SoME-Oct2006

Handbook of WMA Policies
World Medical Association ½ S-2006-04-2006

WMA STATEMENT
ON
MEDICAL EDUCATION
Adopted by the 57th
WMA General Assembly, Pilanesberg, South Africa, October 2006
PREAMBLE
The practice of medicine is dynamic and continues to evolve. edical education represents
a continuum of learning that commences with undergraduate medical school and endures
until a physician retires from active practice. Its goal is to prepare practitioners of medi-
cine to apply the latest scientific knowledge for the promotion of health and the prevention
and cure of human diseases and the mitigation of symptoms of presently incurable dis-
eases. Medical education also comprises the ethical standards governing the thought and
behaviour of physicians. All physicians have a responsibility to themselves, the profes-sion
and their patients to maintain a high standard for their medical education.
BASIC PRINCIPLES OF MEDICAL EDUCATION
Medical education consists of basic medical education, postgraduate medical education,
and continuing professional development. The profession, the faculties and educational
institutions, and the government share the responsibility for guaranteeing that medical edu-
cation meets a high quality standard throughout this continuum. The aim of medical edu-
cation is to develop competent and ethical physicians that deliver high quality healthcare
to the public.
BASIC MEDICAL EDUCATION
The goal of basic medical education is to instruct students in the practice of the profession,
and to supply the public with well-qualified physicians. The first professional degree
should represent the completion of a curriculum that qualifies the student for a spectrum of
career choices, including, but not limited to, patient care, public health, clinical or basic
research, or medical education. Each of these choices will require additional education
beyond the first professional degree.
SELECTION OF STUDENTS
A general liberal education is beneficial for anyone embarking on the study of medicine.
A broad cultural education in the arts, humanities, and social sciences, as well as bio-logical
and physical sciences, is advantageous. Students should be chosen for the study of
medicine on the basis of their intellectual ability, motivation, previous experiences, and
S-2006-04-2006½ Pilanesberg
Medical Education

character and integrity. The numbers admitted for training must meet the needs of the
population and be matched by appropriate resources. Selection of students should not be
influenced by age, sex, race, creed, political persuasion or national origin, although the mix
of students should reflect the population.
FACULTY
Basic medical education must be taught by a structured faculty. The faculty must possess
the appropriate qualifications that can only be achieved through formal training and
experience. The selection should not be based on age, race, creed, political affiliation, or
national origin.
The faculty must foster an academic environment in which learning and inquiry are en-
couraged and can thrive. As such, active research to advance the body of medical know-
ledge and the quality of care must take place in academic settings that promote the highest
medical standards. The goals, content, format and evaluation of the education provided are
the responsibility of the faculty. Medical schools should ensure continued growth of the
teaching skills of the faculty.
The faculty is accountable for providing its own basic curriculum in an academic environ-
ment that allows learning to flourish. The faculty should review the curriculum frequently,
allowing for the needs of the community and for input from practising physicians.
Furthermore, the faculty is responsible for regularly evaluating the quality of each
educational experience and for reviewing each other.
In addition to competent faculty, the institution must require that library resources, re-
search laboratories, clinical facilities, and study areas be available in sufficient quantity to
meet the needs of all learners. Moreover, a proper administrative structure, including but
not limited to academic records, must be maintained in order to provide the most com-
prehensive education.
CONTENT OF BASIC MEDICAL EDUCATION
The educational content should equip the student with a broad base of general knowledge
in the whole field of medicine. This includes a study of the biological and behavioural
sciences as well as the socio-economics of health care. These sciences are basic to an
understanding of clinical medicine. Critical thinking and self-directed learning should also
be required, as should firm grounding in the ethical principles upon which the physicians
will function and in the principles of human rights. The student should also be introduced
to medical research and its methodology at this stage.
CLINICAL EDUCATION
The clinical component of medical education must be centered on the supervised study of
patients and must involve direct experiences in the diagnosis and treatment of disease. The
clinical component should include personal diagnostic and therapeutic experiences with a
Handbook of WMA Policies
World Medical Association ½ S-2006-04-2006

gradual increase in responsibilities. An appropriate balance among the patient base,
trainees and teachers must be observed.
Before beginning independent practice, every physician should complete a formal pro-
gram of supervised clinical education. This clinical experience should range from primary
to tertiary care in a variety of inpatient and outpatient settings, such as university hospitals,
community hospitals and other health care facilities.
The faculty and medical schools have the responsibility to ensure that students who have
graduated and received the first professional degree have acquired a basic understanding
of clinical medicine and the basic skills needed to evaluate clinical problems and take
appropriate action independently, and exhibit the attitude and character to be an ethical
physician.
POSTGRADUATE MEDICAL EDUCATION
It is highly desirable, and in many jurisdictions it is already a requirement, that a graduate
from a basic medical education institution participate in a postgraduate training program
prior to obtaining a license. Postgraduate medical education, the second phase of medical
education, prepares physicians for practice in a medical specialty. Postgraduate medical
education focuses on the development of clinical skills and general and professional
competencies and on the acquisition of detailed factual knowledge in a medical specialty.
This learning process prepares the physician for the independent practice of medicine in
that specialty.
The programs are based in communities, clinics, hospitals or other health care institutions
and should, in most specialties, utilize both inpatient and ambulatory settings, reflecting
the importance of care for adequate numbers of patients in the postgraduate medical edu-
cation experience. Postgraduate medical education programs, including Transitional Year
programs, are usually called residency programs, and the physicians being educated in
them, residents. A resident takes on progressively greater responsibility throughout the
course of a residency, consistent with individual growth in clinical experience, knowledge,
and skill.
The education of resident physicians relies on an integration of didactic activity in a
structured curriculum with diagnosis and management of patients under appropriate levels
of supervision and scholarly activity aimed at developing and maintaining life-long learning
skills. The quality of this experience is directly related to the quality of patient care, which
is always the highest priority. Educational quality and patient care quality are interdepen-
dent and must be pursued in such a manner that they enhance one another. A proper balance
must be maintained so that a program of postgraduate medical education does not rely on
residents to meet service needs at the expense of educational objectives. A resident is pre-
pared to undertake independent medical practice within a chosen specialty on the satisfac-
tory completion of a residency.
S-2006-04-2006½ Pilanesberg
Medical Education

PROFESSIONAL DEVELOPMENT OF PHYSICIANS
Continuing professional development* is defined as the educational activities that serve to
maintain, develop, or increase the knowledge, skills, and professional performance and
relationships a physician uses to provide services for patients, the public, or the profession.
Physicians should strive to further their medical education throughout their careers. These
educational experiences are essential to the physician’s continuing professional develop-
ment: to keep abreast of developments in clinical medicine and the health care delivery
environment, and to maintain the knowledge and skills necessary to provide high quality
care. The goal of continuing professional development is to sustain and enhance the com-
petent physician. Medical schools, hospitals and professional societies all share a responsi-
bility for developing and making available to all physicians effective opportunities for
continuing professional development.
The demand for physicians to provide medical care, prevent disease, and give advice in
health matters calls for the highest standards of basic, postgraduate, and continuing pro-
fessional development.
* Note on terminology
There are different uses of the term ‘Continuing Professional Development’ (CPD). One way to
describe it is all those activities that contribute to the professional development of a physician
including involvement in organized medicine, committee work in hospitals or group practices,
teaching, mentoring and reading, to name just a few. One of the components of CPD should be
Continuing Medical Education, which in many jurisdictions is specially defined and possibly
required for licensure.