In the future, we could be students at a global university, learning medicine alongside students from all over the world. Mirza Muminovic explains how
A dream or reality? Susan, a second year medical student from the United Kingdom, has just received an email from Carmen, her colleague in Cuba. She is also in touch with several other colleagues from all over the world, like Sodzi from Ghana and Ang from Singapore. Although geographically miles apart, they have many things in common. Perhaps the most interesting one is that they are second year medical students of the International Networked Medical School (INMedS).
This story might have sounded completely unrealistic 10 years ago, but nowadays, the concept of INMedS sounds much more like an amazing reality. Unfortunately, it is still waiting to happen. More than ever, there is a need for high quality and cost effective global medical education to be delivered locally. This vision was shared by participants of the INMedS workshop held in London in August 2002. As BMJ Clegg Scholar, I had the opportunity to observe the course of the workshop from a student's point of view.
The workshop brought together a group of very dedicated and highly motivated representatives from partner medical schools who have signed up to INMedS, and invited guests as well. The partner schools were selected on the basis of geography, their local economic need, their ability to deliver information technology and distance learning, and special healthcare problems to be addressed locally.
Participants of the workshop came from all over the globe: Australia, Cuba, Denmark, Ghana, Russia, Singapore, South Africa, Sweden, Ukraine, the United Kingdom, and the United States.
Professor Colin Green, director of the Northwick Park Institute for Medical Research and one of the project codirectors of INMedS, gave a short overview of the activities that preceded the workshop. And they have come a long way since the INMedS vision was first created a few years ago; much planning, negotiating, and assessment has been done, and initial funding has been secured for a feasibility study. It was a story of the dream being slowly developed into reality.
Five years ago, Professor Janet Grant and Professor Dame Lesley Southgate wrote a virtual paper on plans for a networked medical school (reference not available). They wanted to increase the opportunity to train many more doctors in a more flexible way, combining traditional methods of teaching with new technologies and distance learning methods. The integration of medical students and medical school in the local community were other important issues, along with quality assurance and developments in education and health care.
One of the partners in the network is St George's Hospital Medical School in London. Professor Sean Hilton, dean of undergraduate medicine, spoke more about the achievements of their programme. St George's was the first medical school in the United Kingdom to offer a predominantly web based, graduate entry medical degree programme to graduates from any discipline. The school has developed a large bank of web based resources suitable for wider use, and it is willing to explore ways of sharing and adapting these resources with other INMedS partners.
Presentations from other medical schools followed, full of interesting facts about their countries and their ways of teaching medicine and structuring healthcare systems. For example, I learned about a virtual health university in Cuba and its experience with postgraduate medical education. It is a virtual academic institution composed of programme systems of distance learning and telemedicine. The use of new computer science technology gives an opportunity for broader postgraduate education, as well as for clinical consultations and discussions.
Another great experience followed from Singapore, a country that has made great progress in economic and educational terms. Singapore is known for its organisation of healthcare services, and SingHealth was presented. The organisation believes in shifting the centre of gravity of health care back to general practitioners through its general practitioner empowerment programme.
We heard interesting experiences of medical education in Russia and Ukraine, where funds are very limited. In South Africa there has been a revolution in social terms over the last decade. Ghana is struggling with its developing and economic efforts.
But back to INMedS, how it could be possible to bring all these different experiences together in a single dispersed medical school? Not an easy task, of course, and a very challenging one. The internet has created a whole new world that brings new possibilities that were unthinkable just 10 years ago. Besides that, we have new ways of teaching and learning medicine; the ways in which evidence based professional programmes will be taught and learnt in the future. We should take full advantage of these developments.
So, what would the course look like? The proposed structure of the curriculum, with the capability to be adapted to local needs, is that of a five year course. The first two years would be devoted to a foundation course, based on self directed learning. It is hoped that such a foundation course would consist of up to 80% e-learning with 20% local tutorial support. The third year would be a problem based learning course, when the overall course can be much further adapted to local needs. Finally, the clinical course would be fully dedicated to clinical experience in the last two years.
Someone again might ask, "Why do we need to change anything?" The healthcare situation today is not what it could or what it should be. Assessment is strongly needed, and global standards in medical education need to be established. Quality assurance plays an important part too. New ways of teaching and learning in medicine have emerged over the past years. Finally, as we speak of the globalisation process in the world, we can speak of globalisation of medicine as well.
Can medical education really cross national boundaries? Numerous potential problems for the INMedS concept were raised during the workshop. A number of solutions to the problems were presented as well. A concept such as this can simply help to develop universities. Knowledge is constantly increasing and needs a common information technology platform for medical education. In that way, universities will benefit by reaching their maximum potential.
In the end, as we all know--nothing is ever easy. But I know that time is on the side of INMedS. The day when Susan, Carmen, Sodzi, Ang, and many other medical students from all over the world will be brought much closer is inevitably coming. This dream will become a reality.
