Suchergebnisse

Health care is deficient in many parts of the world, in money, facilities and manpower. In wealthy countries, the costs and complexity of health care are increasing unsustainably. Nevertheless, richer countries claim an ever escalating need for doctors, who migrate from poorer countries, with an ensuing global health workforce crisis. These political, social, demographic and international events necessitate a discussion on the roles and values of the doctor in the world today. The international mobility of both doctors and patients underlines the need for a global definition. Only when these roles and values are agreed in a global perspective, will medical education be capable of producing a professional equipped to fulfil that role. This doctor will then be useful both as a leader and as a member of health care teams with a flexible composition, related to resources and needs of particular regions, and at the same time be able to practise within any given health care system. An international task-force of the World Federation for Medical Education (WFME) is working to agree themes relevant to the role of the doctor globally, and developing a statement that can be used world-wide, and used to develop medical education policy.

AbstractMedical care is deficient in many parts of the world, while in richer countries the costs and complexities of health care are rising unsustainably. Thus, societies need to understand what it is that only doctors can do and what can or should be done by other members of the healthcare team. The duty of doctors to examine their accountability to society as a whole is critical, in order not to continue blindly to do what has always been done. We argue that doctors may not need, in the future to undertake all their traditional roles, while other new roles may emerge instead. A synthesis of these elements is necessary to propose a policy and philosophy for the future global role of the doctor. Only when we have defined this, is the stage set for medical education to produce a person equipped to fulfill that role.

Undergraduate medical education in Sweden has moved from nationally regulated, subject-based courses to programmes integrated either around organ systems or physiological and patho-physiological processes, or organised around basic medical science in conjunction with clinical specialities, with individual profiles at the seven medical schools. The national regulations are restricted to overall academic and professional outcomes. The 5½ year long university undergraduate curriculum is followed by a mandatory 18 months internship, delivered by the County Councils. While quality control and accreditation for the university curriculum is provided by the Swedish National Agency for Higher Education, no such formal control exists for the internship; undergraduate medical education is therefore in conflict with EU directives from 2005. The Government is expected to move towards 6 years long university undergraduate programmes, leading to licence, which will facilitate international mobility of both Swedish and foreign medical students and doctors. Ongoing academic development of undergraduate education is strengthened by the Bologna process. It includes outcome (competence)-based curricula, university Masters level complying with international standards, progression of competence throughout the curriculum, student directed learning, active participation and roles in practical clinical education and a national assessment model to assure professional competence. In the near future, the dimensioning of Swedish undergraduate education is likely to be decided more by international demands and aspects of quality than by national demands for doctors.

Undergraduate medical education in Sweden has moved from nationally regulated, subject-based courses to programmes integrated either around organ systems or physiological and patho-physiological processes, or organised around basic medical science in conjunction with clinical specialities, with individual profiles at the seven medical schools. The national regulations are restricted to overall academic and professional outcomes. The 51/2 year long university undergraduate curriculum is followed by a mandatory 18 months internship, delivered by the County Councils. While quality control and accreditation for the university curriculum is provided by the Swedish National Agency for Higher Education, no such formal control exists for the internship; undergraduate medical education is therefore in conflict with EU directives from 2005. The Government is expected to move towards 6 years long university undergraduate programmes, leading to licence, which will facilitate international mobility of both Swedish and foreign medical students and doctors. Ongoing academic development of undergraduate education is strengthened by the Bologna process. It includes outcome (competence)-based curricula, university Masters level complying with international standards, progression of competence throughout the curriculum, student directed learning, active participation and roles in practical clinical education and a national assessment model to assure professional competence. In the near future, the dimensioning of Swedish undergraduate education is likely to be decided more by international demands and aspects of quality than by national demands for doctors.