Ecfmg 2015 Annual Report
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- Bu səhifədəki naviqasiya:
- Regional Institute Location Established
- International Fellowship in Medical Education
- Inaugural FAIMER-Keele Master’s Class Completes Residential Session at Keele University
- Research: Discovering Patterns and Disseminating Knowledge
- Characteristics and Quality of International Medical Education Programs
- IMGs and the U.S. Physician Workforce
- Quality of Care Provided by IMGs
- Data Resources: Informing Research, Policy, and the Public
- Directory of Organizations that Recognize/Accredit Medical Schools (DORA)
- International Opportunities in Medical Education (IOME)
- Master’s Programs and Ph.D. Programs in Health Professions Education
- Postgraduate Medical Education (PME) Project
- World Directory of Medical Schools
- Brazil Argentina Bolivia Peru Ecuador Colombia Venezuela
- Educational Commission for Foreign Medical Graduates
Regional Institutes FAIMER Regional Institutes adapt the curriculum model and content of the FAIMER Institute to the needs of specifc regions. Hosted by local medical schools, participants are drawn from health professions education institutions in the region. Tis regional concentration facilitates the development of a strong local professional community for collaboration and peer support. FAIMER has a particular focus on developing regions in Africa, Asia, and Latin America, and has established Regional Institutes in India, Brazil, Sub-Saharan Africa, and China. More than 900 Fellows representing 28 countries have participated in the Regional Institutes.
GSMC-FAIMER Regional Institute Mumbai, India 2005
CMCL-FAIMER Regional Institute Ludhiana, India 2006 Brazil-FAIMER Regional Institute Ceará, Brazil 2007
PSG-FAIMER Regional Institute Coimbatore, India 2007 Sub-Saharan Africa-FAIMER Regional Institute South Africa 2008
CMB-CMU-FAIMER Regional Institute Shenyang, China 2013 Manipal University-FAIMER International Institute for Leadership in Manipal, India 2015
Interprofessional Education Education Centers Institutions with at least four faculty members who have completed a FAIMER Institute or Regional Institute fellowship are eligible to become FAIMER Education Centers. Te values, goals, and methods for faculty development at the school must be aligned with those of FAIMER. FAIMER evaluates the school’s faculty development curriculum and workshop design, as well as its methods for evaluating the quality of faculty development workshops and actual evaluation data. Faculty at Education Centers receive ongoing mentoring and consultation from FAIMER staf. Tis support aims to enhance faculty development within the institution for improved teaching quality, alignment of education and health care practice, and long-term institutional and regional change.
Graduates of the FAIMER Institute and Regional Institute programs are eligible to progress to the International Fellowship in Medical Education (IFME) program. Te IFME program allows selected Fellows to pursue a Master’s in Health Professions Education (M.H.P.E.) or a Ph.D. in health professions education at an approved academic institution. Participants complete this degree through a distance learning program that may be combined with a brief residential component of approximately two to four weeks per year. Five IFME Fellows were selected in 2015. Eighteen IFME Fellows in total were supported by FAIMER in 2015. Current IFME Fellows are pursuing degrees at Maastricht University in the Netherlands, the University of Illinois at Chicago, and Stellenbosch University in South Africa, as well as through the FAIMER-Keele Distance Learning Program. In addition to the IFME program, FAIMER continued to provide support in 2015 to a Sub-Saharan Africa-FAIMER Regional Institute Fellow pursuing an advanced degree in health professions education at the University of Cape Town in South Africa. found Ation f or Ad VAnCeMent of internA tionAl MediC Al eduC Ation And reseArCh 45 45 FAIMER Distance Learning Te FAIMER Distance Learning (FAIMER DL) program ofers a robust course of study in health professions education with a focus on assessment and accreditation. Te FAIMER-Keele Certifcate, Diploma, and Master’s courses were developed by more than 120 experts in health professions education, and are presented under the leadership of FAIMER faculty members John Norcini and Janet Grant. Dr. Grant is Director of the Centre for Medical Education in Context (CenMEDIC) and Emerita Professor of Education in Medicine at Te Open University Centre for Education in Medicine in the United Kingdom. Dr. Norcini, the President of FAIMER, is an international expert in assessment. Courses are administered by CenMEDIC and follow the strict quality assurance guidelines and policies of Keele University in the United Kingdom. Te Certifcate and Diploma programs are conducted entirely on-line, while the Master’s Degree is a blended learning program that, in addition to on-line course work, includes a brief residential session and a dissertation. Te FAIMER-Keele Distance Learning program enables educators in medicine, nursing, dentistry, and other health professions to acquire the knowledge and skills to advance health professions education at their institutions to the highest international standards. Courses began in April 2013.
The inaugural class of the FAIMER-Keele Master’s in Health Professions Education Distance Learning program completed their residential session at Keele University in the United Kingdom from August 30 to September 4, 2015. The session was led by Program Directors Dr. Janet Grant and Dr. John Norcini, as well as unit authors Dr. Danette McKinley and Dr. Jack Boulet, both of FAIMER. The intensive residential session provided an opportunity for students to have face-to-face meetings with the faculty, administrators, and classmates they have been corresponding with since the program’s implementation in April 2013. Members of the Master’s class submitted and defended their dissertation proposals during the weeklong session. With their proposals approved, they will conduct the activities needed to complete their dissertations in early 2016. 46
Research: Discovering Patterns and Disseminating Knowledge Te provision of high-quality patient care demands sufcient numbers of adequately trained health care professionals, including physicians, nurses, and other allied health professionals. FAIMER staf study many of the complex issues concerning the education of, supply of, and need for physicians and other health care workers around the world. To help inform policy, and with the ultimate aim of improving world health, FAIMER concentrates its research eforts in the following areas: • characteristics and quality of international medical education programs • U.S. physician workforce, including the role of international medical graduates (IMGs) in the provision of primary care services • quality of care provided by international medical graduates Characteristics and Quality of International Medical Education Programs Te health care workforces of several countries, including the United States, Canada, and Australia, are at least partially dependent upon large numbers of physicians trained in other countries. To better understand how these diversely trained professionals might impact the quality of health care delivery, it is important to gather information on the characteristics of international medical education programs. Te collection of information on the characteristics of medical schools also supports the eforts of regulatory and accrediting authorities whose goals are to protect the public by ensuring the quality of individual practitioners and the schools where they are educated. ECFMG’s new certifcation eligibility policy, to be implemented in 2023, requires that IMGs seeking ECFMG Certifcation graduate from a medical school that has been appropriately accredited. Tis has motivated FAIMER to collect information on medical school accreditation practices, how these oversight activities are conducted, and their potential impact on educational quality. FAIMER research staf continues to compile information for FAIMER’s Directory of Organizations that Recognize/Accredit Medical Schools (DORA) that allows for the investigation of the characteristics and qualities of international accreditation practices and their potential role in improving the education process. Tere are many research studies that will be helpful in further demarcating the role of accreditation in quality improvement eforts. All of these will, at least to some extent, demand detailed data on the characteristics of international medical education programs, including historical changes in curriculum models, and longitudinal information on how and where internationally trained physicians choose to practice. FAIMER continues to collect data from medical schools throughout the world and to report on the status of physician education internationally. Collaborative research projects with various partners utilizing a variety of new performance measures, including patient outcomes, physician disciplinary actions, and specialty board certifcation, are now in development. IMGs and the U.S. Physician Workforce For the next fve to ten years, the United States is projected to have a signifcant health workforce shortage, particularly among primary care physicians. While enrollment at U.S. allopathic and osteopathic medical schools has been increasing annually at a rate of approximately three percent, the supply of physicians, and demand for physician services, will likely continue to be impacted by a number of factors, including: • limited increases in the availability of graduate medical education (GME), a requirement for licensure in all states • a growing and aging patient population that will require more health services • full implementation of the Patient Protection and Afordable Care Act, which will likely increase both the number of Americans who seek health care services and the frequency of their health care visits 47 47
found Ation f or Ad VAnCeMent of internA tionAl MediC Al eduC Ation And reseArCh ECFMG data, including initial exam registrations and certifcation success, has been linked with physician practice data to yield a longitudinal profle of IMGs in the United States. IMGs come from more than 1,400 medical schools in more than 160 countries/territories, and constitute approximately 24% of practicing physicians and residents in the United States. For several specialties, such as psychiatry and internal medicine, IMGs constitute an even greater proportion of active practitioners. Exhibit 16 compares graduates of international medical schools to those who graduated from U.S. and Canadian medical schools. Tere are some states with much larger numbers of IMGs in practice. Te states with the highest proportion of IMGs are New Jersey (40%), New York (38%), and Florida (35%). Licensure policies in each of the states are likely to afect practice patterns, and states with higher populations tend to have more physicians in active practice. Te contribution of IMGs to the U.S. health care system, including practice in the primary care specialties and the provision of care to underserved populations, is well-documented. However, there has been a shift in citizenship of those seeking ECFMG Certifcation and subsequent entry into U.S. GME programs. While debate Exhibit 16: Physicians in Active Practice in the United States, 2015 District of Columbia Number of Physicians Proportion of International Medical Graduates Proportion of U.S. and Canadian Medical Graduates in Active Practice 1,000–5,000 5,001–10,000 10,001–20,000 20,001–30,000 30,001–50,000 50,001–100,000+ “Active practice” includes hospital-based physicians (including fellows, interns, staff, and residents), and those in office-based practice. Sources: American Medical Association Physician Masterfile and ECFMG database. Data current as of December 31, 2015. 48
about the ethics surrounding migration of health care workers continues, it is interesting to note shifts in the characteristics of IMGs who have obtained ECFMG Certifcates in the last 10 years. Exhibit 17 shows the trends in the top four countries of citizenship of ECFMG certifcants, 2006–2015. While the number of Indian citizens has been declining, the number of U.S. and Canadian citizens has been increasing. With these emerging trends in mind, FAIMER staf has focused research eforts on collecting data to help understand the push and pull factors that infuence IMGs’ decisions to seek practice opportunities outside of their countries of undergraduate medical education.
IMGs must pass the same set of licensure examinations required of U.S. medical students and graduates before obtaining a license in any U.S. jurisdiction. Adequate performance on a subset of these examinations, combined with various other credentialing requirements, allows an IMG to be certifed by ECFMG, a necessary requirement for entry into GME programs in the United States. Given the comparable licensing requirements for all physicians, regardless of country of medical school education, one would expect that the quality of care provided by IMGs would be similar to that of U.S. medical graduates. While measuring quality of care can be a difcult undertaking, and can be confounded by a number of factors, including how and where care is provided, FAIMER staf is in the process of exploring patient outcomes for IMGs and comparing these to those for U.S. graduates. Initial investigations, involving select patient conditions and the specifc medical specializations of providers, suggest that patient outcomes are not, at least on average, related to a physician’s country of medical school education. To better understand the relationships between educational practices, licensing examination performance, specialty board certifcation, and patient outcomes, additional studies of practicing physicians, both IMGs and U.S. graduates, are being planned and conducted. Exhibit 17: Top Four Countries of Citizenship, ECFMG Certificants 2006–2015 3,500 3,000
N um be r o f Ce rti
2,500
2,000 1,500
1,000 500
0 2006
2007 2008
2009 2010
2011 2012
2013 2014
2015 Canada
India Pakistan United States
Citizenship is as of the time of entrance into medical school. Top four countries based on aggregate data over a 10-year period. Source: ECFMG database. Data current as of March 2, 2016. 49 49 Data Resources: Informing Research, Policy, and the Public FAIMER strives to be the single best source of data on international medical schools and their graduates. FAIMER makes both current and historical information available to medical educators, researchers, policy makers, health care consumers, students, and organizations concerned with credentialing and licensure. FAIMER’s data resources are available free of charge on the FAIMER website.
for medical education and accrediting medical schools in their countries. DORA lists accreditation authorities in more than 100 countries, including details about accreditation processes and links to specifc regulatory agencies.
students, residents, and faculty at medical schools around the world. IOME represents the collaborative eforts of FAIMER and the Association of American Medical Colleges.
FAIMER provides directories for both Master’s programs and Ph.D. programs in health professions education around the world. Listings include institution and program names, locations, and links to each program’s website.
Te PME Project describes postgraduate medical education programs worldwide. It provides information, at the country level, on formal medical education and clinical training beyond the basic medical school curriculum. Country listings typically include the duration of studies, trainee selection processes, specialty curricula and licensing authorities, areas of specialization, and regulations regarding specialty education and licensure/ certifcation. Te PME Project was developed in collaboration with the European Medical Association. Program information is being enhanced through FAIMER’s data exchange program (see page 34).
Developed in partnership with the World Federation for Medical Education (WFME), the World Directory of Medical Schools is a searchable database of the world’s medical schools, ofering listings for more than 2,800 institutions located in 184 countries and territories. Te World Directory includes listings for both operating schools and those that have closed. Medical school listings typically include the school’s current name and university afliation, previous names and afliations (where applicable), and contact information. Te World Directory also provides information for each medical program ofered by the school, including the title of the medical degree awarded, the language of instruction, whether international students are admitted, and the number of graduates. Te World Directory is the result of a merger of FAIMER’s International Medical Education Directory (IMED) and WFME’s Avicenna Directory. Sponsors of the World Directory include a number of international medical regulatory agencies who advise the directory’s management with regard to the directory’s mission, the criteria for school inclusion, and ongoing data collection. 50
Exhibit 18: Operating Medical Schools in South America No. of medical schools 151+ 21–50
11–20 1–10
Brazil Argentina Bolivia Peru Ecuador Colombia Venezuela Paraguay Uruguay Guyana Suriname French Guiana Chile found Ation f or Ad VAnCeMent of internA tionAl MediC Al eduC Ation And reseArCh Source: World Directory of Medical Schools. Data current as of February 29, 2016. 51 51 Educational Commission for Foreign Medical Graduates 3624 Market Street Philadelphia, PA 19104-2685 USA (215) 386-5900 www.ecfmg.org 54 Document Outline
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