EDITORIAL

Responsabilidad social y Bolonia

Social accountability and Bologna

Albert Oriol Bosch

Presidente de la Fundación Educación Médica.
E-mail: aoriolb@terra.es

The Bologna process' mandate is straight: the Universities are institutions with a clear social function that should be carried out in a responsible manner and with fill accountability. Social accountability means not only to do what should be done to attend to the present and foreseeable societal needs, but also, to account for what is being done, why it does what is doing instead of other things, and that it does it as it should be done according to the present state of the art.

With respect of what is being done by the Universities, the Bologna process demands that their degrees should provide 'employability' to the graduates, that is to say, that the Universities should provide degrees for which a social demand exists. This is not to say , naturally, that the Universities should become vocational schools. Universities should also nurture the humanities, the sciences and the culture en due form. Nevertheless, the time in which the Universities' endeavors were devoted exclusively to their own vegetative needs is over. The tine in which a specific University could offer 450 courses to a few more of 500 students because it had sufficient teaching staff to do so should end. The main question should not be the maintenance or increase of their academic stall that will thereafter adjust their teaching offer to their available time. The main question ought to deal with the adjustment of their educational, human or instrumental resources to the educational projects of social interest. This social interest should be contemplated not only with a short term perspective , that is to say, responding to the present needs, but also from the vantage viewpoint in the foreseeable future.

This is not only of local concern, it is a global issue, concerning everybody everywhere, involving qualitative (the kind of graduates with the competencies achieved that are produced by the Universities) and quantitative aspects (how does the University utilize its resources to produce a certain number of graduates of each degree). The independent commission of The Lancet recently analyzed the world production of health professionals (physicians, nurses and public health officers) and the global challenges we face worldwide [1]. A. Segura in this issue extensively comments this document. Also in this issue we publish the consensus document that from a global perspective with the Social Accountability of the Medical Schools [2] deals with the Bologna's challenge as it concerns de Medical Schools.

Mutatis mutandis, similar considerations concerning the Universities' knowledge transfer or educational function could be carried out in relation with their knowledge generation or research function. With limited resources, a steady situation since never and nowhere resources have been unlimited, the research that is being done at the Universities should not be exclusively concerned with the personal interests of the researcher. While knowledge as an end by itself can not be fully disregarded by the Universities, they should not become the greenhouse for a bunch of genius candidates. Some such specimens can coexist with others prepared to put their capacities and efforts at the service of the society that provides the means to create new knowledge. Therefore, some of the basic research ought to be directed towards important scially perceived needs, going without say, that quality is, in any case, a constant requirement also in all kind of research that deserves to be called so.

The abundant amount of talent the Universities possess, often isolated into the ivory tower, should also become interested in the improvement of the services provided by the Universities, specially so in the field of the health sciences, which educational and research functions are mainly carried out in the academic health care centers. The academic health care centers should contribute significantly to the improvement of the care delivered to the population in order to justify their higher costs.

If the Universities and their Medical Schools do not show a high degree of social responsibility accounting for their attempts to deal with the social priorities, they will not be complying with the Bologna's mandates. Arguing that they can't because of a shortage of money, an ever present reason, will not be satisfactory argument to justify them if they can not show their previous efforts to align with the societal needs the use of the remarkable amount of resources and talent they accumulated.

The necessary change in the Universities, in general, and the medial Schools, in particular, comes not only from the expansion of the scientific knowledge but also as consequence of an increment of democratic culture of the population, that now expects that their publicly financed institutions, independently of how ancient and prestigious they are, should take into account the social needs and priorities. Not attending to what begins to be said loud and clear would be dangerously wrongdoing.

References

1. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010; 376: 1923-58.        [ Links ]

2. Boelen C, Wollard RF (copresidentes). Consenso Global sobre la Responsabilidad Social de las Facultades de Medicina. Educ Med 2011; 14: 7-14. (Versión inglesa: http://healthsocialaccountability.sites.olt.ubc.ca/files/2011/01/GCSA-Consensus-Document-English.pdf).        [ Links ]