For the past few years, SI has been working with the University of the Virgin Islands (UVI) in developing a concept and strategy for a new medical school and simulation center in the territory. We are excited to share news that the University of the Virgin Islands (UVI) broke ground this week for a classroom building for the School of Medicine and it’s Simulation Center. Government officials, UVI officials and investors gathered on March 2, 2016 for the groundbreaking ceremony. UVI President David Hall said, “the creation of an accredited medical school in the V.I. has been the dream and the desire of many Virgin Islanders for many years and we have collectively decided to step out on those dreams and their faith and commit ourselves to making that dream a reality.”
The UVI School of Medicine aims to be the first accredited, English-speaking medical school in the Caribbean. The classroom building on St. Thomas is designed to house an anatomy lab that will allow for cadaver-based dissections, a 100-seat lecture hall with smart classroom technology, a 1,200-foot clinical skills lab for group instruction and six individual clinical skills rooms, large seminar rooms and more than 5,000 square feet of administration space.
Also this week, UVI broke ground for the School of Medicine’s Simulation Center. The Center on St. Croix will be a state of the art facility that will provide training for third year medical students and continuous professional development opportunities for on and off campus nurses, physicians assistants, doctors and other professionals. Dr. Ben Sachs, Dean of the UVI School of Medicine announced that the center will have surgical skills lab, an operating room, training and debriefing rooms, a lecture hall and state-of-the-art simulation labs and much more. He also said, “it will be one of very few buildings in the United States that can do this kind of training.”
The SI Digital Media team had the privilege to partner with Weill Cornell Medicine – Qatar to create www.innoHealthEd.com. The site is home to the academic journal, Innovations in Global Health Professions Education, and will be a preeminent forum for the presentation and discussion of innovative concepts in all areas of healthcare professional education. The platform has videos, podcasts, and of course, scholarly articles.
Congratulations to IGHPE!
On January 18, 2015, we at Strategy Implemented had the pleasure of joining medical and educational experts who convened in Doha for the Innovations in Global Medical and Health Education (IGMHE) Forum, hosted by Weill Cornell Medical College in Qatar (WCMC-Q).
Both IGMHE speakers and the audience were invited to discuss the global need to address the shortage of well trained healthcare professionals in designated regions of the world, and the opportunities and challenges presented by a wide range of both global and local innovations in medical education, assessment, licensing, and program accreditation.
Members of the academic healthcare community from Qatar, Oman, UAE, Lebanon, China, Canada and the US gathered for a one-day highly interactive meeting. The debates covered the growing use of competency based medical education, the impact of accredited medical schools and programs, and a broad range of specific interventions used to improve education and training outcomes. I encourage those with an interest in advancing and potentially transforming medical education locally or globally, to take a look at the Forum’s presentations below:
- Welcome and Opening Remarks | Javaid I. Sheikh, MD
- Capacity Building for a Global Health Workforce | Victor Dzau, MD
- Accreditation of International Medical Schools | John Norcini, PhD
- Transformation of the Education of Health Professionals in China: Practice of PKU-HSC | Yang Ke, MD, PhD
- Leveraging Competency-based Medical Education to Maximize Individual Outcomes| Eric Holmboe, MD
- Do Doctors Know Best? And Who Will Take Care of the World? | Rima Afifi, PhD
- Assessment Needs for Individualized Competency-based Medical Education | Donald Melnick, MD
- Do Doctors Know Best? And Who Will Take Care of the World? | Kelley Skeff, MD, PhD
- Is breaking bad news all bad news? | Mohamud A. Verjee, MD
- Inter-Professional Education: Diabetes Themed Activities | Stella C. Major, MBBS
- An OSCE Curriculum for Assessment of Resident Communication Skills | Dora J. Stadler, MD
- Using Webinar Discussions to Increase Connections Between International Hospital and Medical School-Based Faculty | Amal Khidir, MBBS
Presentations above can be found on the WCMC-Q website.
The Forum was coordinated by WCMC-Q’s Division of Continuing Professional Development and sponsored by the Innovations in Global Medical and Health Education Journal, an open-access web-based publication issued by Bloomsbury with the support of Qatar Foundation.
Amanda J. Pullen, PhD
Sr. Vice President
Strategy Implemented, Inc.
On behalf of all of us at Strategy Implemented, Inc., we are excited to announce two sessions that SI have helped organized at the 2014 AAMC Annual Meeting. The sessions are part of the Global Health Learning Opportunities (GHLO®) collaborative session series under the direction of our AAMC colleague Dr. Jenny Samaan. The 60 minute sessions – Collaborative Approaches to Preparing Global Physicians and Implementing Technology to Advance Medical Knowledge Across Borders described below discuss innovative models and technologies that impact the globalization of medical education and will be moderated by SI’s Bob Crone and Amanda Pullen respectively.
Collaborative Approaches to Preparing Global Physicians
November 10, 2014 | 9:30 AM-10:30 AM
Hyatt Regency Hotel Chicago | Room: Crystal C
This session will highlight three different medical school models that prepare global physicians: 1) The West Virginia University Global Health Program; 2) A creative partnership between an Australian medical school, Queensland University, and a US hospital system – Ochsner Health System jointly deliver an Australian medical degree for US citizens and permanent residents; 3) A partnership between Ben Gurion University of the Negev in Israel and Columbia University that jointly manage the Medical School for International Health that emphasizes cross cultural and global medicine and sends almost all of their students to developing countries in their final year.
After a representative from each program describes the characteristics of their respective program, the moderator and the panelists will conclude with a discussion to address various challenges, lessons, trends and recommendations for preparing global physicians.
At the completion of this session, learners will be able to:
Understand three very different medical education models and ways of engaging partners.
Understand what goal each is addressing and how it is contributing to developing global physicians.
Describe the motivations of students to engage in these programs.
Moderator: Robert Crone, President & CEO of Strategy Implemented, Inc.
Richard Deichmann, Deputy Head of Clinical School, Students and Associate Professor at Ochsner Clinical School
Christopher Martin, Professor and Director at West Virginia University
A. Mark Clarfield, Director, Medical School for International Health at Ben-Gurion University of the Negev
Implementing Technology to Advance Medical Knowledge Across Borders
November 10, 2014 | 11:00 AM-12:00 PM
Hyatt Regency Hotel Chicago | Room: Crystal C
This session will provide attendees with an opportunity to hear about and engage with 4 different innovations that utilize technology for collaborative learning and information sharing. Colleagues in Care’s work utilized IBM’s Cloud technology to share medical information and volunteer wisdom in Haiti. Current work on grassroots hypertension training is challenging them to identity new modalities for transmitting content and employing technology for collaborative learning. Medical students Shiv Gaglani, and co-founder Ryan Haynes, have created Osmosis, an innovative, web-based platform that combines lectures, classroom-created content, study guides and push notifications with practical and clinical cases in advance of exams. This new tool is engaging medical students with the potential to greatly expand medical knowledge and incorporate global contributions. The third program is Stanford University’s Center for Global Health and Johns Hopkins University’s Berman Institute of Bioethics, Doris Duke Foundation-funded on-line course entitled Ethical Challenges in Short-Term Global Health Training. Finally, the University of Minnesota has developed GAPS (Global Ambassadors for Patient Safety)- an online course, with a series of modules, that prepares health professions students for international global health placements, focusing on patient safety, ethical considerations, and essential cross cultural skills.
At the completion of this session, learners will be able to:
Understand ways in which technology is being used for information dissemination and community building from the four programs highlighted.
Discover how their medical students can benefit from the tools created.
Share ways in which their medical school is creating/utilizing technology innovatively.
Moderator: Amanda Pullen, Senior Vice President at Strategy Implemented, Inc.
Shiv Gaglani, Co-Founder of Osmosis
John Kenerson, Co-Founder of Colleagues in Care
Matt DeCamp, Assistant Professor at Johns Hopkins University: Ethical Challenges in Short-Term Global Health Training
Tricia Todd, Assistant Director at University of Minnesota: Global Ambassadors for Patient Safety
In addition, our colleagues at GHLO® will be hosting other sessions at this year’s annual meeting including:
Global Collaborations: The Jigsaw Puzzle
November 8, 2014 | 10:30 AM-11:30 AM
Hyatt Regency Hotel Chicago – Regency D
This panel discussion will provide an opportunity for attendees to explore three different non-profit organizations’ approaches to partnerships that promote global health and medical education and training across the continuum. Collaborative engagement between Global Health Learning Opportunities (GHLO), Consortium of Universities for Global Health (CUGH) and Global Health Education, Training and Service (GHETS), supports each program’s primary focus on students, faculty members and health care practitioners, respectively, while simultaneously creating new opportunities for expanding networks and capacity strengthening. Time will be allotted for attendees to discuss with each other, and with presenters challenges they face when developing or maintaining international collaborations.
At the completion of this session, learners will be able to:
Distinguish the goals and structures of the three organizations engaged in global health while understanding their complimentary roles.
Reflect upon their dialog with others regarding challenges to meaningful international engagement.
Identify possible ways of engaging with, or contributing to, the expansion of these programs.
Keith Martin, Executive Director at Consortium of Universities for Global Health
Janette “Jenny” Samaan, GHLO Founder, Sr. Director at the Association of American Medical Colleges
David Egilman, President of Global Health through Education, Training and Service (GHETS)
GHLO Collaborative Update
November 9, 2014 | 11:00 AM-12:00 PM
Hyatt Regency Hotel Chicago – Acapulco
This update session will introduce and review changes in the network of institutions facilitating international mobility for final-year medical students while promoting faculty engagement and innovation towards building global awareness and understanding.
For more information on how to register for the 2014 AAMC Annual Meeting and the complete meeting agenda, click here.
Robert K. Crone, MD, President & CEO
Amanda J. Pullen, PhD, SVP
Amanda Chin, Director of Marketing & Program Management
Strategy Implemented, Inc.
I am pleased to share with you news on an exciting peer-reviewed, open-access, international education journal that launched this past December. Entitled “Innovations in Global Medical and Health Education (IGMHE), it is published jointly by the Weill Cornell Medical College in Qatar and Bloomsbury Publishers with the support of the Qatar Foundation. I had the honor of serving as an author and guest editor of the inaugural issue. It has been a pleasure to collaborate with the journal’s visionary Chief Editors, Dr. Javaid I Sheikh, Professor and Dean of Weill Cornell Medical College in Qatar and Dr. Victor Dzau who is President and CEO of Duke University Health System and Chancellor of Health Affairs and Professor of Medicine at Duke. These individuals are leaders in the globalization movement.
This first edition of the IGMHE is derived from the proceedings of a symposium entitled the “Globalization of Medical Education” held at the Association of American Medical Colleges (AAMC) annual meeting in San Francisco in 2012. I had the pleasure of co-hosting this symposium with the AAMC’s Global Health Learning Opportunities (GHLO™) Program Director Dr. Jenny Samaan who had the vision to put together a “Going Global” session series that emphasize the growing importance of medical education on a global scale. These sessions set the stage for medical educators, as well as healthcare opinion leaders and policy makers to engage in an open dialogue on the direction and implications of the globalization of healthcare and medical education. With the encouragement of Dr. Samaan, the AAMC supported an expansion of the Going Global track at the AAMC’s annual meeting held in Philadelphia in November, 2013, which we hope will become an increasingly important feature of all future AAMC annual meetings. (To find out more about the GHLO programs – click on this link.)
The timely and stimulating discussions, and presentations at the “Globalization of Medical Education” symposium became the basis for articles in the inaugural issue of IGMHE. The symposium speakers are the contributing authors of the IGMHE’s first issue and these prominent leaders in international medical education and from the US House of Medicine are now fully engaged internationally. We were very fortunate to have the leadership from some of the key institutes that are pioneers in global medical education as well as the leaders of the National Board of Medical Examiners (NBME) and USMLE, The Educational Commission for Foreign Medical Graduates (ECFMG), The Liaison Committee for Medical Education (LCME), The Accreditation Council for Graduate Medical Education (ACGME) the American Board of Medical Specialties (ABMS), the Federation of State Medical Boards (FSMB) and the Association of American Medical Colleges (AAMC) all in the same room at the same time to discuss this important topic. We are pleased that many of these individuals are sharing their insight and perspectives on what globalization means for undergraduate and graduate medical education in a series of articles:
- The globalization of medical education | Robert K. Crone, Jenny S. Samaan
- Three global adaptations of the American medical education model | Javaid I. Sheikh, Kamal F. Badr, Robert K. Kamei, Thurayya Arayssi
- Globalization of medical education: Educational Commission for Foreign Medical Graduates (ECFMG) concerns and initiatives | Emmanuel G. Cassimatis
- International assessment of medical students: Should it matter anymore where the school is located? | Donald E. Melnick
- Engaging with others to improve global medical care through international board certification | Krista Allbee, Lois Margaret Nora
- Graduate medical education across national boundaries | Thomas J. Nasca
As a member of the IGMHE editorial board, I am excited to see this new journal facilitate and encourage an ongoing dialogue regarding the nature, pace, and implications of breaking down traditional barriers concerning the delivery of undergraduate and graduate medical education and its impact on healthcare. I want to thank and congratulate all my colleagues and featured authors who contributed to this effort.
- Stimulate a debate on global medical and health professional education
- Enable medical educators, physicians, students, policy makers and all healthcare professionals to remain abreast of issues related to global medical education and healthcare delivery
- Bring high quality, evidence-based content and innovative thinking to this important debate.
I invite you to visit the journal online here and invite your comments!
Robert K. Crone, MD
President & CEO
Strategy Implemented, Inc
Recently, my colleague Dr. Amanda Pullen and I were invited to participate in the Global Women’s Cancer Summit in Washington, DC sponsored by the Susan G. Komen International, a new and growing initiative of the Susan G. Komen Foundation Race for the Cure.
The conference brought together leaders in health and cancer care from around the world. Keyote speakers included Komen Founder, Nancy Brinker, former First Lady, Laura Bush, NBC Medical Editor, Nancy Snyderman, Susan G. Komen International head, British Robinson, as well as key leaders in cancer care from around the world.
The conference served to launch a new effort by the Komen Foundation, led by Komen International Vice President Ms. British Robinson, to extend its reach globally in its quest for the prevention, early diagnosis, and ultimately a cure for breast and cervical cancers which are increasingly impacting women in low and middle income countries around the world. Discussions included defining the scope of the problem world-wide, strategies that are currently working, new strategies needed, as well as challenges faced in implementing programs for screening, prevention and treatment in resource constrained communities.
This link http://vimeo.com/60564992 will take you to a panel discussion that I was privileged to lead focusing on multinational, national andlocal leadership and mobilization strategies currently employed, including those used in the quest to control the HIV/AIDS epidemic, in selected locations. The panelists included:
- The Honourable M. Perry Gomez, M.D. | Minister of Health of the Commonwealth of The Bahamas
- Kennedy Lishimpi, M.D. | Executive Director, Cancer Diseases Hospital, Lusaka, Zambia
- Lisa Stevens, Ph.D. | Deputy Director for Planning and Operations, Center for Global Health, National Cancer Institute
- Julie Torode, Ph.D. | Deputy CEO and Director of Advocacy and Programmes, Union for International Cancer Control
The panelists addressed the following:
- In the panelists’ experience, what is the role for multinational organizations and NGO’s such as WHO, NCI, UICC, BHGI, IAEA, PACT, NCDA and others in framing policy as well as in developing and implementing guidelines and solutions in Low and Middle Income Countries (LMIC),
- Have they been maximally effective in their efforts?
- How do we better coordinate their efforts?
- What is the role of LMIC Governments?
- How have LMIC governments responded effectively?
- What policies are in place and what else is needed?
- How do we effectively implement policy at the country and community level?
- How do we ensure that policies and strategies can be practically implemented and effectively used?
- Are time-based goals practical and feasible in resource constrained environments?
- What financial resources are needed?
- Should BHGI guidelines be linked to financing?
- How do we make major public health advances such as HPV vaccine affordable in LMICs?
- Are there strategies for supporting procurement of vaccines, medication, equipment & materials?
- What sources of financing are available?
- What human resources are needed?
- What are strategies for training and supporting healthcare professionals and building local capacity? Are there examples of successful implementation of training programs and capacity building?
- What is the role of technology in addressing human resource gaps and in developing and implementing practical solutions?
- How do we best educate the public and what components of cancer prevention, public communication, screening, diagnosis and therapy can be centralized and/or accomplished remotely?
- What are examples of effective strategies for enhancing public awareness to encourage screening and early diagnosis?
- What are some real-world examples from our panelists?
The day was most fruitful for the exchange of knowledge, the awesomeness of the task at hand, the relating of some great success stories and the extraordinary and inspiring commitment of many individuals, institutions and governments in addressing this very important public health challenge.
According to the World Health Organization, of 57 million global deaths in 2008, 36 million, or 63%, were due to non-communicable diseases (NCDs). The four main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases.
The burden of these diseases is rising disproportionately among lower income countries and populations. For example in 2008, nearly 80% of non-communicable disease deaths — 29 million — occurred in low- and middle-income countries with about 29% of deaths occurring before the age of 60 in these countries.
The leading causes of NCD deaths in 2008 were cardiovascular diseases (17 million deaths, or 48% of all NCD deaths), cancers (7.6 million, or 21% of all NCD deaths), and respiratory diseases, including asthma and chronic obstructive pulmonary disease (4.2 million). Diabetes caused another 1.3 million deaths.
It is estimated that breast cancer will strike more than 1.3 million women annually over the next 20 years, killing 11 million of them, with most new cases coming in countries least prepared to deal with them. Cancer knowledge and medical resources vary significantly from country to country, particularly in the most resource constrained communities. Women in many of these countries still face stigma and shame when they are diagnosed and have nowhere to turn for treatment and support.
According to a study published recently in the Annals of Oncology, there were an estimated 530,000 cases of cervical cancer and 275,000 deaths from the disease world-wide in 2008. In spite of effective screening methods it remains the third most common female cancer ranking after breast (1.38 million cases) and colorectal cancer (0.57 million cases), however, cervical cancer is the leading cause of cancer-related death among women in Eastern, Western and Middle Africa; Central America; South-Central Asia and Melanesia. New methodologies of cervical cancer prevention, diagnosis and treatment should be made available and accessible for women of all countries through well-organized programs. Recognizing the growing global impact of breast and cervical cancer, the shared challenges among countries worldwide, and the value of coordinated advocacy in the battle against these diseases, our expert panelists will be discussing ways to advance the common cause of breast and cervical cancer prevention, screening, early detection and management in low and middle income countries of the world.
Once again, the experience of partaking in an event that brings together key thought leaders to explore innovation and best practices in research, science and program implementation of global breast cancer care, treatment and prevention is truly inspiring. Our thanks to the leaders of the Susan G Komen Foundation for their vision, industry and commitment to extending their mission world-wide.
Robert K. Crone, MD
President & CEO
Strategy Implemented, Inc.
Tomorrow’s prospective medical students may have many more options for where and how to obtain a medical degree – including the possibility of designing one’s own medical educational program. The launch of the AAMC’s Global Health Learning Opportunities (GHLO) program last week will help to build a framework around international clinical electives – but GHLO may also contribute to some very different thinking about gaining a degree in medicine. “Program” may need to replace “School” or “Institution” as students increasingly seek opportunities to be educated and trained in different parts of the world to enrich their clinical experience, and/or gain benefits from lower tuition fees or a shorter time to graduation than that in the United States. This was just one of the many issues highlighted at the Globalization of Medical Education Session held at the 2012 AAMC Annual Meeting on November 4th, which was introduced by Dr. Robert Crone, CEO of Strategy Implemented and Dr. Janette Samaan, Director of the AAMC GHLO program.
The Session aimed to show academic medical institutes an alternative picture of the possible new globalized marketplace in which we will be operating. One where fewer students and trainees would be coming to the US for their degrees and certification, and where academic programs outside North America will be increasingly attractive to US medical students as well. Session speakers had many different perspectives on globalization, which were masterfully teased out by the moderator, Dr. Lewis First, Professor and Chair of Pediatrics, Vermont University College of Medicine and Chair of the National Board of Examiners.
Leaders of 3 prominent international medical schools with American roots, namely American University of Beirut, Weill Cornell Medical College in Qatar and Duke-National University of Singapore Graduate Medical School, emphasized that it is already possible to deliver education internationally, of equivalent high quality to that in the US. Indeed lessons learned from Duke-NUS program are now being transferred back to Duke University in North Carolina. All the schools described their programs and the success of their students who are working throughout the world.
As medical education and postgraduate training diversifies and globalizes, so too will evidence-based accreditation of programs and assessment and certification of students and trainees. Dr. Thomas Nasca, CEO of the Accreditation Council for Graduate Medical Education (ACGME) and Dr. Donald Melnick, CEO of the National Board of Medical Examiners (NBME) both envisioned major change in the accreditation landscape. Dr. Nasca advocated for greater integration and coordination of education program accreditation and of individual performance certification, than currently exists in the US. Dr. Melnick went so far as to suggest that “named” medical schools may no longer be considered an adequate proxy for a quality education as competency-based assessment becomes more granular and continuous throughout education, training and finally throughout a physician’s career of practice. Dr. Emmanuel Cassimatis, CEO of the Educational Commission for Foreign Medical Graduates (ECFMG) outlined new programs and products that ECFMG is developing to address the need for the portability of primary-source verified documents throughout a physicians career, regardless of where they are practicing in the world, as well as the need to ensure that medical schools and programs do undergo rigorous accreditation based on WFME standards. The importance of accreditation was seconded by Dr. Dan Hunt, Co-secretary of the Liaison Committee for Medical Education (LCME), which is, upon request, providing consultation services to regional and national accrediting bodies and medical schools around the world.
Dr. Lois Nora, CEO of the American Board of Medical Specialties (ABMS) emphasized the importance of specialty certification not only as a point in time, but also continuously through maintenance of certification strategies as ABMS extends its footprint outside of the United States. Dr. Nora was enthusiastic and optimistic that the US organizations that make up the US “House of Medicine” can work together and with their international counterparts to “change the world” by enhancing quality of training, raising standards of care which will lead to improved outcomes for patients world-wide. There is mentioned benefit of learning from institutions abroad as well.
A lively discussion with the speaker panel concluded the Session – below is a summary of some additional questions addressed by the speakers and questions and comments that were received about the topic via email, text and twitter. The presentation is available on the AAMC 2012 website. In the meantime, we look forward to seeing any comments and questions you might have! — The SI Team
Questions on the Role of the US:
Q1. How do we reconcile the reputation of US medical training as the best in the world with the fact that our health care system is nowhere near the best in the world? Shouldn’t the best education system lead to the best health outcomes?
A1. Arguably the best education system should lead to the best health care outcomes for patients treated by graduates of that education system. At the same time, the education system is only one component of a country’s health care system. Health outcomes are likely dependent upon many additional factors such as equitable access to health care, public health and safety environment, equitable socioeconomic conditions, etc.
Q2. How are US centric accrediting and assessment organizations working with international institutions to help them create their own sustainable in-country systems rather than relying on US agencies for the long term?
A2. In countries with small populations of medical professionals (independent of socioeconomic status) there is a long history of collaborating with external or international groups to support medical education, training and assessment incountry. As a result of the many initiatives underway by US, Canadian and European entities it is anticipated that broad-based international associations may be created for healthcare professionals of which any national entity could become a part – in much the same way as the airline industry created IATA to ensure standardization for the safety of its passengers, crew and aircraft.
Questions to Medical Schools Using US Curriculum Internationally:
Q1. What cultural challenges to regional healthcare education and research collaborations exist for your school(s)? And how are/can they be successfully addressed?
A1. While globalizing best practice in medicine should enable all citizens of the world to have access to equivalent high quality care, there is no question that localization and cultural understanding and sensitivity are critical to success.
Q2. Do American accreditation guidelines and requirements for healthcare education fully meet the health care needs of local populations?
A2. The majority of human health concerns are common, globally, and so broadly speaking where US guidelines and requirements for medical education and assessment have a proven track record of serving those common concerns, they work for other non-US populations. However, there are always local demographic, cultural and systems differences and these need to be reflected in curricula development and in the design of examinations.
Q3. Are any/all of the schools wanting LCME accreditation? Are you accredited by an international accrediting organization? If so, which one?
A3. WCMC-Q being a branch campus of the WCMC in NY, seeks such recognition by LCME. While WCMC-Q is recognized by ECFMG on the iMed database, and is part of various international listings, an International accrediting organization does not currently accredit it.
It is safe to say that all schools want a US-standard accreditation modeled after the LCME. Like WCMC-Q, AUB is not accredited by an international accrediting organization. The University and several of its Faculties, however, are accredited by top US organizations (see Dr. Kamal Badr’s PowerPoint below).
Q4. What percentage of grads from AUB, Qatar and Singapore end up practicing in these countries, as opposed to coming and staying in the US?
A4. WCMC-Q is a young school, having graduated only 112 doctors in the last four years. Most of them are still finishing their residency/fellowship training in the US and elsewhere. While WCMCQ fully expects a substantial percentage of graduates to return to Qatar, it is too early to make any realistic projections at present.
According to Dr. Kamal Badr, 40% of all Lebanese physicians graduating every year end up practicing in the United States. The figures for AUB are closer to ninety percent.
Q5. How has the change of model changed the cost of providing education? Is it less? If so, do you charge less in tuition to reduce student debt?
A5. WCMCQ’s tuition and related fees are equivalent to WCMC in NY. Qatar Foundation provides interest free loans to mitigate the burden of carrying student loans.
Dr. Kamal Badr said if anything, the “change of model”, which he assumes means the new curricula and assessment standards, is more costly. AUB’s tuition fees have been rising steadily, but so have AUB’s financial support packages and loans. No AUB student is refused admission or promotion for financial reasons.
Q6. Please discuss issues with obtaining US residency spots and overcoming the barriers.
A6. This is a major issue for Weill Cornell Medical College in Qatar (WCMC-Q) graduates and for other IMGs. The broad category of IMGs encompasses a wide variety of institutions all over the world and their quality can vary tremendously. It is not surprising that there are negative stereotypes surrounding IMGs. Dean Sheikh believes that the single best way to overcome this barrier is to consistently and repeatedly be able to place WCMC-Q graduates at very good residency programs. This will establish a track record, which should make it easier for future generations of WCMC-Q graduates.
As for AUB, Dr. Kamal Badr said AUB’s ultimate goal is for AUB graduates to complete their residencies and fellowships at AUB. Historically, AUB residents have gone on to complete fellowship training in the US because AUB residency qualified them to sit for the Boards. With the new regulatory environment in US medical training, the refusal of ACGME to accredit programs outside the US and its territories has resulted in all students finding residency slots in US institutions. AUB graduates have faced no barriers in finding US residencies. The hope, however, is that the new direction taken by the US organizations to transpose their standards abroad, exemplified by the ACGME-I and likely soon by ABMS-I, will create pathways for graduates of accredited programs to go on to fellowship training in the USA if they wish to do so.
Questions to LCME:
Q1. There are educational programs that are developed/being developed to train US citizens with a global perspective and to return to practice medicine in the US. What is the position of the LCME with regards to accrediting these programs?
A1. LCME is responsible for the accreditation of medical education programs leading to the medical degree in the United States and Canada. At the present time, there are no plans to extend accreditation beyond the passport granting territories, provinces, and states of these two countries. The LCME has been active in providing assistance to other regions or countries in developing their own medical education accreditation systems. This is consistent with the approach of the World Federation of Medical Education (WFME) who encourage regional accreditation bodies who can be sensitive to local health care needs and local customs and practices. In order to assure a minimum level of quality of these accreditation systems, the WFME provides a process for recognition of these regional accreditation systems.
Q2. What does the LCME think of US schools partnering with non-US schools which have Accreditation – not through LCME – but through their own country’s accreditors?
A2. The LCME has no position on schools outside of the US or Canada that partner with LCME accredited medical schools.
Q3. Will the LCME consider accrediting global programs that are truly university based and allow students to study as part of their degree abroad?
A3. At the present time, the LCME is not entertaining a future of accrediting medical education programs outside of the US and Canada.
Questions on Support for Developing World:
Q1. There were many questions associated with the impact of globalization in regions where there is social and economic disparity, for example:
- If an international assessment program were agreed upon, how might that be paid for – especially in resource poor regions?
- Considering that about 100 medical schools with graduate programs will be opening in Africa in the next 10 years, are you prepared to take any steps to help them adequately develop and prepare their programs?
- How do we ensure that quality rises faster than cost?
- The international accreditation/certification initiatives will have the effect of fostering migration from the south to the north. Do we have an ethical responsibility to prevent the potential devastation to the medical systems of the LMICs?
- What is the relationship between country or regionally based accreditation standards and healthcare graduates’ desires to move and practice globally especially in underserved areas?
A1. Many issues emerge when trying to solve inequalities in healthcare and education in different regions of the world. Probably, among the most critical for sustainability are:
- Stable Government
- Healthy economy
- Adequate financing systems for healthcare and education
- Public health and safety environment
- Employment and personal growth opportunities in healthcare and education
- K through 12 education systems
- An indigenous desire to become a healthcare professional in the region
- High quality graduate training in good clinical facilities that leads to job opportunities in country
If technology, networking and professional collaborations make education and training models more portable, affordable and have real local value, then accessibility to medical education and training becomes less dependent on where you live. The hope would be that this also contributes to better access to higher quality healthcare for citizens around the world. All the US entities currently developing or operating international programs share this vision.
Questions about Products and Services:
Q1. What is the relationship between eFolio and EPIC?
A1. EPIC has been designed by the ECFMG as a repository of primary source-verified credentials for individual International Medical Graduates that can also serve the needs of regulatory bodies worldwide. It is expected that EPIC will evolve further in response to IMG needs.
For more information see http://www.ecfmgepic.org/
The AAMC and NBME are developing eFolio in response to the need to drive inter-operability of data contained in an increasing number of disparate portfolio systems. The aim is to create a meaningful data set for medical students, residents or practicing physicians.
For more information see https://www.aamc.org/download/76810/data/efolio.pdf
Q2. Advise if “international foundation of medicine” benchmark exam is good enough to prove meeting with US medical standards.
A2. The IFOM exam addresses content determined by an international panel of experts to be relevant to the knowledge and skills of a medical student receiving a medical degree anywhere in the world. The IFOM is intended to determine an examinee’s relative areas of strength and weakness in general areas of clinical or fundamental science, not to predict performance on USMLE. The content covered by the two examinations is somewhat different. However, because there is substantial overlap in content coverage and many IFOM items were previously used in USMLE, it is possible to roughly project IFOM performance onto the USMLE score scales. The results of IFOM would not be considered equivalent for purposes of obtaining a license to practice medicine in the US or certification from the ECFMG. It may be considered a measure of the requisite knowledge and skills to pursue educational activities in the US that do not require a medical license or completion of USMLE components.
For more information about IFOM see www.nbme.org/ifom2013.
We want to thank all the 200+ attendeees who joined us at the 2012 Annual Meeting: Globalized Medical Education. We also sincerely appreciate all our esteemed speakers and moderator who presented at the session and participated in the lively panel today.
Please come back to this blog at the end of the week as we will have a summary of session highlights, a list of the questions that were sent to us during the session as well as updates to share with you. The AAMC will be posting all speaker presentations on their website and we will post the link to these presentations when they become available.
We look forward to continuing the dialogue! Thank you.
Bob Crone, Strategy Implemented and Jenny Samaan, AAMC
I am excited to announce a program that I will be co-hosting at at the 2012 AAMC Annual Meeting with my AAMC colleague, Dr. Jenny Samaan. We have organized a 3-hour discussion on the globalization of medical education. We have invited prominent leaders in international medical education and from the US House of Medicine now involved internationally, to give us their insight on what globalization means for undergraduate and graduate medical education. The future of US medical education and the US healthcare workforce may be impacted significantly by trends occurring beyond our shores. This 2-part session includes dialogue with the speakers and an opportunity for the audience to join in this lively debate. [Read More]
Robert K. Crone, MD
President & CEO
Strategy Implemented, Inc.