CORE COMMITTEE, INSTITUTE FOR INTERNATIONAL MEDICAL EDUCATION*
Institute for International Medical Education, White Plains, New York, USA
SUMMARY The process of globalization increasingly evident in medical education makes the task of defining the global essential competencies required by the 'global physicians' an urgent matter. This issue was taken up by the newly established Institute for International Medical Education (IIME). The IIME Core Committee developed the concept of 'global minimum essential requirements' (GMER) and defined a set of global minimum learning outcomes, which students of the medical schools must demonstrate at graduation. The 'Essentials' are grouped under seven broad educational domains with set of 60 learning objectives. Besides these 'global competencies', medical schools should add national and local requirements. The focus on student competences as outcomes of medical education should have deep implications for curricular content as well as the educational processes of medical schools.
Introduction
The Board of Trustees of the China Medical Board of New York, Inc. approved a grant to establish the Institute for International Medical Education (IIME) on 9 June 1999. The Institute's task is to provide the leadership in defining the 'global minimum essential requirements' ('essentials') of undergraduate medical programs. These 'essentials' were to consist of the medical knowledge, clinical skills, professional attitudes, behavior and ethics that all physicians must have regardless of where they are trained.
The task of defining the 'global minimum essential requirements' was given to the Core Committee, which comprised international medical education experts from different parts of the world. The IIME Steering Committee, consisting of eight senior education and health policy experts with broad national and international experience, advises the leadership of the Institute and helps guide the Core Committee. Further advice is provided by the IIME Advisory Committee composed of Presidents or senior representatives of 14 major international organizations active in medical education. The Committee provides a forum for information exchange, advice and helps to ensure that other efforts are complementary and not contradictory to the IIME process.
It was understood from the beginning that defining such competencies or outcomes of the medical education process would have significant implications for medical school curricula. Medical school graduates should demonstrate professional competencies which will ensure that high quality care could be provided with empathy and respect for patients' well-being.
Graduates should be able to integrate management of illness and injury with health promotion and disease prevention and be able to work in multi-professional teams. In addition, they should be able to teach, advice and counsel patients, families and the public about health, illness, risk factors and healthy lifestyles. They should be able to adapt to changing a pattern of diseases, conditions and requirements of medical practice, medical information technology, scientific advances, and changing organization of health care delivery while upholding the highest standards of professional values and ethics.
The IIME Project Consists of Three Phases:
The first phase (Phase I) 'Defining Essentials', began with the establishment of the Institute for International Medical Education. Its task was to develop a set of 'global minimum essential requirements' ('GMER') drawn in part from standards that currently exist. These standards were to include the sciences basic to medicine, clinical experiences, knowledge, skills, professional values, behavior and ethical values. These 'essentials' were to represent only the core of a medical curriculum since each country, region and medical school also has unique requirements that their individual curricula must address. Hence, each school's educational program will be different but all will possess the same core.
In the second phase(Phase II), the 'Experimental Implementation' of the 'GMER' will be used to evaluate the graduates of the leading medical schools in China. The schools will use the evaluation methods that are consistent with their experience, and have to cover all seven domains and 60 learning outcomes, to identify the strengths and deficiencies eventually found in the schools participating in this experiment. Efforts then will be made to improve all areas of weakness before a second evaluation is made. If a school meets all of the 'Essentials', it will be certified accordingly.
In the third (Phase III), or 'Dissemination Phase',the lessons learned and the process used will be modified and offered to the global medical education community for its use. Hopefully the 'essentials' will serve as a tool for improving the quality of medical education and a foundation for an international assessment of medical education programs.
