Relevance of the WFME global standards in medical education to ...

Need for standards in medical
education
The increasing internationalisation of the
medical profession raises the question of
safeguarding the practice of medicine and
the use of the medical workforce.
Within the framework of globalisation and
cross-border education, we have observed
pronounced migration of medical doctors.
As a consequence of this development,
commercialisation and privatisation and
even a for-profit approach of education
providers have become realities. Medical
education thus follows the conditions of
other parts of higher education, becoming
a trade commodity with the risk of
compromising quality. This fact has
brought about renewed interest in quality
assurance mechanisms, exemplified in
greater concern about standard setting
and establishment of accreditation
systems, and a number of international
organisations and agencies are now
working with these issues.
The need to define global standards in
medical education arises from the
implications of this globalisation process,
but also from an attempt to meet national
problems and challenges due to
institutional conservatism and insufficient
management and leadership.
One paramount world-wide problem is the
mushrooming of new medical schools of
about 100 per year over the last 10 years.
This development has serious
consequences in many new medical
schools due to unclear mission
statements, insufficient educational
resources, lack of clinical training settings,
and limited research attainment. The lack
of accreditation procedures or other quality
assurance mechanisms in many countries
adds to the disquiet.
The WFME global standards
programme
The WFME launched its ambitious
programme on international standards in
medical education in a WFME executive
council position paper published in 1998
(WFME, 1998).
The working process consisted of three
international task forces with all together
76 experts representing all five continents.
Members of the Task Forces were
selected on the basis of their expertise.
The trilogy of global standards for quality
improvement in medical education,
covering basic medical education (BME),
postgraduate medical education (PME)
and continuing professional development
(CPD) of medical doctors and published in
2003 (WFME, 2003) was the essential
background material for the 2003 WFME
world conference in medical education
entitled: Global standards in medical
education for better health care. The
conference resulted in consensus
worldwide on the standards programme
(van Niekerk, 2003; van Niekerk et al.,
2003) and gave WFME a renewed
mandate. The implementation process has
been ongoing since 2001, comprising pilot
studies, translation (the BME Standards
have been translated into more than 20
languages), basis for self-evaluation and
external reviews of educational institutions
and incorporation in national standards
and accreditation systems around the
world. More than 250 medical schools
have used the standards directly and more
than 60 countries use the WFME
standards as a reference in national
standard setting.
In defining global standards, dissimilarities
between regions and countries regarding
the basic conditions and management of
medical education must be taken into
consideration. The WFME task forces also
discussed the “pros” and “cons” of
standard setting. Among the advantages
enumerated were incentive for
improvement, basis for national
evaluation, formulation of curricular
essentials (core), opportunity for education
research, facilitation of reforms, instrument
for funding, facilitation of exchange
(students/teachers/programmes) and
foundation for accreditation. On the other
hand, reservations were also expressed,
the most important ones being
interference with autonomy, focus on
minimum requirements, risk of conformity,
sense of control, lack of common
relevance, disregard of local differences,
equation of “global” and “western” and the
risk of increasing brain drain. Balancing
these views, the task forces came to the
conclusion that time was ripe for common
global standards for medical education to
be explored.
South East Asian Journal of Medical Education
Inaugural issue
3