ECFMG programme: a quality tool for incoming non-EU medical Doctors to EU?

1. ECFMG programme: a quality tool for incoming non-EU medical Doctors to EU? Theo M.G. van Berkestijn, MD Chairman Committee Foreign Degree Holders Health Care, The Hague Co-authors T.Splinter (Rotterdam), O. ten Cate (Utrecht), R.Bezema (Groningen), J.Dijkstra (Maastricht) and C.Postma (Nijmegen) AMSE conference June 5-7 2008

2. The problem • EU-border = borders of member states • Member states have different procedures for admittance of doctors from outside the EU • How do we prevent the admittance of insufficiently qualified doctors? Committee Foreign Degree Holders Health Care

3. EEA = 31 countries • EU • EFTA-members, Liechtenstein, Norway, Iceland • Switzerland Committee Foreign Degree Holders Health Care

4. Sectoral directives - Recognition of specific professional qualifications - Co-ordination of education and training of these professions - Mutual recognition of qualifications Committee Foreign Degree Holders Health Care

5. EU- sectoral directives for five health care professions: • Doctor • Dentist • Nurse • Midwife • Pharmacist Committee Foreign Degree Holders Health Care

6. Minimum requirements on content and duration of medical education: 6 years and 5500 hours pre-clinical and clinical course Committee Foreign Degree Holders Health Care

7. Formal assessment of IMGs in: UK – IRL – DK – S – FIN – N – ICE – CH- NL – F – ES -> Only 11 of 31 countries Committee Foreign Degree Holders Health Care

8. Assessment of IMGs in the Netherlands: • Premedical • Basic medical knowledge • Clinical knowledge • Clinical skills Committee Foreign Degree Holders Health Care

9. Premedical test Developed by the University of Groningen • Dutch language, (medical) • English reading • ICT-basics • Dutch health care system Committee Foreign Degree Holders Health Care

10. Assessment of Basic Medical Knowlegde Co-ordinated by the University of Maastricht • A sample of 320 basis science items from the Interfaculty data base of Progress Tests • 160 “true-false” items; 160 multiple choice Committee Foreign Degree Holders Health Care

11. Assessment of Clinical Knowledge Co-ordinated by the University of Maastricht • 100 patient cases • “key feature approach” Committee Foreign Degree Holders Health Care

12. Assessment of Clinical Skills in OSCE format Developed and executed by the University of Nijmegen Comparable to procedures at USMLE Clinical Skills Examination • A one-day clinical skills examination in 10 stations with simulated patients • 10 cases : 20 minutes with the patient, 10 minutes for report Committee Foreign Degree Holders Health Care

13. Assessment of Clinical Skills in OSCE format (2) • Special attention for the quality of: - history taking - physical examination - professional behaviour - communication - report - problem list - differential diagnosis -management policy Committee Foreign Degree Holders Health Care

14. Example of an individual result Committee Foreign Degree Holders Health Care

15. Results for the candidate lead to limited number of alternative decisions: • No additional training necessary Licence after a 12 week clinical rotational with observation of professional behaviour • Additional training of: - 0.5 year - 1 year - 2 years - 3 years - full 6 years medical course Committee Foreign Degree Holders Health Care

16. Not all EEA countries have a sound assessment of IMGs (other procedures for recognition?) • Doctors form outside the EEA will use the weakest link to enter the EU Do we want that? Committee Foreign Degree Holders Health Care

17. Next necessary step * Consensus in the EEA to assess foreign graduates conform the same standard as for domestic students * Draw the attention from the authorities in Brussels and the EU- Member states Committee Foreign Degree Holders Health Care

18. Targets • An EU-directive • Agreements between medical faculties in Europe and the competent authorities of the member states Committee Foreign Degree Holders Health Care

19. Invitation If you agree with us on the importance of Common European Standards for the Assessment of non EEA medical graduates.... then please leave your name and (e-mail) address with us. We will get in touch on future collaboration. Committee Foreign Degree Holders Health Care