Stages and transitions in medical education around the world: Clarifying structures and terminology

University Medical Center Utrecht , The Netherlands.
Medical Teacher (Impact Factor: 1.68). 01/2013; 35(4). DOI: 10.3109/0142159X.2012.746449
Source: PubMed

ABSTRACT Background: In a world that increasingly serves the international exchange of information on medical training, many students, physicians and educators encounter numerous variations in curricula, degrees, point of licensing and terminology. Aims: The aim of this study was to shed some light for those trying to compare medical training formats across countries. Methods: We surveyed a sample of key informants from 40 countries. Survey questions included: structure of medical education, moment that unrestricted practice is allowed, various options after general medical licensing, nomenclature of degrees granted and relevant terminology related to the medical education system. In addition, we searched the literature for description of country-specific information. Results: Based on the results, we described the six models of current medical training around the world, supplemented with a list of degrees granted after medical school and an explanation of frequently used terminology. Conclusions: The results of this questionnaire study lead to the conclusion that while there are many differences between countries, there appear to be six dominant models. The models vary in structure and length of medical training, point of full registration and degrees that are granted.

Download full-text


Available from: Olle ten Cate, Sep 26, 2015
188 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To investigate country-to-country variation in performance across clinical science disciplines and tasks for examinees taking the Step 2 Clinical Knowledge (CK) component of the United States Medical Licensing Examination. Method: In 2012 the authors analyzed demographic characteristics, total scores, and percent-correct clinical science discipline and task scores for more than 88,500 examinees taking Step 2 CK for the first time during the 2008-2010 academic years. For each examinee and score, differences between the score and the mean performance of examinees at U.S. MD-granting medical schools were calculated, and mean differences by country of medical school were tabulated for analysis of country-to-country variation in performance by clinical discipline and task. Results: Controlling for overall performance relative to U.S. examinees, results showed that international medical graduates (IMGs) performed best in Surgery and worst in Psychiatry for clinical discipline scores; for clinical tasks, IMGs performed best in Understanding Mechanisms of Disease and worst in Promoting Preventive Medicine and Health Maintenance. The pattern of results was strongest for IMGs attending schools in the Middle East and Australasia, present to a lesser degree for IMGs attending schools in Europe, and absent for IMGs attending Caribbean medical schools. Conclusions: Country-to-country differences in relative performance were present for both clinical discipline and task scores. Possible explanations include differences in learning outcomes, curriculum emphasis and clinical experience, standards of care, and culture, as well as the effects of English as a second language and relative emphasis on preparing students to take the Step 2 CK exam.
    Academic medicine: journal of the Association of American Medical Colleges 09/2014; 89(11). DOI:10.1097/ACM.0000000000000488 · 2.93 Impact Factor