In his latest blog Professor Harden discusses his WFME, AMEA, AUC and Vanderbilt visits, practicing without training, benefits of publishing in Medical Teacher, students and medical education, and medical education and Iran
WFME, AMEA, AUC and Vanderbilt
I had an interesting April with visits to the WFME World Conference in Seoul, Korea, the AMEA Conference in Kuala Lumpur in Malaysia, the AUC Board meeting in Miami, USA, and a visit as the John E. Chapman lecturer to Vanderbilt University. The major theme at the WFME Conference in Seoul was the WFME approval of medical school accrediting agencies. This is in anticipation of the ECFMG requirements by 2023 for all students to come from a school that had been accredited by an approved accrediting agency. Accrediting agencies who had been approved reported their experience. Also reported at the meeting was work in progress with regard to an updating of the WFME Basic Standards for medical education. The current standards are being reviewed to bring them up to date and to reduce the number of specified criteria. While in Seoul I was invited to make a presentation at the Korea University College of Medicine. I was interested to learn that all of the medical schools in Korea, as a result of a government edict, had changed from a direct entry to medicine from secondary school to entry, as in the USA, following a another degree course. The result of this, however, had not been successful and a majority of schools have now reverted to a direct entry from secondary school.
The theme of the AMEA meeting was the impact of the Fourth Industrial Revolution on medical education. There is an excellent account of the changes expected in the Fourth Industrial Revolution in the book by Klaus Schwab, The Fourth Industrial Revolution. In my opening presentation at the AMEA Conference I looked at the future impact of the Fourth Industrial Revolution on medical education in the context of the delivery of a more authentic curriculum, the move to adaptive learning, greater collaboration including unbundling the curriculum, more student engagement, and the changing role of teachers.
Neil Osheroff, Professor of Biochemistry, hosted my visit to Vanderbilt. He is passionate about both biochemistry and medical education. For my programme he organised, in addition to my formal Chapman lecture and workshop, a series of 19 meetings with staff and students. This allowed me to have an understanding of the curriculum at Vanderbilt. I was impressed. I remember when I first moved to Dundee the Professor of Biochemistry, Peter Garland, wanted to move the teaching of biochemistry from early in the curriculum to the final part of the curriculum, after students had their clinical experiences. I was interested to note that in the Vanderbilt curriculum the teaching of foundational sciences is in year one, clinical experiences in year two, and then in year three there are scheduled integrated science clinical themes. Students can choose four of 16 possible themes. Foundational sciences is now the preferred term for basic sciences! I was impressed by the students’ enthusiasm and engagement with the curriculum. They run a clinic for uninsured patients as an interprofessional exercise with medical students, nursing students, social workers, pharmacy students, and divinity students. I was most impressed with the dean Bonnie Miller, who was formerly a surgeon. She has made a major contribution to the changes in the curriculum at Vanderbilt and is universally admired and respected by staff and students. On my first evening Don Moore took me to the Grand Ole Opry, knowing my love of country and western music. This was a great evening and we had a talk over dinner and the next day about Don’s interest in the master adaptive learner. We also had an interesting discussion about learning styles and came to the conclusion that despite the moves to discredit the concept of learning styles there remain aspects of the concept which are relevant.
Practicing without training
The Sunday Times reported “a bogus psychiatrist” who had practiced for 22 years in the NHS in the UK with no medical qualification. She was found to have no formal qualifications during a court case when she was found guilty of faking a patient’s will in an attempt to inherit her £1.3 million estate. I remember many years ago a trainee orthopaedic surgeon in the hospital where I was working was only found to have no medical qualifications during an insurance case after his car crashed with the professor of orthopaedics’ car. Perhaps their psychiatric and orthopaedic care may have not been up to the required standard. The fact that they were able to practice medicine with no or only minimum training, however, is of interest. Do we really need 13 years to train a doctor for practice?
£2000 salary increment for publishing in Medical Teacher
There continue to be pressures to publish in a recognised journal. There can be an associated financial benefit. I heard recently that publishing an article in Medical Teacher was associated with a salary increase of £1000-2000.
On a different theme, we are currently reviewing the membership of the Medical Teacher Editorial Board and the panel of reviewers with a view to a gender balance. Of the authors who published papers in the journal in 2018, 538 were male and 501 female. There were, however, slightly more female first authors (138) than male first authors (132).
Students and medical education
I continue to be impressed by the increasing commitment of students to medical education. With John Dent as lead we ran for the fourth year a very successful Essential Skills in Medical Education (ESME) course for students. Some of the course facilitators also have responsibilities for our ESME course for teachers. At our recent December Examiners Board meeting for the Student ESME course, three facilitators reported that they preferred working with their student group rather than their teacher group and were impressed by the students’ commitment, work ethic, and vision.
Medical education and Iran
There is in the country, however, an enthusiastic and bright group of workers in the field of medical education. I had been invited to make an opening presentation at the Iranian Conference on Health Professions Education (ICHPE) on 3rd May, the day after I came back from the USA. This was arranged using the Adobe Connect platform. A number of hurdles had to be overcome, however, but on the day the presentation went well and there were no technical problems. I was impressed that not only was I able to make a live presentation but I was able to see and hear members of the audience who asked questions following my contribution.