Northern State Medical University Arkhangelsk (Tempus IV ) Seminar on Quality Control Standards in Higher Medical School Student’s Mobility in European Faculties Pr Sylvain Meuris Faculté de Médecine Université Libre de Bruxelles

Is it necessary to promote mobility in medical schools ? Social missions of a Faculty of Medicine ?  To locally educate and train local students to become physicians available for local patients...  To produce physicians able to understand, communicate, relieve and cure patients, in their own language  The answer is no  However,...

Reasons for student mobility  The training of future medical doctors must meet the needs in the society  Rapid changes in the demographics of Europe induce new challenges for the Health Care systems  => Openness and mobility of ideas in medical education and training are crucial to : Embrace new trends, Promote quality improvement and Accelerate global harmonisation

4 Is mobility easy ?  Academic track is complex  not easily comprehensible  not legible  Is Rigid  Precocious choice  Impossibility to shift  No International Recognition  reduced mobility  quite impossible mobility  Why is it so difficult to move as a student ?

History of student mobility From Middle Age to XIX th century  Separation between academic and political authorities  Jus ubique docendi  Mobility of Students Teachers Ideas – Printing  Common language  Scientific Societies  Common academic rules for graduation

Industrialized Revolution An Evolution ?  Birth of Modern nations and Taxes  Hermetic barriers to mobility Frontiers, Passports, National currencies,  National rules in all domains Strategic economical activity Competition, struggle and wars

Industrialized Revolution : Consequences for Universities ?  Directly subsidized by the State  Academics designated by the State  Control on Curriculum Research domains Prestige, secrets & patents  Complex regulation for (no) diploma recognition...

European Union A (very) slow harmonization  Mobility of goods Single Market Borders abolition  Mobility of citizens Common passport Schengen area  Mobility of wealth, Single currency € Direct tax harmonization (VAT)  => Loss of national power

EU principle : Mobility of citizens  Private sector : Open  Public sector : Closed No diploma recognition  Exception rule Principle of mutual recognition of professional ability (1975) Regulated professions  physicians, pharmacists, dentists, veterinary, nurses,... Punishable obstruction => Condemned States

Bologna declaration (1999) Adopted by Ministries of education 29 countries (46 today)  Harmonization of diploma (Ba-Ma-Do or LMD)  System de transferable credits (ECTS)  Promotion of mobility  Quality assurance of qualifications Diploma supplement Objectives of competences  European Recognition  => European Space for Higher Education

Harmonization, Mutual Recognition and Confidence Objective : training recognized everywhere in Europe to improve mobility of young generations

Benefits of training harmonization  - MOBILITY of students and teachers  - Automatic RECOGNITION of diploma  - EMPLOYABILITY across the EU  - ATTRACTIVENESS of the European education system

The reform of medical curricula Traditional curriculumReformed curriculum

Ba / Ma CurriculumReformed curriculum Reformed and Ba/Ma medical curricula

UE : promotion of student mobility  Pilot Phase Initiated by the Commission Limited number of Faculties  Program launched in medicine  Consortium 20 Faculties of medicine - AU, BE, CH, DE, DK, ES, FR, GR, IR, PT, SE, UK enlarged to > 50 in 2010

Unequal national mobility policies

2002 : 1 million 2010 : 3 millions (= 5% of student population) Future : cumulative ECTS, Life Long Learning European Student Mobility

Obstacles to mobility  Governments face problems of Education Infrastructure Health Budget Health Coverage  Hospitals  Equipment  => General tendency to limit expenses Decrease supply & Limit Medical Education

Consequences of restrictions  Decrease in care offer  Discontent of people Unexpected aging population  Desertified rural areas  Disorganisation of hospitals  Solutions To attract physicians from other countries To produce more health workers

Migration policies  Unfair competition between hospitals and countries Attractive salaries Brain drain  Cost evaluation of training : dollars / physici an  => Rapt of more than 500 millions dollars per year from developing countries to industrialized countries

Consequences : Unequal distribution

World Distribution of Physicians Total Number - 7 ’ 500 ’ 000 (WHO stats, 2007)

Conclusions  Objective : To disseminate quality standards and transfer of know-how for the benefits of patients and the society  Measures : Short-term mobility  During medical studies  During specialization  Life-long learning Increase training capacity  New medical schools in developing world Develop networking  Between universities, hospitals, scientific societies  Between diaspora and local physicians