WFME

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WFME WORLD FEDERATION FOR MEDICAL EDUCATION
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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
VILNIUS CONFERENCESEPTEMBER 2005
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OUTLINE OF PRESENTATION

• The medical profession
• The European dimension
• Global perspectives

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BACKGROUND

• World Federation for Medical Education (WFME)
• WHO/WFME Strategic Partnership
• Advisory Committee on Medical Training in EU

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10 ACTUAL TRENDS INHIGHER EDUCATION

• Internationalisation
• Globalisation
• ICT industrialisation
• Virtualisation
• Commercialisation
• Privatisation
• Harmonisation
• Standardisation
• Quality Assurance
• Accreditation

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ACTUAL HIGHER EDUCATIONQUALITY ASSURANCE
INITIATIVES

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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

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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

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ARTICLE 23BASIC 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

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ARTICLE 23BASIC MEDICAL EDUCATION
Specific requirements Six years/5500 hours
of theoretical and practical instruction in
a university
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ARTICLE 24SPECIALIST 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

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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

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THE BOLOGNA PROCESS AND MEDICAL EDUCATION

• STATEMENT ON
•  
• THE BOLOGNA PROCESS AND MEDICAL EDUCATION
•  
• February 2005

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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)

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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

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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

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EU THEMATIC NETWORK MEDINE

• Organisations responsible for Task Force III
• World Federation for Medical Education (WFME).
• Association of Medical Schools in Europe (AMSE).

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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.

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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.

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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.

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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.

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Aims of WFME Standard Programme

• Medical Education Quality Improvement Tool
• Instrument in Safeguarding Internationalisation
  of Medical Doctors

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TWO LEVELS OF ATTAINMENT

• Basic Standards or Minimum Requirements (musts)
• Standards for Quality Development (shoulds)

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WFME Trilogy of Standards Areas
Basic Medical Education Postgraduate Medical Education Continuing Professional Development (CPD
1. Mission and Objectives 1. Mission and Outcomes 1. Mission and Outcomes
2. Educational Programme 2. Training Process 2. Learning Methods
3. Assessment of Students 3. Assessment of Trainees 3. Planning and Documentation
4. Students 4. Trainees 4. The Individual Doctor
5. Academic Staff/Faculty 5. Staffing 5. CPD-Providers
6. Educational Resources 6. Training Settings and Educational Resources 6. Educational Context and Resources
7. Programme Evaluation 7. Evaluation of Training Process 7. Evaluation of Methods and Competencies
8. Governance and Administration 8. Governance and Administration 8. Organisation
9. Continuous Renewal 9. Continuous Renewal 9. Continuous Renewal
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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

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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

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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

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INCORPORATION IN NATIONAL STANDARDS/ACCREDITATION
PROCEDURES (BY REGIONS)
Africa Americas Eastern Mediterranean
Kenya South Africa Zambia Argentina Canada Colombia Ecuador (Latin America) Mexico USA Venezuela Bahrain Egypt (Gulf-countries) Iran Jordan Kuwait Oman Qatar Saudi Arabia Sudan United Arab Emirates
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INCORPORATION IN NATIONAL STANDARDS/ACCREDITATION
PROCEDURES (BY REGIONS)
Europe South East Asia Western Pacific
(Central Asian Republics) (CIS Countries) Denmark France Germany Ireland Kazakhstan Kyrgyzstan Poland Russia Spain Switzerland Turkey United Kingdom Bangladesh India Indonesia Nepal Sri Lanka Thailand Regional Standards Australia China Fiji Islands Japan Malaysia New Zealand Papua New Guinea Taiwan Vietnam
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WFME GLOBAL STANDARDS PROGRAMME
WORLD HEALTH ORGANIZATION

• WHO/WFME Guidelines
• for
• Accreditation of Basic Medical Education
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•   Geneva/Copenhagen 2005

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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

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WHO/WFME GUIDELINESPREREQUISITES
The WHO/WFME guidelines are

• Non-binding guidelines
• Global, but flexible guidelines

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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

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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

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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

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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

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THE SELF-EVALUATION
Purpose of the self-evaluation is

• To provide the institutions 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

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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

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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

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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

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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.

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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
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USE OF WFME STANDARDS BY OTHER HEALTH PROFESSIONS
EDUCATIONS

• Chiropractics
• Dentistry
• Nursing
• Pharmacy

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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

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WFME WORLD FEDERATION FOR MEDICAL EDUCATION
Web-site http//www.wfme.org