Transformative Education
for Health Professionals

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Social Accountability, Ghent University, Faculty of Medicine and Health Sciences

Prof. Jan De Maeseneer

From its very beginning in 1815, Ghent University had a Faculty of Medicine. 

Between 1997 and 1999 a very intense process for restructuring the undergraduate medical education was put in place, with an important participation by the students. The programme-develoment started from the needs of society: the changing demographic and epidemiologic field, the social-economic changes especially the social gradient in health, the social-cultural changes with patients becoming consumers, the scientific revolution with new insights in 'mechanisms of disease' and therapeutic possibilities, and the globalization of health problems at an international scale.

 

Full project description: 

From its very beginning in 1815, Ghent University had a Faculty of Medicine. It developed as a traditional faculty, implementing the Flexner-report guidelines at the beginning of the previous century. In the seventies, the curriculum was still a very traditional one based on an enormous amount of basic medical sciences, but also on physics, plant biology, zoology,….The skills training was limited to one year of clerkship, the 'seventh' year after six years of mainly theoretical study.

Between 1997 and 1999 a very intense process for restructuring the undergraduate medical education was put in place, with an important participation by the students. The programme-develoment started from the needs of society: the changing demographic and epidemiologic field, the social-economic changes especially the social gradient in health, the social-cultural changes with patients becoming consumers, the scientific revolution with new insights in 'mechanisms of disease' and therapeutic possibilities, and the globalization of health problems at an international scale.

The decision was taken with a 2/3rd majority by the faculty council to develop an Integrated Contextual Medical Curriculum, based on interdisciplinary thematic 'blocks' and four continuous 'lines', spanning the whole trajectory from the first to the sixth year of the undergraduate training. The first line was on clinical, communicative and technical skills. The second line is on exploration in the health system and ethics, the third on information handling and problem-solving, the fourth on independent scientific work.

At the occasion of the second assessment in 2005, the curriculum received a very positive score and a special quality award for “community-orientation” and “social accountability”.

Different research project documented the impact of the Integrated Contextual Medical Curriculum. Students in the curriculum use more appropriate learning styles and have the same or a better score on a knowledge-test, compared to the performance of students in the traditional curriculum.

The undergraduate medical training program has a special focus on “personal professional development”: students reflect during the six years, 4 times a year, in a small group (7 students) with an experienced staff-member as mentor,  on their role as future physicians. This helps the program to detect in an early stage students with problems and to offer them professional help.

The next phase in curriculum reform will consist in the integration of theory in relation to medical problems, with clerkship in the corresponding disciplines, both in hospital and in the community.

One of the strong points of the curriculum in Ghent is the student-participation: students participate in every step of the development of the learning process, and are present in all the advisory boards.  Every year, students spend a week of their holidays in assessing the quality of the curriculum, writing a report with a comprehensive appraisal of the quality, that then is analyzed by the faculty. They also organize a “research day”. Student participation is seen as a contribution to leadership development.

Students are recruited mainly from the secondary schools with strong programs in sciences. There is a regional Entrance Examination before the start of the first year: 35 % pass the exam. Those students mostly have a very successful trajectory, as 85 % succeeds in the first year. 

Watch the video; Ghent University, Social Determinants of Health Education and training

Contining work:

The numbers of graduates in the different disciplines, do not always match the needs of the population. There are shortages in geriatrics, (child) psychiatry and also in family medicine. However a joint effort of the Departments of Family Medicine, based on early exposure to primary care and multiple clerkships in the discipline, led to a threefold increase of graduates in the last six years.

This case study relates to:

Case study addresses:

Quality: 
Yes
Quantity: 
No
Relevance: 
Yes
Sustainability: 
Yes