ORIGINALES

Medical Education in Globalizing World

La Educación Médica en un mundo en proceso de globalización

Profesor Andrzej Wojtczak MD., PhD

In opening address Sir Lionel Whit, President of the World Medical As-sociation at the First World Conference on Medical Education in 1953 in London said: „The world …has become so shrunken…that we can no longer take parochial view of our problems". Fifty years later we also think that the medical education stands at the doorsteps of profound changes. This feeling in fact has less to do with scholars' self-reflection, but rather is a direct con-sequence of the process of globalization that has penetrated almost all areas of our life and what mandate a different kind of physician.

Do we need more evidence of globalization of medicine than recent epi-demics of SARS and bird flu? They began in a distant part of the world and have quickly alarmed the globe. In combat of this diseases were involved experts and laboratories from all over the world. It is a good reminder that physicians and scientists of every nationality are increasingly part of global virtual network expected to serve a global public in accordance with certain universal knowledge and practices. We face also other challenges such as spread of HIV/AIDS and other infectious diseases are still killing about 17 million people yearly. To add to that increased mobility of doctors world-wide we see a need for the "global doctor".

It is estimated that about 25% of doctors trained in Africa are likely to migrate to developed countries and 50% Lithuanian graduates move to work in other countries. So, the medical schools in all countries are expected to produce graduates that meet these expectations. But truth is that nearly 2000 medical schools worldwide are producing doctors whose competences differ very much. Consequently, we can not neglect an urgent need for defining the global standards that would specify the "core" knowledge, skills, behavior of the universal values to ensure that graduates regardless of where they are educated have similar competences. As medicine is not only scientific but also cultural pursuit it requires internationally developed standards that would be acceptable globally and would permit for assessment of professional com-petences of graduates.

Such defined competences would also help indicate what teachers are supposed to teach, what students are expected to learn and what educational experiences all physicians across world must have. On the other hand, the medical schools are expressing desirability to demonstrate that doctors they train are competent practitioners. In last few years, two sets of complemen-tary global medical education standards were developed by international medical education experts. The WFME International Standards developed for accreditation of medical schools, and the IIME "Global Minimum Essential Requirements" (GMER) and measurement tools to assess required competen-cies of graduates. Both might serve globally to evaluate quality of medical schools and their products.

The recent introduction of telematics creates new possibilities in the de-velopment of networks for multi-center medical education and research on a global scale. A good example of such development is IVIMEDS - the world-wide partnership of medical schools and institutions working together to develop the full potential of e-learning across the continuum of medical school education.

Finally, it is worthwhile to say that the issues of medical education in a globalizing world were discussed at more than 20 international conferences organized in last two years around the world. One of its important messages to be remembered is that mastering the reality of today does not prepare stu-dents for the challenges of tomorrow - we have to prepare them how to man-age future changes.

1. Publicados en español en Educación Médica Volumen 7, Suplemento 2 (Julio-Septiembre 2004)
2. Publicados en español en Educación Médica Volumen 6, Suplemento 2 (Julio-Septiembre 2003)