Quality Assurance &Accreditation Faculty of Medicine Cairo University Efforts, Achievements & Challenges

1. Quality Assurance &Accreditation Faculty of Medicine Cairo UniversityEfforts, Achievements & Challenges Lamis Ragab, MD Vice Dean for Postgraduate Studies & Research

2. The improved health of all people is the main goal of medical education • There is a global and national call for quality improvements and assurance in medical education

3. There are global changes in health care practice * Clearer professional recommendations * Increased consumerism * Increasing student numbers * Specialization of clinical clerkships

4. WFME in its 1998 position paper launched the program on International Standards in Medical Education • A mechanism for quality improvement in medical education, in a global context, to be applied by institutions responsible for medical education, and in programs throughout the continuum of medical education

5. The Faculty of Medicine Cairo University started the activities of Quality Assurance in 2003

6. The self- study was conducted in 2003 • Limited to the undergraduate program (using the basic standards of WFME as a Benchmark) • A corrective action plan was suggested to overcome the weaknesses and enhance the strengths

7. Final report endorsed to the faculty and university councils • Dissemination to the Faculty staff members, students and some stakeholders • December 2004: external evaluators from the WFME invited for a 3-days site visit

8. The Self –Study helped the faculty in designing the vision towards accreditation • Also, the mission and the strategic objectives of the faculty were reviewed and endorsed to the faculty council for the first time.

9. Establishment of the Internal Quality Assurance System: under the guidance of the National Committee for Quality Assurance and Accreditation (the National Committee)

10. Projects Project # 1 Development of a Strategic Plan for Quality Assurance Project # 2 Establishment of sustainable QAA Centers in the Egyptian Universities Project # 3 Establishment of an Internal Quality Assurance System in the faculties Project # 4 Development of Academic Reference Standards

11. Project started in September 2005 • Establishment of project's managerial and implementation committees • The quality unit at the faculty had a place and a structural organization

12. Program and courses’ specifications of the undergraduate program according to the templates provided by the (NQAAC) • Awareness and orientation seminars to the academic staff, non academic staff, and students to introduce the quality system to the faculty's community

13. Gradual cultural change especially of the academic staff who actively participated in compiling the documents of the project • Course reports were completed by the staff members in each academic department at the end of the academic year

14. Theproject team completed the program report and produced the first Faculty Annual Self-Evaluation Report (2004/2005) following the evaluative framework designed NQAAC ( including 5 major areas: academic standards, quality of learning opportunities, research and other scholarly activity, community involvement, and effectiveness of quality management and enhancement)

15. Developmental Engagement (DE) site visit in October, 2005. Documents reviewed before the site visit : program specifications, course specifications, course reports, program report and Faculty Annual Self –Evaluation Report • Meetings: faculty staff members, vice deans, under-& postgraduate students and some stakeholders • Revision of students' work and assignments • Oral feedback about the points of strengths and that need further improvement • A comprehensive report of the developmental engagement site visit 2 months later • An action plan to enhance the strengths and improve the areas of weakness to prepare the faculty for accreditation was required

16. Faculty of Medicine Cairo University • Project #3 in cycle one (2004) • Site visit in Oct. 2005 • Action plan in Feb. 2007

17. A lag period for few months (transition of leadership) • Quality unit reconstituted in March, 2007

18. The faculty submitted the course reports, program report, the second Faculty Annual Report (2005/2006) and an action plan for accreditation to the NQAAC

19. ■Follow up visit in April 2007 for one day to monitor and support the faculty in the developmental engagement stage • Oral feedback was given at the end of the day about the achievement of the quality at the faculty in the last year • Report of the team's evaluation and their expectation about the readiness of the faculty for submission for accreditation

20. The Evaluation Framework • Academic Standards • Intended learning outcomes • Curriculum • Student assessment • Student achievement • Quality of Learning opportunities • Teaching and learning • Student support • Learning resources • Research and other scholarly activity • Community Involvement • Effectiveness of Quality Management and Enhancement • Governance and leadership • Quality assurance system • Self-evaluation, plans and impact

21. External reference standards (Benchmark) approved by the Faculty Council in April 2007: the General Medical Council standards (UK) • The Medical Sector Committee approved the National Academic Reference Standards for the Medical Faculties in Egypt

22. New Higher Curriculum Committee • Revision of curricula of: community medicine with integration between Pediatrics & OB-GYN • Ongoing revision of curricula of Ophthalmology, Bio, OB-GYN according to the mission

23. لجنة المناهج

24. Establishment of an Assessment Committee and development of a code of practice for student assessment (6/2/2007)

25. لجنة التقييم

26. قواعد التقييم Code of Practice in the Area of Student Assessment Approved by the Faculty Council in May 2007

27. Some departments modified both written and clinical examination to be more objective • Pediatric department arranged OSCE at the end of the year that was appreciated by the students and faculty staff

28. Program specifications for some postgraduate degrees: Pediatrics, Biochemistry, Dermatology, Andrology, Pathology, Internal Medicine

29. Workshop on Program & Course Specifications (Postgraduate Programs) 5/3/2007

31. اسماء وبيانات الحاضرين لاجتماع توصيف برامج الدراسات العليا يوم 5 مارس 2007

32. تابع اسماء وبيانات الحاضرين لاجتماع توصيف برامج الدراسات العليا يوم 5 مارس 2007

33. External Evaluators for two postgraduate programs (Master Degree of Pediatrics and MD of Neurosurgery)

34. In general terms, the Egyptian MD candidates were fairly well prepared and had an adequate fund of knowledge.Most demonstrated an adequate knowledge of the field and appropriately managed the clinical cases presented to them.

35. Another significant difference between the US ABNS and Egyptian MD examinations is with regards to the area oftest objectivity.

36. Another major difference in theUS andEgypt systems are that theUS examinees are expected to pass the oral boards on the first try. From my understanding, approximately 80% of the candidates do so. A lower pass rate suggests that the examinees were poorly trained or that there were potential testing irregularities that precluded the examinees from obtaining a higher pass rate.Also, the examineesare allowed to sit for the oral boards three times. If they are not successful by the third try, they must re-take their written examinations before being allowed to re-take the oral boards.

37. Having participated and observed MD examination process, I would make the following major suggestions: • There should be a single Egyptian board examination comprised of a highly objective written examination. • The oral board examiners should be selected from a pool of MD’s (that do not necessarily need to be University Professors) and this pool should be rotated yearly so as to increase the objectivity of the examiners. • Prior to sitting for the oral boards, the potential examinees should have: • a) passed their written exams • b) submitted practice data which should be reviewed for safety and consistency.

38. They are allowed to go for a maximum of three times for their oral exams; at which time if they fail all three times they should repeat the written exams again. • A 70-80% pass rate should be expected in board exams. • Residency programs should provide teaching and clinical scenarios that simulate the oral board (MD) testing experience so that the examinees have a rational framework for thought processes. • The oral board (MD) testing experience should be made as objective as possible through the incorporation of known/expected clinical scenarios and patient encounters. There should be specific objective measures (fund of knowledge, management skills, interpretation of diagnostic tests, etc) rated during the exam independently by each examiner followed by a conference after the first testing sessions.

39. 2) Quality of Learning Opportunities: • ○Lectures Students divided into 5 groups(300/group) Audiovisual facilities in 11 lecture halls (capacity 300-1000 students) • ○ Early clinical exposure in some departments (physiology and pathology)

40. ○ Student handbooks (under-&postgrad) • ○ Student support office (Academic year 2006-2007) • Academic support & counseling committee (approved by Faculty Council 10/2007) • ○ Learning resource centre: training on models and facility for e-learning

41. 3) Effective Quality Management and Enhancement : • ○ Functioning reporting system; reports of the academic year 2005/2006 were completed • ○ Revision of the mission, approved by the Faculty Council in September 2007 • ○ Establishment of an internal audit committee for the educational program • ○ Regular meeting between the members of the quality assurance unit and the dean and the three vice deans • ○ Realistic action plan covering all areas in the educational program, with a justified budget

42. 4) Research and Other Scholarly Activities: • ○ Astrategy and plan for research activities based on the research strategy of the University • ○ New postgraduate bylaws adopting the credit hour system (ECTS)

43. What is ECTS? • The European Credit Transfer and Accumulation System is a student-centred system based on the student workload required to achieve the objectives of a programme, objectives preferably specified in terms of the learning outcomes and competences to be acquired.

44. العلاقة بين البرنامج التدريبى و الشهادات الأكاديمية

45. Data base for the international publications and projects

46. الأبحاث المنشورة بالدوريات العالمية

47. الأبحاث المنشورة بالخارج

48. الأبحاث المنشورة بالدوريات العالمية

49. الأبحاث المنشورة بالدوريات العالمية

50. الأبحاث المنشورة بالخارج