Educational pathways and developing competencies in medical education International Experience Dr Richard JAMES HRH Consultant WHO, Viet Nam
Content ⚫ History of medical education ⚫ Health Professional Education Pathway ⚫ Development of competency framework for doctors – International experiences ⚫ Postgraduate Pathway and Continuing Medical Education – Postgraduate Academic and Clinical Training 2 |
Developments in Medical Education Early 20th century Early 20th century Curricular reform and a move to a science based curriculum Late 20th Century New learning methods 21 st Century Patient and population centeredness, competency based curricula 3 |
Health Professional Education Pathway (1) Regulatory framework: accreditation, licensing and certification Primary institution Under- Continued Health Post-graduate graduate workforce Professional training training pool Development Secondary institution Qualified Eligible Competent Workforce graduates Workforce Graduate Examination 4 |
Health Professional Education Pathway (2) Regulatory framework: accreditation, licensing, certification Regulation Body [ Medical Council ] Competency- PG Specialist Competencies Based Curriculum Competencies Primary institution Health Under- Post-graduate Continued workforce graduate Specialist Professional pool training training Development Secondary Future institution Needs Qualified Eligible Competent Workforce graduates Workforce Assessment of Community Health Competencies Needs National Licensing Examination [ Graduate - or - Exit Exam ] 5 |
Development of Competency Frameworks for Doctors Country examples include regulatory and accreditation bodies producing the competencies required to become a doctor: UK General medical Council (GMC) Canada Canadian Medical Education Directives for Specialties (CanMEDS) USA Accreditation Council for Graduate Medical Education (ACGME) Other examples of drafting by Government Ministries, Universities and legislative advisors produce frameworks and legal guidance • Vietnam - Decision 1854 [ May 2015 ] 6 |
Competency framework for Doctors – Country Comparisons table Cambodia Laos PDR Viet Nam China** Canada UK Scientific Medical Application of Information and Communicator Medical foundations for knowledge Medical Management technique medical practice Knowledge service Provisions and Patient care and Medical Care Clinical skills and Collaborator Medical management of clinical Skills patient care diagnosis norm patient care Professional Professional Professional Professionalism Manager Teaching and and Personal behaviour Practice training skills behaviors Interpersonal Communicati Interpersonal Health Promoter Interpersonal and on and Communication communication communication Cooperation skills Pubic Health Health promotion Scholar Teamwork and disease prevention Medical Ethics Academic research Professionalism Professionalism Teamwork Medical expert Master of medical **Liu Z, Tian L, Chang Q, Sun B, Zhao Y (2016) A Competency Model for Clinical Physicians in China: A knowledge 7 | Cross-Sectional Survey. PLoS ONE 11 (12):
Competency framework for Doctors – Country Comparisons table Cambodia Laos PDR Viet Nam China** Canada UK Scientific Medical Application of Information and Communicator Medical foundations for knowledge Medical Management technique medical practice Knowledge service Provisions and Patient care and Medical Care Clinical skills and Collaborator Medical management of clinical Skills patient care diagnosis norm patient care Professional Professional Professional Professionalism Manager Teaching and and Personal behaviour Practice training skills behaviors Interpersonal Communicati Interpersonal Health Promoter Interpersonal and on and Communication communication communication Cooperation skills Pubic Health Health promotion Scholar Teamwork and disease prevention Medical Ethics Academic research Professionalism Professionalism Teamwork Medical expert Master of medical **Liu Z, Tian L, Chang Q, Sun B, Zhao Y (2016) A Competency Model for Clinical Physicians in China: A knowledge 8 | Cross-Sectional Survey. PLoS ONE 11 (12):
Competency framework for Doctors – Country Comparisons table Cambodia Laos PDR Viet Nam China** Canada UK Scientific Medical Application of Information and Communicator Medical foundations for knowledge Medical Management technique medical practice Knowledge service Provisions and Patient care and Medical Care Clinical skills and Collaborator Medical management of clinical Skills patient care diagnosis norm patient care Professional Professional Professional Professionalism Manager Teaching and and Personal behaviour Practice training skills behaviors Interpersonal Communicati Interpersonal Health Promoter Interpersonal and on and Communication communication communication Cooperation skills Pubic Health Health promotion Scholar Teamwork and disease prevention Medical Ethics Academic research Professionalism Professionalism Teamwork Medical expert Master of medical **Liu Z, Tian L, Chang Q, Sun B, Zhao Y (2016) A Competency Model for Clinical Physicians in China: A knowledge 9 | Cross-Sectional Survey. PLoS ONE 11 (12):
Health Professional Education Pathway – Postgraduate and Continuing Medical Education Regulatory framework: accreditation, licensing and certification Primary institution Under- Continued Health Post-graduate graduate workforce Professional training training pool Development Secondary institution Qualified Eligible Competent Workforce graduates Workforce National Licensing Examination 10 |
Post Graduate Academic and Clinical Pathways (1) Academic tracks in many countries MD-PhD dual degrees of 7-8 years including: Pre-clinical curriculum 2yrs PhD graduate training 3-5yrs Clinical rotations 2yrs Masters or PhDs in basic sciences, clinical research and public health is offered to medical graduates and Bachelor Science graduates • Subsequent careers (academia, research, biotech, pharmaceutical industry, health policy) 11 |
Post Graduate Academic and Clinical Pathways (2) ⚫ Define policy objectives of PGME, with clarity of roles for clinical and academic specialists within the health system. ⚫ Platform for those representing medical specialties desirable (example: the Societies/Colleges system) ⚫ Strict requirements and planning for entrants into PG specialist training - academic requirements, numbers, curriculum and suitable facilities. ⚫ Health workforce planning to inform enrolment 12 |
Post Graduate Academic and Clinical Pathways (3) ⚫ Clinical practice accompanied by licensing requirements and a review or re-licensing process - CME update/maintain clinical knowledge - Regular clinical practice required ⚫ Close coordination between ministries and departments 13 |
Summary • Historical context of competencies and CBME • Competent health professionals are important for quality and patient safety • Fit for future – planning health professional education now, for future needs • Postgraduate medical education • Importance for health professionals to have specialist competencies • Importance to clearly define the clinical and research track – each with own competencies 14 |
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