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  

ate of upload: 26th Jan 2010

                                               Copyright © 2010 All Rights Reserved.