The QS Subject Focus Summit on Medicine was prefaced by a welcome dinner where we witnessed a range of outstanding choir, string and aboriginal music and dance performances by Kaohsiung Medical University students. It was then followed by the delivery of welcome remarks and a keynote from the President of Kaohsiung Medical University, Ching-Kuan LIU and legislator and former Kaohsiung Medical University Vice-President, Yi Ming CHEN.
Kaohsiung Medical University was the first private medical university and first medical university founded by local Taiwanese. Earlier institutions were either being founded under the Japanese colonial government or transplanted from Chinese Mainland following the 1949 communist revolution.
With a large number of Southeast Asian delegates and speakers attending the Summit, it demonstrated great significance in the context of Taiwan’s government policies; which under the new administration, are aimed at deepening engagement with Southeast Asia.
The main Summit consisted of 3 tracks: Balancing Research, Training and Patient Care, The Medical Curriculum of the 21st Century and Reinventing the Academic Medical Career.
The track on Balancing Research, Training and Patient Careincluded a presentation by Gabriel LEUNG (Dean, Li Ka Shing Faculty of Medicine, University of Hong Kong) who shared the human resources, student recruitment and financial strategy of the medical school. He emphasized the long-term nature, creativity and flexibility needed for human resources planning, the importance of recruiting students from diverse social backgrounds and the diverse stakeholders who fund the medical school’s scholarships, building and refurbishment projects.
Shang-Jyh HWANG (Vice Superintendent, Kaohsiung Medical University Hospital) spoke on the rise of non-communicable diseases due to an ageing population in Taiwan and the diverse strategies undertaken by government, hospitals and universities to improve patients’ quality of life. Through a combination of early diagnosis and treatment, the life expectancy and life quality of patients with kidney and other diseases have been significantly extended.
Luis COLLADO YURRITA (Director, Department of Medicine, Complutense University of Madrid) noted the importance of empathy in medical education and the need to understand the complete patient. Such empathy is not automatic, in fact medical education can make students less empathetic with their patients, a matter of grave concern. The need to admit students with the right mind-set was also mentioned.
Abdul Jalil NORDIN (Dean, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia) spoke on the importance of integrating basic sciences into the medical curriculum. It serves to stimulate students’ interest in the and learning of the basic sciences and ensuring that they can successfully apply this knowledge to their clinical studies.
The panel discussion that followed touched on a wide range of related topics. The importance of exposing students to different environments, subjects and cultures was highlighted. For this, the curriculum needs to create adequate “free space”, preferably for an extended period of 6-12 months. This is to ensure that students can really undertake in-depth studies or experiences in areas that are outside of their field. Strategies for recruiting outstanding international faculty were also shared. Regarding the balancing of research, training and patient care: while institutions should seek this balance, there can be imbalance among staff depending on their specific role within the medical school.
The second track The Medical Curriculum of the 21st Century included a presentation by Vincent EMERY (Senior Vice-President for Global Strategy and Engagement, University of Surrey) who mentioned the different skills-set that future doctors will need, including in communication with patients, using new diagnosis and monitoring technologies and being more cost-aware as pressure on health care expenses continues to rise. He also noted the ambition of the University of Surrey to open a medical school in the near future.
Roger WONG (Executive Associate Dean for Education, Faculty of Medicine, University of British Columbia) explained the unique challenge in British Columbia to train medical professionals in their local community to increase the chance of their continued residence in remote areas; remote areas being underserved by medical professionals. More generally, he noted that personal factors (e.g. employment of spouse, availability of child care) are major influencers of success and progress in medical education.
Yen-Ping KUO (Assistant Dean for Curriculum, School of Osteopathic Medicine, Campbell University) discussed her experiences in building integrated curricula centred on specific symptoms and parts of the body. This integrated approach is highly stimulating for students and an effective teaching method. However, it requires close collaboration between subject matter experts.
Wanbeom PARK (Associate Dean for Education, College of Medicine, Seoul National University) discussed the experience of implementing a new competency-based curriculum. Integrating concepts of flipped-classroom teaching, promoting self-directed learning, teamwork and leadership into a new curriculum required extensive preparation and convincing of faculty. It also sparked some resistance from students, some of whom could not accept the inevitable trail-and-error involved.
Lourdes D. MAGLINAO (Dean, Faculty of Medicine and Surgery, University of Santo Tomas) discussed the many digital education initiatives that were successfully undertaken and its impact on students and faculty. The digitisation has essentially led to a paperless education system, with materials, work submissions and a significant degree of student and faculty interaction all occurring online.
The panel discussion again touched on a wide range of issues. These included the concept of a ‘unified global basic medical curriculum’. There was consensus that in principle this was possible, as many jurisdictions desired very similar competencies from medical professionals. However, there should be room to vary the methods of teaching depending on the students and local situation. At the same time there were opportunities to share micro-modules between universities.
The importance of suitable examinations and admissions were also touched upon, although these are often in the hands of medical boards or government agencies and not of the medical schools themselves.
Regarding student empathy and “soft skills”, the matter of the “hidden curriculum” was also raised. There are some unintended and negative side-effects of medical education, in part to do with pressure to perform, which should be addressed.
The third track Reinventing the Academic Medical Career featured presentations by five speakers, including Ivy YEH (School of Humanities, Nanyang Technological University) who described her departments’ latest research in the medical humanities and who emphasized the importance for doctors to understand their field in a global and historical context.
Poornima BALIGA (Pro Vice Chancellor, Faculty of Health Sciences, Manipal University) shared her institution’s mission in fighting ill-health, ill-literacy and ill-wealth (poverty) around the world through capacity-building projects. She highlighted the importance of educating students who understand and are in touch with the needs and beliefs of the local community, and emphasized health literacy.
Ratna SITOMPUL (Dean, Faculty of Medicine, Universitas Indonesia) highlighted the tremendous healthcare challenges facing Indonesia following the recent expansion of its national health insurance program. The government of Indonesia has set ambitious targets for the expansion of medical education, establishing more teaching hospitals and investing in research and innovation to develop solutions specific to the Indonesian context.
Chanuantong TANASUGARN (Dean, Faculty of Public Health, Mahidol University) emphasized the need for improved health literacy and shared the integrated approach being taken in Thailand. The approach involves both top-down and bottom-up education, information and training campaigns.In this, the training of students and faculty and the transformation of organizations so that they are also health literate, is an important step.
Matthew WALTERS (Director, School of Medicine, Dentistry and Nursing, University of Glasgow) noted the decline in clinical academics in the UK due to a mix of factors, including uncertainty in career advancement, a heavy workload and more attractive alternative pathways either as researchers or clinicians. More planning and mentoring are seen as ways to reduce ‘leakage’ in the clinical academic talent pipeline.
The panel discussion that followed touched upon the academic clinical work-life balance and also the darker side of medical education, including relatively high suicide rates compared to other courses of study. Sometimes suicidal tendencies were also linked to parental pressures. Some students displayed other social problems, for instance because they had relocated to an urban area from a remote rural area.
The need for screening and student monitoring was therefore emphasized, including peer monitoring. However, reducing pressure on students is difficult as medical education is demanding. A final-year medical student taking part in the panel discussion noted the need for role modelsand the big gap that exists between the classroom and difficult real-life experiences such as witnessing the death of a patient.