Global Medical Education Past Present Future

1. Global Medical EducationPastPresentFuture PROFESSOR DAVID WILKINSON Dean of Medicine The University of Queensland Australia

2. Overview • Higher education as a global industry • Framework of Transnational Medical Education • Different models • Direct experiences • Future opportunities: a global medical program?

3. Higher education as a global industry

4. Higher education and the global economy www.theaustralian.com.au

5. A academic revolution is underway “An academic revolution has taken place in higher education in the past half century marked by transformations unprecedented in scope and diversity. Comprehending this ongoing and dynamic process while being in the midst of it is not an easy task. Arguably, the developments of the recent past are at least as dramatic as those in the 19th century when the research university evolved, first in Germany and then elsewhere, and fundamentally redesigned the nature of the university worldwide. The academic changes of the late 20th and early 21st centuries are more extensive due to their global nature and the number of institutions and people they affect”.

6. A academic revolution is underway “Globalization…the reality shaped by an increasingly integrated world economy, new information and communications technology, the emergence of an international knowledge network, the role of the English language, and other forces beyond the control of academic institutions….. Internationalization… is response to globalization…including sending students to study abroad, setting up a branch campus overseas, or engaging in some type of inter-institutional partnership”.

7. A academic revolution is underway “The last decade has also seen a veritable explosion in numbers of programs and institutions that are operating internationally. Qatar, Singapore and the United Arab Emirates stand out as examples of countries that have boldly promoted internationalization as a matter of national policies: they have recruited prestigious foreign universities to establish local campuses, with the goal of expanding access for the local student population and serving as higher education "hubs" for their regions. But for the world's poorest countries and most resource-deprived institutions, the opportunities to engage internationally can be extremely limited”.

8. Impact in Australia www.theaustralian.com.au

9. Australia www.theaustralian.com.au

10. Saudi Arabia www.theaustralian.com.au

11. Impact in Australia www.theaustralian.com.au

12. Impact in Australia www.theaustralian.com.au

13. Higher education as a global industry www.theaustralian.com.au

14. Australian reliance on global education www.theaustralian.com.au

15. Global medicine • Medicine and disease are global • HIV/AIDS, SARS, Influenza, TB • Doctors are highly mobile • Medical students electives • Specialty training • Global medical workforce • Academic medicine • Medical migration and dependence on IMGs • Medical tourism • A new industry • Expansion of agencies and institutions globally • ACGME International in Singapore • Joint Commission hospital accreditation

16. Framework of Transnational Medical Education Harden R. International Medical Education and Future Directions: A Global Perspective Academic Medicine 2006; 81 (12 suppl) s22-s29. • Visiting teacher: becoming less common • Virtual teacher: slowly increasing • Technology supports potential: synchronous / not How would we design this? • Widespread adoption • Common across globe • ? Mainly ‘North to South’ • Almost always an ‘elective’?

17. Framework of Transnational Medical Education

18. Some different models • Outbound student mobility • Electives ++ • Core rotations / clerkships -- • Incoming student mobility • Electives ++ • Core rotations / clerkships -- • Staff mobility and sabbatical • Conferences / visits • Formal exchange • Academic partnering • IMU • IVIMEDS • Offshore campus development • Cornell in Qatar • ‘Franchised’ curriculum • Maastricht in Saudi Arabia • International schools • Caribbean • Institutional partnerships • UQ-Ochsner

19. Australia’s Global Medical School • Global Faculty & Curriculum • Global Students: Diversity • Global Student Exchange • Global Key Partnerships • Global Projects • Global Presence

20. Clinical training offshore: Outbound mobility • 2011 Graduating Cohort • 80% graduates had an offshore placement (elective & core) • 15% of these did >1 placement • In CY 2011 30% offshore placements were core rotations • In each year, about 500 UQ medical students undertake about 600 offshore placements • Where: Canada, USA, UK, • India, Pacific Islands, Asia

21. A novel model at UQ-Ochsner • Partnership between UQ and Ochsner Health System • Students are US citizens / permanent residents • Spend first 2 years of the UQ MBBS degree in Brisbane, Australia • Second 2 years in New Orleans, USA • UQ curriculum, UQ quality assurance, UQ appointments, UQ Clinical School • Extensive bilateral exchange between faculty; research programs developing • Fully accredited by the Australian Medical Council • Students take USMLE and are eligible for residency match in US (but treated as IMGs) • Graduates are eligible to apply for internship in Australia (but treated as international medical students; lower priority)

22. Partnership projects

23. Future opportunities? ✔ ✖ ✔ • 2 (top) universities • 2 degrees • Global curriculum • Global students • Global faculty • 6 x 2 week intensives in LA, Singapore, Shanghai, and Bangalore

24. A Global Medical Program? • A Possible Model • Small group of medical schools • Global curriculum / track within curriculum • Global students • Global faculty • Time spent in different global settings • Focus on range of global health / medical projects • Options • Work within existing accreditation frameworks • Each partner grants own degree • ? Additional qualification • No threat to registration • Focus on quality, impact, social responsibility • Partners would determine depth of engagement • Flexibility, focus on educational impact, • Barriers • Accreditation? • Registration? • Cost-Benefit? • PARTNERS • University of Queensland • Maastricht University • National University of Singapore • Queens University, Canada

25. Questions please