

  35. Medicine - Internship • Program ending – University Examination • Professional Qualification – Medical Doctor • Possibility to get Licence of Medical Doctor • Assistant physician • Limited independent practice • Emergency Room • Ambulance • Nursery

  36. Residency training • Established since 1990 • University and University Hospitals based • Duration • 6 years – 3 programs (paediatrics) • 5 years – 18 programs • 4 years – 26 programs • 3 years – 13 programs (incl. Family doctor)

  37. Medicine - Residency training • Final university examination • Professional qualification - specialist in medicine • Possibility to get Licence for independent practice

  38. License • Medicine, Odontology, Nursing, Pharmacy • Obligatory licence • Termless • Obligation for CPD • Control • Public Health • For certain practices (decision of Government)

  39. Licensing Body • Ministry of Health Care • State Agency Of Accreditation For Health Care Practice • Commission of specialists • Chamber of Odontologists • Non governmental professional organisation • Obligatory participation

  40. License of Medical Doctor Medical diploma Certificate of internship Evidence of satisfactory health Limited independent practise Full License (Specialist) Medical diploma Certificate of internship Certificate of specialist (residency) training Evidence of satisfactory health Types of Doctors’ Licenses

  41. Re-licensing • Formally – non exists • Informally – requirement to prove obligatory CPD

  42. CPD • Law On Practice In Medicine • Decision of Minister of Health Care • Principles of Organisation • Forms • Financing - partially (75%) financed by government

  43. CPD - Forms • Updating courses and traineeship • Conferences and seminars • Participation • Presentations • National - under supervision of Universities • Articles in journals • Subscription of journals • Other

  44. CPD - Volume • Doctors – 120 hours per 5 years, incl. 70 hours in University settings • Nurses – 100 hours • Pharmacists – 120 hours • Odontologists – 120 hours (Chamber of Odontologists)

  45. Conclusions • System of under and post graduate education • Minimal requirements of EU directives followed • Licensing and regulation practice functioning • Still many unsolved questions

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