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TITLE / TITRE

AUTHOR / AUTEUR

CONCERNING / CONCERNE

PURPOSE / OBJET

DATE

KEYWORDS / MOTS CLEFS

CPME 2004/037 EN

Policy statement from EMSA – The Bologna Declaration and Medical Education

EMSA

All delegations

DECISION

22/03/2004

Medical Education

EMSA – c/o Standing Committee of European Doctors (CPME) – Rue de la Science 41 – B-1040 Brussels - Belgium

www.emsa-europe.org

E u r o p e a n M e d i c a l S t u d e n t s ’ A s s o c i a t i o n

17th March 2004 Dear Mrs. Lisette Tiddens – Engwirda Re: EMSA-Council With regards to the above matter, as the President of the European Medical Students’ Association (EMSA), I would like to ask of the Standing Committee of European Doctors (CPME) to support and assist EMSA in the process of EMSA-Council. EMSA-Council aims to improve the cooperation and communication between medical students throughout Europe. We hope to represent their interests and opinions, discuss and form joint policies on issues surrounding medical students and most of all to defend the rights and interest of medical students across Europe. EMSA is planning to organize an Inaugural EMSA-Council meeting in late August or early September this year in London, United Kingdom. Plans have been made to utilise the BMA House (BMA Council Chambers) in Tavistock Square, London with the help of the BMA – MSC (Medical Students’ Committee). At this point in time, we are discussing financial issues related with room hires and accommodation for the participants. We plan to invite 2 student representatives (from the official medical student body) from each country to be able to gather all the voices and opinions of all medical students throughout Europe. As well as that, we also want to invite 2 representatives from the National Medical Association of each country to be able to guide us as the discussion goes on. Therefore, officially there will be 4 representatives from each countries delegation. The EMSA-Council meeting will hopefully run from a Thursday to Saturday to enable numerous issues to be discussed and for any decisions to be made if necessary. At this moment in time, we are rather concern over the Bologna Process and its effect over the medical students in Europe. Therefore, one of the main agenda of our Inaugural EMSA-Council meeting will be a discussion over the Bologna Issues. EMSA has organized numerous workshops in the last couple of months to gather thoughts and opinions of medical students throughout Europe regarding this issue with the help of IFMSA – International Federation of Medical Students’ Association. We have also came up with a statement from the group of students that got together to discuss this issue. As I currently do not have a copy of the statement, I will fax them over to your office in the morning for your references. The statement is only the thoughts and opinions of a group of students and is not significantly representative of European medical students’ opinion – therefore, EMSA would like to follow the workshops and the statement up with the EMSA-Council meeting. We would hope that the statement produced by the EMSA-Council meeting will be supported by CPME and its AO as well as channelling it to the European Union – as we understand that any statements or opinions must be submitted prior to February 2005. Hence, we would like to ask of the steering committee to discuss the CPME support for EMSA’s initiatives regarding the Bologna Process in under 'any other business' and present the issue for discussion at the Board Meeting subsequently. We would appreciate if CPME and its AO could assist us in contacting the National Member Organizations of each country and in any other way possible to realize the EMSA-Council meeting. On a final point, we would be gratified if CPME could develop a point of view on the matter or if CPME would support EMSA in building a standpoint and divulgating it in Europe. Thank you in advance for all your support and understanding. Yours sincerely, Amanda Victorine Z.Y. Wong President European Medical Students’ Association

The Bologna Declaration and Medical Education A Policy Statement from the Medical Students of Europe Ljublijana, Slovenia February 7th 2004 Outcome of a workshop on the Bologna process organized by the International Federation of Medical Student’s Associations (IFMSA) and European Medical Student’s Associations (EMSA) Background The Bologna Declaration1 of June 1999 established the following objectives:

1. Adoption of a system of easily readable and comparable degrees 2. Adoption of a system essentially based on two main cycles, undergraduate

and graduate. 3. Establishment of a system of credits – such as the ECTS system 4. Promotion of mobility by overcoming obstacles to the effective exercise of free

movement 5. Promotion of European co-operation in quality assurance 6. Promotion of the necessary European dimensions in higher education

These objectives are, according to the Declaration, to be attained “within the framework of our institutional competencies and taking full respect of the diversity of cultures, languages, national education systems and of University autonomy.” Two subsequent meeting were held where additional points were added: Prague communiqué2 May 19th 2001:

7. Integrate life long learning into the overall strategy 8. Higher education institutions and students 9. Promoting the attractiveness of the European Higher Education Area

Berlin communiqué3 September 19th 2003:

10. Establish a European research area 11. Stocktaking

1 http://www.bologna-berlin2003.de/pdf/bologna_declaration.pdf 2 http://www.bologna-berlin2003.de/pdf/Prague_communiquTheta.pdf 3 http://www.bologna-berlin2003.de/pdf/recommendations.pdf

Our Viewpoint 1. The degree we study for is that of Medical Doctor, a several millennia old tradition. Adoption of a system of easily readable and comparable medical degrees can be attained through the establishment of a European Core Curriculum in medical education, as mentioned by the British General Medical Council in 1993 and defined by AMEE Education Guide no 54 (this does not include teaching methods). 2. While we support the spirit of the Bologna declaration we strongly oppose a division of the medical curriculum into bachelor and master degrees. We believe that this would cement the traditional division between the natural sciences in the preclinical part of the study from the clinical sciences. This could seriously hamper the current movement to update and make current the medical curriculum, since it would most probably lock us into the traditional basic science and clinical clerkship division, as described in the Flexner Report of 19105. Progressive medical schools worldwide strive to integrate basic science with the clinic. This establishes a meaningful context in which to integrate current research with patient care. It is supported by adult learning theory, which acknowledges the difference between having factual knowledge and being able to apply it to a real-life situation. It is crucial for us as medical students that we learn the subjects with our future profession in mind. 3. Establishment of ECTS can easily be done in most European countries, and has already been implemented at several European medical schools. When it comes to different grading systems (pass/fail, A-F) we find it difficult to take a position because we see both positive and negative consequences to such systems. Whichever system emerges, it is of utmost importance that both quality and mobility are ensured. 4. Promotion of mobility can be done on the basis of individual courses or clinical clerkships as in today’s Erasmus program. We believe the introduction of a common European Core Curriculum would also increase mobility. In the future, standardizing licensing exams should improve mobility. 5. Quality Assurance can be achieved through the establishment of a Core Curriculum and an adoption of, for instance, the WFME Global Standards for Quality Improvement6. We believe that a common European standard of assessment of medical students/schools would establish and maintain high educational quality and provide a means for comparison between different medical schools. While we welcome standards it should be in the spirit of improvement as opposed to

4 AMEE Education Guide no 5, R M Harden & M Davis: The Core Curriculum with Options or Special Study Modules. www.amee.org 5 Abaham Flexner, Medical education in the United States and Canada, The Carnegie Foundation for the Advancement of the Teaching Bulletin Number Four, 1910 www.carnegiefoundation.org/elibrary/docs/flexner_report.pdf. 6 WFME Global Standards for Quality Improvement, Basic Medical Education, WFME Office: University of Copenhagen, Denmark 2003 www.wfme.org

constraining the diversity of the individual medical schools in Europe. Students should be accorded an active role in the quality assurance process. 6. There are large differences between medical curricula in different European medical schools. In some countries, the emphasis is more on clinical competencies (knowledge, skills, and attitudes) while others are more theoretically oriented. We hope that the future European medical education is based on a holistic view of the complex world we are living in and reflects the fast changing environment and growing knowledge base of tomorrow’s doctors. 7. The healthcare environment is rapidly changing making continuing medical education essential after graduation. The role of medical schools in preparing their graduates for this process cannot be stressed enough. We see the utilization of modern teaching methods and self-directed learning as setting the foundation for this life long learning. 8. The recognition of students as “competent, active and constructive partners7” is a step forward in increasing the quality of medical education. We welcome this invitation of the ministers for more active student participation which we hope will be welcomed at all levels. We feel strongly about our education and that of the generations to come. We are the key to shaping tomorrow’s education. We will, after all, be tomorrow’s teachers. 9. Through maintaining and improving the quality of our medical education through, among other things, the steps outlined above, we believe that Europe will become more attractive to students. 10. In our knowledge-based society, research is one of the pillars of the modern university. We see the potential benefits of the establishment of a European research area and appreciate its importance in academia. 11. We feel that in the stocktaking process attention must be paid to progress thus far in medical education as the non-applicability of the Ba/Ma system makes medical education a special case. In conclusion, we welcome the Bologna process, which encourages flexibility, mobility and quality assurance while we maintain that the integration of the basic sciences and clinical worlds from day one is paramount to our success as future doctorsi. The implementation of the Bologna action lines should not interfere, but rather support this new focus on medical education. We therefore strongly oppose the forced application of the two-cycle, Ba/Ma model to medical education. We look forward to active participation in Europe’s drive towards the highest quality medical education possible. We look forward to co-creating a common future for healthcare in Europe

7 http://www.bologna-berlin2003.de/pdf/Prague_communiquTheta.pdf

Signatories: Katja Kovac, Slovenia Hans Jacob Westbye, Norway Carl Savage, Sweden Amanda Victorine Wong Zhi Yan, United Kingdom Emily Spry, United Kingdom Carl Robert Blesius, Germany Thomas Shiozawa, Germany Urška Gajšek, Slovenia Barbara Rupnik, Slovenia Ajda Skarlovnik, Slovenia Maja Kušnjer, Croatia Valpuri Saarinen, Finland Fiona Horneff, Germany Thorsten Hornung, Germany Alexander Lavinius Ungur, Germany Jan Westermann, Germany Masha Sukunda, Slovenia Nikola Borojević, Croatia Aleš Agatanović, Slovenia Vjekoslav Peitl, Croatia Siniša Crnogorac, Serbia and Montenegro Dijana Hasičić, Slovenia Mircha Poldrugovac, Slovenia Nikola Ivan Leder, Croatia