Brief Assessment on Medical Education in Turkey Dr Brief Assessment on Medical Education in Turkey Dr. Bayazıt İlhan Immediate Past President Turkish Medical Association September 24th, 2016 KOS

Medical Education in Turkey Faculties of medicine State Foundations 6 years of education 3 years basic sciences and theoretical lectures 2 years practical training combined with theoretical lectures 1 year internship

Medical Education in Turkey Despite distortions in health environment and medical education Medical faculties are among the most preferred Still high quality medical education in eminent medical schools TMA follows quality of medical education closely

Leading problems Launching new schools of medicine without due consideration of necessary infrastructure and human resources Increasing the quotas of present schools 93 medical schools Main argument: “not enough physicians” *Country with the highest rate of launching new medical schools within the last 10 years *Number of medical schools per 100 000 population above OECD average

Medical schools and students Number of medical schools Number of medical students 2002 44 31,710 2015 93 >60,000

New medical schools Shortage of faculty members No academic staff in some basic and clinical sciences Lacking anatomy and physiology laboratories or libraries A medical school with graduates who have never had any training course in paediatrics!

Ministry of Health reports Number of medical students more than necessary Total annual student quota should reduce to 5,250 from 12,000 within 2 years Two problems TMA kept warning Low quality medical education Danger of unemployment of medical doctors

TMA efforts for quality medical education Contributions for accreditation of education programmes A member of the National Medical Education Accreditation Board (NMEAB) established in 2008 recognized by the YÖK (Higher Education Board) and the World Federation for Medical Education granted accreditation to only 22 programmes

Marketization of health Direct effects on medical education Number of hospital admissions induced by demand 3 in 2002 8,3 in 2015 Some doctors examine more than 100 patients a day Medical education in a market-oriented health environment where patients have become customers “performance based remuneration scheme” faculty members are driven farther from education and research to service delivery

Problems on determination of faculty members Nepotism and political intervention in the posting and promotion of faculty members TMA has been drawing attention for years as detrimental to the scientific foundation of medicine more apparent with operations conducted after the recent coup attempt a vicious circle with current practices such as seizure of schools, dismissals, suspensions and postings Solution: Taking scientific and secular education as basis and sticking to merits in academic promotions.

Post Graduate Medical Education By university and Ministry of Health (MoH) education and research hospitals A dynamic working area of the Turkish Medical Association (TMA). Medical Specialties’ Coordination Council of the TMA is an umbrella institution of 103 medical specialty associations

Challenging circumstances “Health Sciences University (HSU)” Totally under the control of MoH 55 education and research hospitals affiliated Lack of strategic planning in future medical specialty training High number of institutions which the specialty training is given Lack of standardization among institutions Lack of qualified personnel Lack of technical infrastructure Lack of regular institutional inspection mechanisms

Challenging circumstances Selection system problems Problems arising from health system changes Weakness in “merit” in academic career development system

Continuing Medical Education / Continuing Professional Development TMA’s view: a right and professional responsibility TMA is the leading organization in this respect TMA created the Continuing Medical Education Accreditation Board in 1994 Alignment with European and international standards besides local representation

CME/CPD Together with 103 specialty associations, TMA adapted accreditation standards to Turkey in line with principles laid down by the WFME. For physicians TMA is determined to fulfil its responsibilities together with all relevant parties in improving the quality of CME.