Standards and Guides

Standards for Basic Medical Education

Time:2013-11-06 17:09:00     Source:     Visited:1130

Preface

The goal of medical education is to provide a competent healthcare workforce for society. After studying the experience in China and the trends of international reform and development, we have come to a clear understanding that the aim of enhancing the quality assurance in medical education is to train high quality medical graduates able to deliver better health care.

At the end of the last century, the World Federation for Medical Education (WFME) conducted an “International Collaborative Programme for the Reorientation of Medical Education[i]”. The key component of this global collaboration, which was approved by the World Health Organization (WHO) and the World Medical Association (WMA), was the adoption of international standards in basic medical education. In 1998, WFME launched the programme on International Standards in Medical Education, and in June, 2001, the WFME Executive Council ratified and issued International Standards in Basic Medical Education[ii]. At the same time the Association for Medical Education in the Western Pacific Region and WHO Western Pacific Regional Office (WHO/WPRO), formulated Guidelines for Quality Assurance of Basic Medical Education in the Western Pacific Region[iii] based on the WFME standards. These regional guidelines which also provided a framework for quality assurance processes such as accreditation were issued in July 2001. Some developed countries such as the United Kingdom, the United States, Australia, the Republic of Korea and Japan have published their own medical education standards.

Indicated in the Preface to the Trilogy of WFME Documents Global Standards in Medical Education,“WFME had already in its position paper of 1998 suggested that a World Register of Medical Schools be developed, aiming to constitute a roster of quality assurance in medical educational institutions, and indicating specifically that institutions included have attained globally accepted and approved standards for medical education programmes.”

The emergence of Global Standards for Medical Education has offered an opportunity for China to solve problems in medical education reform and development, to regulate the management of medical schools and to assure the quality of medical education. The priority in developing and improving China’s medical education is to globalize China’s medical education to ensure its recognition by international communities. Formulating China’s standards must be done after a careful study of these global standards and take into account China’s national context. Entrusted and endorsed by the Ministry of Education, the Task Force on Quality Assurance in Basic Medical Education of China has formulated Chinese National Standards for Basic Medical Education, which conforms to the Higher Education Law of the People’s Republic of China and is based on twenty years of experience of medical education assessments in China. It includes Attributes for Basic Medical Graduates (33 items), and Standards in Basic Medical Education (44 items in 10 areas) for medical schools. All the schools providing basic medical education on the Chinese mainland must meet the requirements of the Standards.

Basic medical education is the first stage in the continuum of medical education. Its fundamental mission is to train junior doctors who must complete basic medical training, possess primary clinical skills, lifelong learning ability and appropriate professional attributes and values. It will also lay a solid foundation for further training of medical graduates in any branch of health care delivery sectors. The medical graduates’ professional ability in clinical practice needs to be further developed and improved through postgraduate medical education, continuing professional development and continuous medical practice. These Chinese National Standards for Basic Medical Education are targeted at five-year basic medical education, and are concerned with the essential aspects of basic medical education in China and sets forth the minimum requirements. Higher standards should be set for further medical education on the basis of these Standards.

While the Standards apply to all the medical schools in China, they allow for regional and institutional differences and respect the right of individual medical schools to run their programmes. The Standards will not impose any mandatory provisions for type of educational programme, content of core courses or teaching methods, and allows for each school to develop its own educational attributes. The Standards reflect the international trends, domestic situation and social expectations that China’s medical education is facing, and serves as a reference for individual medical schools to formulate their own educational objectives and programmes, and regulate their teaching management. The Standards are a key component of the quality assurance system in medical schools providing basic medical education, and will function as a lever for medical education reform and development. Based on the Standards, each medical school must formulate its own educational objectives and programmes, and establish its own educational evaluation system and educational quality assurance organization and mechanism.

The Standards are to be used for the evaluation and accreditation of medical education in China. The procedures generally include institutional self-evaluation, site visit by the assessment team, recommendations on accreditation and release of the final decision. The Standards are not used to rank medical schools. The Standards must be periodically examined and revised for improvement. In order for China’s medical education to keep up with international medical education, the Task Force mainly referred to the 2003 version of Basic Medical Education WFME Global Standards for Quality Improvementthe WHO Guidelines for Quality Assurance of Basic Medical Education in the Western Pacific Region in 2001 and the IIME Global Minimum Essential Requirements in Medical Education (GMER) in 2002. The consulted documents also include Functions and Structure of a Medical School issued by Liaison Committee on Medical Education (LCME) of the United States in 2003, Tomorrow’s Doctors issued by General Medical Council (GMC) of the United Kingdom in 2002, Assessment and Accreditation of Medical Schools: Standards and Procedures issued by Australian Medical Council (AMC) in 2002, Guidelines for Medical Education Mode and Contents of Core Courses issued by Japan in 2001, and Handbook of Taiwan Medical Accreditation Council issued by the National Health Research Institutes of Chinese Taiwan in 2002.


Attributes of basic medical graduates

The quality of graduates is the ultimate criterion for measuring the educational quality of any medical school. As medical practitioners, medical graduates must keep upgrading their professional competence with advances in medicine. This depends on them mastering scientific methods and acquiring the ability for lifelong learning during their study in the medical school.

The goal of medical education is to develop doctors who demonstrate appropriate professional attributes and values. When they graduate,medical graduates are competent to practise safely and effectively under the guidance and supervision of senior doctors, and have a solid foundation for lifelong learning and further training. At present, the five-year medical programme is dominant in basic medical education in China. The Standardsset the basic requirements for medical graduates of five-year medical programmes. A higher requirement for long-term medical education must be set on the basis of the Standards.

Professionalism and Ethics

At the end of basic medical education, graduates should demonstrate the following professional and ethical attributes:

1. Acquiring a correct outlook on the world, life and values,and being possessed of patriotism and collectivism, being loyal to the people and willing to make a lifetime contribution to the health care service of the motherland and the health of the humanbody and mind.

2. Caring for individual patients, taking the prevention and treatment of illness as their lifetime responsibility, the provision of end-of-life care as their ethical responsibility and the protection of people’s interests in health as their professional responsibility.

3. Showing the awareness to communicate with patients and their families and involving them fully in planning management.

4. Attaching importance to ethical issues and the cost-effectiveness of patient care throughout their careers, achieving the optimal outcome for the least cost in health promotion and disease prevention, and the maximum benefit from available health resources.

5. Appreciating the concept of lifelong learning, and recognising the importance of continuous self-improvement and pursuing excellence ceaselessly.

6. Respecting every human being and individual belief, and understanding the diversity of human background and cultural values.

7. Realising that doctors encounter clinical problems that exceed their knowledge and skills, and that, in these situations, they need to consult and/or refer the patient to others.

8. Showing respect for colleagues and other health care professionals and willingness to work in a team.

9. Developing the awareness of the legal responsibilities of medical practitioners and learning to protect the patients’ and their own interests.

10. Realising that it is not always in the interests of patients or their families to do everything that is technically possible to make aprecise diagnosis or to attempt to modify the course of an illness.

11. Fostering creativity, analytical and critical thinking and scientific attitude.

Objectives relating to knowledge

At the end of basic medical education, graduates completing basic medical education should have knowledge and understanding of the following areas:

1. Basic knowledge and scientific methods relevant to mathematics, physics, chemistry, life science, be havioural and social sciences, which will be used in their future study and medical practice.

2. The normal structure and function of the human body and mind at all stages of life.

3. The aetiology of common mental and physical ailments at allstages of life, a realization of the influence of environment, society and be havioural psychology on the pathogenesis and development of an illness, and recognition of the importance of disease prevention.

4. The pathogenesis, clinical manifestations, diagnosis, and principles of prevention and treatment of common ailments at all stages of life.

5. Basic pharmacological knowledge and the principles of rational use of drugs.

6. Normal pregnancy and childbirth, the more common obstetrical emergencies, the principles of antenatal and postnatal care, and medical aspects of family planning.

7. The principles of health education, disease prevention and screening, the knowledge of amelioration of suffering and disability, rehabilitation, and the care of the dying.

8. Knowledge of clinical epidemiology, and understanding of the important role of research in medical study.

9. Knowledge of the basic characteristics of traditional Chinese medicine, and understanding of the principles of diagnosis and treatment on the basis of an overall analysis of the illness and the patient's condition.

10. Knowledge of the pathogenesis, development and prevalence of infectious diseases, and the principles of prevention and treatment of common infectious diseases.

Objectives relating to skills

At the end of basic medical education, graduates completing basic medical education should have developed the following skills:

1. The ability to takea tactful, accurate, organized and problem-focused medical history.

2. The ability to perform a systematic and standardised physicaland mental state examination and to write standardised patient medical records.

3. Competence in clinical thinking and communication.

4. The ability to diagnose and manage common diseases in internal medicine, surgery, obstetrics and gynaecology, and paediatrics.

5. The ability to perform diagnosis, first-aid and management of common emergencies.

6. The ability to choose the appropriate clinical techniques andthe most appropriate and economic diagnosis and treatment according to specific situations.

7. The ability to practise medicine utilizing evidence-based medicine to improve diagnosis and treatment.

8. The ability to communicate effectively with patients and their families.

9. The ability to communicate with doctors, nurses and other health care professionals.

10. The ability to use libraries and other information resources, on the basis of clinical practice, to pursue independent inquiry relating to medical problems and acquire new knowledge and relevant information. The ability to use one foreign language to read medical literature.

11. The ability to promote healthy life styles and disease prevention to patients and the public.

12. The ability for self-directed and lifelong learning.

Annotation:

l Internal medicine would typically include infectious diseases, neurology and psychiatry.

Standards for Basic Medical Education

Mission and Objectives

Mission and objectives

The medical school must clearly define its mission and objectives, including its educational orientation, rationale, development plan, training objectives and quality benchmarks.

Formulation of mission and objectives

The mission statements and objectives of the medical school mustbe defined in consultation with its stakeholders, and approved by administrative authorities (educational department or health department). The medical school must make them known to its constituency.

Academic autonomy

According to its development programmes and legal responsibilities, an independent medical school or a medical school in a university must have freedom to design the curriculum and to implement it, to appoint its facultyand staff, and to allocate its available educational resources. The medical school in a university must obtain academic support from the departments of humanities and social sciences and natural sciences, and enhance integration of its disciplines.

Educational outcome

According to Basic Requirements for Medical Graduates, the medical school must formulate appropriate educational objectives and programmes, ensure students satisfactorily complete all the courses and meet the above-mentioned requirements during the valid 5-year study period and are granted a diploma and bachelor’s degree. Students of the longer (seven or eight year) medical programmes are granted corresponding diplomas and medical degrees according to relevant regulations issued by the Ministry of Education and the State Council Academic Degrees Committee.

Annotations:

l Mission and objectives may include the policies and specific issues in the region and the medical school.

l Stakeholders would include the governance of the university, the administrative and academic staff and the students of the medical school, governmental authorities and employers of the graduates.

Educational Programme

The medical curriculum

1. The medical school must design a curriculum suitable for actual conditions based upon the health needs of community and society, the advances in medical sciences and the transformation of the medical model.

2. The curriculum must define the courses and their basic requirements.

3. The medical school must actively conduct curriculum reform, and integrate courses rationally. The curriculum must embody the principles of strengthening foundations and skills training, emphasizing professionalism and developing personal qualities. The curriculum must include core courses and optional contents. The ratio between the two components must be determined by the medical school in the light of the actual conditions.

Instructional methods

The medical school must actively conduct instructional methods reform aiming for student-centered and self-directed learning, and emphasize the training of students’ critical thinking and learning ability.

Annotation:

l Instructional methods encompass teaching and learning methods. The widely applied modes may include heuristic methods, problem-based learning and interactive teaching.

Scientific method

The medical school must teach the principles of scientific method and evidence-based medicine throughout the curriculum, training students in scientific thinking and research methods.

Medical ethics

The medical school must incorporate in the curriculum the contributions of medical ethics.

Natural sciences

The medical school must incorporate in the curriculum the contributions of natural sciences to lay a good foundation for further study of medical sciences.

Annotation:

l Natural sciences include mathematics, physics, chemistry, etc.

Basic biomedical sciences

The medical school must incorporate in the curriculum the contributions of basic biomedical sciences to lay a solid foundation for acquiring clinical science, so that students can adapt themselves to developments in medical sciences and to the health needs of society.

Annotations:

l Biomedical courses typically include human anatomy, histology and embryology, biochemistry, physiology, molecular biology, cell biology, pathogeneticbiology, medical genetics, medical immunology, pharmacology, pathology, pathophysiology, and the integration of these biomedical courses.

Behavioural sciences, humanities and social sciences and medical ethics

1. The medical school must incorporate in the curriculum the contributions of the behavioural sciences, social sciences, medical ethics and medical jurisprudence to adapt students to scientific developments in medicine, to changing demographic and cultural contexts and to the health needs of society.

2. The medical school must incorporate in the curriculum the contributions of humanities education.

Annotations:

l Behavioural and social sciences would typically include psychology, social medicine, medical sociology, health economics, medical jurisprudence, health services administration, etc.

l Humanities education would typically include art, literature, medical history, etc.

Preventivemedicine

The medical school must incorporate in the curriculum the contributions of preventive medicine to develop students’ preventive strategy and awareness of public health. Students must master the knowledge and skills of population healthcare to adapt to scientific developments in medicine and to health needs of society.

Annotation:

l Preventive medicine would typically include epidemiology, occupational health and occupational medicine, health toxicology, environmental health, nutrition and food hygiene, child and adolescent health, maternal and child health care, health statistics, primary health care, etc.

Clinical sciences and skills

The medical school must incorporate in the curriculum the contributions of clinical medicine and clinical practice, advocating early patient contact, to ensure that students have sufficient exposure to patients in order to acquire sufficient clinical experience and competence.

Annotations:

l Clinical sciences would typically include diagnostics, internal medicine, surgery, gynaecology & obstetrics, paediatrics, ophthalmology, otorhinolaryngology, dentistry, dermatology & venereology, anaesthesiology, emergency medicine, rehabilitation medicine, geriatrics, traditional Chinese medicine, etc.

l Clinical skills would include history taking, physical examination, accessory examination, diagnostics and differential diagnosis, decision-making and implementation of management plan, clinical operation, clinical thinking, emergency practices, communication skills, etc.

l Internal medicine is defined to encompass infectious diseases, neurology and psychiatry.

Programme management

1. The medical school must establish committees in charge of programme management for curriculum planning and implementation to ensure the fulfillment of the objectives.

2. The opinions of the faculty, students and other stakeholders must be taken into account in programme management.

Linkage with postgraduate medical education and continuing medical education

Effective institutional linkage must be assured between the basic medical programme and the subsequent stages of postgraduate medical education and continuing professional development that the student will enter after graduation.

Assessment of students

Assessment methods

The medical school must establish an assessment system and standards for student performance and competence throughout the educational process, and must study assessment methods and promote the use of any advanced assessment methods such as Objective Structured Clinical Examination (OSCE) and Computer-based Simulated Case Examination (CSCE). The school must clearly define the types and methods of assessment in order to fully evaluate students’ knowledge, skills, behaviour and attitudes, and their abilities in problem solving, clinical thinking and communication.

Annotation:

l Assessment system includes formative assessment and summative assessment. Formative assessment includes self assessment tests, observation notes, etc that do not contribute to the final mark for the course. Summative assessment includes both within course assessments and end-of-course examinations, etc that contribute additively to the final mark.

Relationship between assessment and learning

The assessment principles, methods and practices in the medical school must be clearly compatible with educational objectives, and the objectives and requirements of medical courses, to promote learning. Assessment should be integrated across various curricular elements to encourage integrated learning. Comprehensive examination is designed to encourage students to integrate their knowledge. Self-evaluation must be advocated and students’ initiative in learning be promoted.

Annotation:

l The number and nature of examinations must be defined in favour of their guiding role in learning to avoid negative effects.

Analysis and feedback of assessment results

The medical school must analyse the assessment results after all the examinations are finished. The result of the analysis must be fed back to students, faculty and academic affairs administrative staff to improve teaching and learning.

Annotation:

Assessment analysis may be conducted on the exam results, to determine the reliability, validity, difficulty, differentiation, and course coverage of examinations.

Assessment management

The administrative department of the medical school must formulate specific rules and regulations on assessment management, establish committees and appoint appropriate staff. The medical school must train faculty in assessment theories to improve the quality of question design and examinations.

Students

Admission policy and selection

1. The medical school must formulate specific rules and regulations on admission according to the policies stipulated by educational authority.

2. The admission policies must be made known to the public, including entry prospectus, admission plan, programmes, tuition and fees,scholarships, mechanism for appeal, etc.

Annotation:

l The admission of undergraduate students in China is controlled by the government according to its annual plan, and approved by the local educational authority.

Student intake

1. The medical school must reasonably define its admission plan and standards in the light of its actual educational resources, the health needs of community and society and the quality of the student applicants.

2. In the course of student selection, the medical school must implement national policies, and take into account the interests of the disadvantaged groups.

Student support and counselling

1. The medical school must establish organisations and appoint staff to provide appropriate student support.

2. Counselling must be provided by the medical school to give students guidance in their learning, campus life, psychological well-being and career choices.

Annotation:

l Student support offers students assistance in health service and career guidance, and makes reasonable accommodation for disabled students. It provides students with financial assistance through scholarship, loan, allowance, subsidy for poor students, reduction or exemption of tuition or fees, etc.

Student representation

1. The medical school must encourage student representatives to participate in school governance, in the design, evaluation and reform of the curriculum, and in other matters relevant to students.

2. The medical school must support students to establish official student organisations. Student activities and organisations must be encouraged and facilitated by relevant departments.

Annotation:

l Student organisations would include relevant bodies for student self-government, self-education and self-service.

Academic staff / faculty

Recruitment policy

The medical school must have a system to recruit and evaluate staff qualifications, to appoint an adequate number of medical and non-medical academic staff, and to ensure a reasonable structure of academic staff to meet teaching, research and service functions. Teachers’ responsibilities must be clearly defined. The staff must have good professional ethics, academic and teaching competence appropriate for their academic titles. They must deliver agreed courses and assessments. Their performance must be evaluated regularly.

Annotations:

l An adequate number of academic staff means that the number of academic staff in the medical school must conform to the educational capacity and objectives of the school, and to the requirements of medical education. Teacher-student ratios must meet national requirements.

l The structure of academic staff refers to medical and non-medical academic staff, full-time and part-time staff, proportion of degrees, etc.

Staffpolicy and development

The medical school must guarantee teachers’ rights and obligations, and have a clearly defined staff policy which is implemented effectively. A balance must be kept in teaching, research and service functions.The school must recognise and support meritorious academic activities and ensure the central position of professional development. A mechanism must be established for staff participation in developing policy relevant to the educational programme. Staff development plans must be formulated to ensure staff training, evaluation and exchanges, and to provide opportunities for their professional development.

Annotations:

l Service functions would include clinical duties in the health care system, administrative and leadership functions, etc.

l Recognition of meritorious academic activities would be by rewards, promotion and/or remuneration.

l Staff exchanges would include the exchanges within the discipline, across disciplines and between schools and international exchanges as well. Special emphasis would be put on staff exchanges between clinical medicine and basic medical sciences in the medical school.

Educational resources

Educational budget and resource allocation

1. The medical school must have sufficient financial support and reliable access to fund raising. In the development of medical education, funds must also be increased annually to ensure the fulfillment of the educational programme.

2. The medical school must have a clear line of responsibility and authority for educational budget and resource allocation, establish a rational financial management system, and strictly control the expenditures of educational funds to increase the benefit of educational input.

Annotations:

l The medical school must have sufficient autonomy and appropriate methods in fund raising and management to help achieve the mission and overall objectives of the school. The tuitions charged by the medical school must be managed and used according to national regulations. The funds used for teaching and their proportion in the annual final account of the school must meet national regulations.

l The educational budget would depend on the budgetary practice in each medical school and region. Its annual increase must at least not be less than that of nationalor local finance to ensure steady educational development.

Physical facilities

1. The medical school must have sufficient physical facilities for the staff and the student population. The physical facilities must be regularly renewed to ensure the fulfillment of educational programme.

2. The medical school must equip laboratories with modern and advanced instruments to ensure the fulfillment of laboratory teaching.

Annotation:

l Physical facilities would include all types of classrooms, multimedia equipment, studios, tutorial rooms, laboratories and equipment for basic medical sciences, clinical instructional classrooms, clinical training equipment, clinical skills laboratories, libraries, information technology facilities and Internet access, recreational facilities, accommodation for students, etc.

Clinical teaching sites

1. The medical school must establish a sound system for the construction and management of clinical teaching sites to ensure adequate clinical experience and necessary resources in clinical teaching, including sufficient patients and clinical training facilities. Clinical teaching sites must be accredited, and qualified at least to provincial accreditation standards.

2. A clinical teaching site must have specialized organisations and staff in charge of the administration and management of clinical training.The medical school must establish an effective system for the management of clinical training and teaching records, and strengthen the teaching quality assurance system, especially the management of clinical skills examinations. Affiliated hospitals of the medical school and their hospital beds must meet the needs of clinical training. The ratios between clinical students and hospital beds must meet national regulations.

3. The medical school must strengthen the construction of teaching facilities at the clinical teaching sites to meet the needs ofclinical training.

4. The medical school must establish good and sound business relations with urban community health care centres, rural health care settings and institutions for disease prevention and control to ensure the delivery of preventive medicine at the teaching sites.

Annotation:

l Clinical teaching sites, according to their relations with medical schools and the task they assume, would be typically classified into affiliated hospital, teaching hospital (with no direct control by the medical school) and training hospital. A teaching hospital must meet the following requirements: governmental documents to ratify it to be a teaching hospital for a medical school; written agreements between the medical school and the hospital; the medical courses delivered by the hospital staff; a sound set of organisations and systems for clinical teaching management and departments for clinical teaching; at least one group of graduates from the hospital.

Library and information technology

The medical school must have well maintained libraries, information technology facilities and Internet access, and formulate corresponding policies and systems, and apply modern information and communication technologies teaching. Teachers and students must have access to information and communication technologies for self-directed learning, acquiring information, managing patients and working in health care systems.

Annotation:

l The medical school must attach importance to the construction of and input to the libraries. The annual purchase outlay for library collections and its proportion in the educational expenditures must meet national regulations.

Educational expertise

1. Educational experts must be involved in deciding on medical education policies, planning the educational programme and developing the teaching methods.

2. There must be effective access to educational experts and evidence demonstrated of the use of such expertise for staff development and for research in the discipline of medical education.

Annotation:

l Educational expertise would deal with problems, processes and practice of medical education and would include faculty with research experience in medical education, management experts, educational psychologists and sociologists, etc. It can be provided by an education unit at the institution or be acquired from another national or international institution.

Educational exchanges

1. The medical school must have a policy for collaboration with other educational institutions and for the transfer of educational credits.

2. Regional and international exchanges of academic staff and students must be facilitated by the provision of appropriate resources.

Annotations:

l Transfer of educational credits can be facilitated through programme recognition between medical schools.

l Other educational institutions would include other medical schools and institutions for education of other health and health-related professions.

Programme evaluation

Mechanisms for programme evaluation

1. The medical school must establish a mechanism for programme evaluation that enables the governance and administration of the medical school, the academic staff and the students to actively participate in programme evaluation. An effective operating mechanism for educational quality assurance must be developed to ensure the implementation of educational programme and the normal operation of each teaching process, and ensure that concerns must be identified and addressed in time.

2. Programme evaluation must address every stage of medical education, with emphasis on the evaluation of educational programme, educational process and general outcome.

Teacher and student feedback

The medical school must establish committees to systematically seek and analyse the feedback from teachers and students for effective teaching management information, which provides evidence for deciding on programme improvement.

Involvement of stakeholders

1. Programme evaluation must involve the governance and administration of the medical school, the academic staff and the students.

2. Programme evaluation must involve a wide range of stakeholders, such as education and health care authorities, representatives of the community, professional organisations and postgraduate education bodies.The medical school must consider their views on the relevance and development of the programme and provide them with access to evaluation results.

Graduate performance

1. The medical school must establish a survey system to gather feedback on the graduates’ work performance to improve educational quality.

2. Relevant information such as graduates’ performance, professional competence, professionalism and employment must be used as principal evidence for the revision of educational programme and the improvement of teaching.

Research

The nexus between teaching and research

1. The medical school must state clearly that research is one of its principal functions, establish relevant management systems and formulate constructive research policies, development plan and management methods.

2. The medical school must provide academic staff with appropriate research facilities, create an academic environment, advocate creativity and critical thinking, and facilitate the integration between teaching and research.

3. The medical school must advocate incorporating research activities and findings into the course of teaching, thereby cultivating students’ scientific thinking, scientific method and scientific spirit.

4. The medical school must strengthen the study of medical education and management to provide theoretical support for educational innovation and development.

Research by staff

The medical school must have an academic staff policy which addresses a balance between their position and their research ability, research projects and research attainment.

Annotation:

l Research projects and outcome would include those in research and teaching at the national, ministerial, provincial, municipal or university level.

Research by students

1. The medical school must consider research activities as an important pathway to cultivate students’ scientific literacy and creativity, and take active and effective measures to provide students with opportunities and conditions to participate in ongoing programmes.

2. The medical school must actively engage in activities which are instrumental in cultivating students’ research ability, such as incorporating adequate comprehensive experiments and designing experiments in curriculum, holding academic lectures for students and organising small group researches.

Governance and administration

Governance

1. The medical school must establish committees for medical education governance and clearly define their functions and position at theschool.

2. The medical school must establish a sound governance systemand operating procedures.

3. The medical school must establish committees such as academic committee, degree committee and teaching committee, to deliberate on key issues such as teaching and research.

Academic leadership

The responsibilities of the academic head of the medical school must be clearly stated and include decision-making and implementation of educational programmes and the reasonable allocation of educational resources.

Administrative staff and management

The medical school must have well-structured administrative staff and management team. They must assume corresponding duties and carry out relevant management rules and regulations to ensure the smooth implementation of educational programmes and other teaching activities.

Interaction with health sector

The medical school must have a constructive interaction with the health and health-related sectors of society and government.

Annotation:

l The health and health-related sectors would include the health care delivery system, medical research institutions, and institutions and regulating bodies with implications for health promotion and disease prevention and control, etc.

Reform and development

Development plan

The medical school must have procedures for regular review and updating of its development plan to rectify deficiencies and meet changing needs.

Continuous reform

The medical school must have a continuous process of renewal in teaching, research and clinical service, which leads tothe revision of the policies and practices of the school to adapt to the needs of the changing society.

Annotations:

l Reform and development is the dynamic drive for the medical school to continuously improve its teaching and meet the needs of social development and health careservice.

l With social development, scientific advances and cultural prosperity, based on study and analysis, the medical school must regularly examine and revise its policies, plans, rules and regulations and continuously improve its structure and functions.

l The medical school must regularly adjust its educational objectives, educational programme, curriculum structure, course contents and instructional methods, and improve assessment methods, to adapt to the changing social needs.

l The medical school must regularly adjust its educational resources such as the size of student intake, faculty number and structure, financial input and teaching facilities according to the needs of the community that it serves.



[i]World Federation for Medical Education, 1984

[ii]World Federation for Medical Education, 2001

[iii]Association for Medical Education in the Western Pacific Region and WHO Western Pacific Regional Office, 2001