Medical school evaluated: Goals and contents of the studies vary – a common vision of Finnish physicians is required

Higher education Suvi Skantz

The strengths of the five Finnish medical school programmes include the spirit of constant development. All of the programmes feature practical training outside university hospitals and functional cooperation with basic healthcare. However, the variation in the contents of medical school should be reduced as the changes in the working environment require closer cooperation and a shared vision of the objectives.

The Finnish Education Evaluation Centre (FINEEC) implemented the first national evaluation of basic medical education in 2016–2018. The evaluation covered the five universities providing the Licentiate of Medicine degree programme: the medical schools of the universities of Eastern Finland, Helsinki, Oulu, Tampere and Turku. An international evaluation group with solid expertise in medical pedagogics visited all the universities and learned about the extensive background materials produced by the universities and student organisations.

All five medical schools have a number of strengths in common. They are committed to constantly improving education, and the students participate in the development by participating as student representatives and providing feedback. International cooperation is increasing.

All medical schools provide clinical training outside university hospitals and the students have the opportunity to work with patients early on. The cooperation between the universities and external teaching units functions particularly well in basic healthcare where some of the teachers are truly inspired and act as role models.

Lack of a common vision of the education and competence of Finnish physicians

The current reform of social welfare and healthcare services requires a shared national vision of the skills, attitudes and role of graduating physicians. Currently, there is some variation in the contents and objectives of the education.

According to the international evaluation group, the medical schools should create a shared definition of how Finnish physicians should be educated and what skills they should possess upon graduation. The definition should be adjusted in cooperation with key stakeholders, in other words, patients, students, other healthcare professionals and employers.

The medical schools are advised to coordinate their curricula so that common and national learning results can be agreed upon and their fulfilment can be reliably evaluated.

– However, defining core competence to make the contents of programmes more consistent does not mean the universities should lose their individual characteristics, says Professor Marjukka Mäkelä, Chair of the evaluation group.

The evaluation group also recommends strong development of physicians’ key skills. The most important task of a physician is to make a diagnosis. The evaluation of clinical skills and the power of deduction when working with patients as well as constructive feedback are a particularly important part of learning. The ability to face challenging situations in a constructive manner is also part of a physician’s core competence and should be practised during the degree programme.

Large groups take away from learning through practical work

Larger numbers of students and changes in the organisations and budgets of universities have influenced the well-being of students and teachers. Larger courses, particularly at clinics, increase the workload of teachers and reduce the students’ opportunities for learning through practical work or receiving individual feedback. The programmes’ means of preventing, identifying and treating the well-being issues of students and employees are in need of development.

Teachers of medicine balance the requirements of teaching, clinical work and research. Faculties should contemplate solutions for increasing the appreciation of teaching and consider creating career paths in medical education. According to the evaluation group, the development units of medical education would systematically offer pedagogic training opportunities to anyone teaching medical students.

Report:

Educating Doctors for the Future – Evaluation of undergraduate medical education in Finland