HMSDC Update
Medical education in the Middle East needs reform
Within a span of about 30
years, the United Arab
Emirates and the GCC countries
have witnessed tremendous
growth within the
medical sector enabling it to
satisfy most of the immediate
needs of a burgeoning population.
The UAE, in particular, is
undergoing major health
reforms and a key component
of this is medical education,
which should focus on the
establishment of national standards
in medical education and
the formation of basic core
curricula in medical schools.
Changes in the practice of
medicine in the last decade or
so have had major benefits for
all aspects of clinical care.
Unfortunately these changes
are not always reflected in
medical education in the
Middle East region. The recent
Arab Knowledge Report 2009
notes grave concerns over the
state of education in the Arab
world in general and specifically
the quality of university
education. Some of the major
concerns in the report focus on
the lack of specialised science
and modern techniques,
including communication
technology. The report also
points out that the region lacks
a critical mass of highly skilled
professionals equipped with
the ability to innovate and to
answer the needs of the
marketplace. This is supported
by a recent Middle East
Intelligence report which says
the need for physicians in the
GCC is growing exponentially
and will continue to do so in
the next decade.
Traditional undergraduate
medical education in the UAE
and many Arab countries
continues to focus on the accumulation
of a large body of
illness-related medical knowledge,
while graduate medical
education continues to operate
in the form of a service-oriented
opportunistic apprenticeship
model.
In most Developed
Countries medical education
has evolved so that education programmes are based on
specific goals and objectives.
In these countries medical
education is moving towards
outcome-based education
designed to prepare physicians
and specialist physicians for
broader aspects of competence
rather than mere medical
expertise. There are national
bodies in many of these countries,
such as the ACGME
(American Committee for
Graduate Medical Education),
to ensure that agreed standards
and educational
outcomes are met. For
example, ACGME and the
World Federation for Medical
Education have identified six
competencies that must be
taught across residencies.
Although they may be known
by different names, these
competencies are standard.
The ACGME standards are:
● patient care
● medical knowledge
● interpersonal skills and
communication
● practice-based learning and
improvement – residents
must be able to investigate,
evaluate and improve their
patient care practices
● professionalism
● system-based practice
It then becomes clear that
the traditional didactic lecture
method of undergraduate
medical education or the ‘see
one do one’ method in
Graduate Medical Education
that continues to dominate in
the Arab world will fail to
achieve the desired learning
outcomes in medical education
of the future.
A body of literature exists,
both in teaching and learning
in higher education and
specifically medical education,
which can inform practice.
However, most this body
of work is unknown to the
very people it affects. The old
model of learning to teach by
mere experience and trial and
error is increasingly untenable
in an era of increased accountability,
widening diversity,
technological and medical
advances.
Faculty development programmes will play a crucial
role in these new developments.
There now exists a rich
and ever increasing body of
literature on facilitating
teaching and learning in the
post-compulsory sector and the
development of teaching practice.
This also applies to
medical education. However,
despite all these developments,
the way academic staff are
supported for their teaching
role within the medical and
health sectors remains largely
ad hoc and unsystematic in the
Middle East and the Arab
region. The majority of medical
educators have differing ideas
of what facilitating teaching is
and these differences are
reflected in their diverse
teaching methodologies and
assessment techniques.
Within this context, there is
a crucial need for medical and
health educators in the region
to re-conceptualise their role
and for all to acquire new
pedagogical knowledge and
skills to facilitate the learning
experience of the young
trainee physicians. Medical
educator programmes will be
essential for the ‘professionalisation’
of medical education if
the UAE is to provide a
competent and adaptable
workforce to ensure excellence
in healthcare standards and
the capacity to respond to the
changing health needs and
expectations of the UAE population.
● Zahra Baalawi, EdD, is
Director of Education at
Harvard Medical School Dubai
Center (HMSDC), Sheikh
Mohammad Bin Rashid Al-
Maktoum Academic Medical
Center
Date
of upload: 26th Jan 2010
