МЕДИЦИНСКОЕ ОБРАЗОВАНИЕ
ESTABLISHING INTERNATIONAL MEDICAL EDUCATION LINKS -THE KAZAKH-BRITISH CONNECTION
Dr Chris Stephens, Associate Dean - Education & Student Experience Dr Anja Timm, Senior Research Fellow in Education, Division of Medical Education
School of Medicine, University of Southampton, UK
In October 2010 the Ministry of Health ran a medical education workshop for representatives of all publicly-funded medical schools in Kazakhstan. The event was held at and organised by Karaganda State Medical University. The workshop sought to provide participants with the following opportunities:
•To explore different models of medical education research, medical education research methods and different types of medical education research outputs
•To learn about interactive teaching techniques for large group teaching •To discuss aspects of case-based teaching within medical education •To work collaboratively on a project
•To gain an understanding of the medical education research publishing context •To present on curricular aspects of your medical school and receive feedback
Participants were drawn from a variety of backgrounds. They ranged from a Professor of Internal Medicine and several surgeons to those working in the basic and clinical sciences (Chemistry, Biophysics, Anatomy, Pharmacy, etc.) to those with pedagogic or management specialisations, e.g. in charge of quality assurance, internship training or innovative technologies.
The workshop started with presentations by all six medical schools where each delegation highlighted local initiatives and approaches that had developed alongside the national curriculum. For example, the Kazakh National Medical University told us about their student advisor system and outlined its plans to offer medical students the chance to undertake summer electives at the National University. Meanwhile, Semey State Medical Academy had introduced prizes for the best university teachers and reported on research links with Hiroshima University in radiation research. Through these presentations we learned about the similarities and differences between institutions, specific challenges and specialisation opportunities.
Other insights into medical education in Kazakhstan were derived from a small impromptu survey. As part of the workshop, we asked the participants to tell us anonymously about the problems they encountered in their day-to-day activities. The exercise was intended to highlight the locally relevant issues that might be explored through medical education research project, either within or collaboratively across institutions.
It was particularly interesting to see just how unanimous participants were in their responses. Asked about the problems medical teachers were facing, most participants noted the low morale among staff - mainly due to: •extremely long hours •the vast student numbers
•the low standard of the qualifications of students and •the inflexibility of the national curriculum
Within this context medical teachers noted that they found it difficult to motivate themselves, their colleagues and their students. Low salary for academic staff was another contributing factor mentioned.
Questioned what they thought were the big issues for medical students, medical teachers responded overwhelmingly that their students were also struggling with motivation. Many appear to enter medicine without being specifically interested in studying the subject or in pursuing a medical career. Moreover, medical schools are clearly handicapped when it comes to selection: unlike most Western countries where admission to medicine is extremely competitive, in Kazakhstan entry requirements for applicants to medical school are rather low. Moreover, despite the nature of medical practice, candidates' specific suitability for the profession is currently not being assessed.
Finally, we asked about the obstacles that institutions were battling. Medical teachers observed that institutions too were restrained by the national curriculum and in turn this restricted their responses to the challenges they were facing. Other factors mentioned were the lack of finances for teaching and the inadequate support for research.
On the final day of the workshop, facilitators and participants also discussed a list of recommendations that were to be put to the Ministry of Health regarding improvements to medical education in Kazakhstan. As a starting point, participants reviewed the OECD Review of National Policies for Education on Higher Education in Kazakhstan (2007) [http://www.oecd.org/document/10/0,3343,en_2649_39263238_38864842_1_1_1_1,00.html / Russian language executive summary available here: http://www.oecd.org/dataoecd/14/43/39549241.pdf].
Whilst some of the recommendations have already been adopted, other issues still require further attention and development. With so little being known about medical education in Kazakhstan outside the country itself, it is hoped
that the current Worldbank project on Kazakh Medical Education [http://wwwwds.worldbank.org/ exter-nal/default/WDSContentServer/WDSP/IB/2006/10/17/000104615_20061017151946/Rendered/PDF/Project0Inform1cu ment1Concept0Stage.pdf] will provide further insights.
The workshop coincided with the 60th Anniversary of Karaganda State Medical University. A sumptuous celebratory dinner was attended by university staff, guests and alumni, many of whom had travelled from abroad to be in attendance. There was also plenty of entertainment, ranging from student performances to seasoned performers of national stature. For workshop participants (and workshop facilitators) this provided an opportunity to bond over dinner and dancing.
For us from Southampton, this was the third interaction with Kazakh medical teachers. Back in October 2007 the Ministry of Health had sponsored a three week long visit to the University of Southampton where delegates underwent in-depth training. A year later, in November 2008 we travelled to Kazakhstan to deliver a one-week workshop on assessment, curriculum development and leadership. Each time we were delighted to meet a group of enthusiastic and hard-working medical educators and it was a pleasure to work with them. However, this time - the workshop in October 2010 - was special. Firstly, we encountered some of the participants from previous workshops and we were delighted to hear of how they had adapted and implemented insights from previous training. Secondly, it became apparent that we were not merely here to teach, but also to learn about medical education in Kazakhstan and to be inspired by the dedication and commitment of the teachers we met.
Congratulation to our friends at the Kazakh National Medical University in Almaty on the 80th anniversary of their institution! We hope we will meet again and that we will continue the dialogue about medical education in both countries.
МЕХАНИЗМЫ ПРИЕМА ГРАЖДАН В МЕДИЦИНСКИЕ ОРГАНИЗАЦИИ ОБРАЗОВАНИЯ РЕСПУБЛИКИ И НЕЗАВИСИМАЯ ОЦЕНКА ЗНАНИЙ АБИТУРИЕНТОВ, СТУДЕНТОВ, ВЫПУСКНИКОВ
Н.К. Хамзина, А.С. Кусаинова, С.Б. Мукашева
Министерство здравоохранения Республики Казахстан, город Астана
Прием абитуриентов в медицинские вузы в Республике Казахстан осуществляется на конкурсной основе по общей схеме для всех поступающих в высшие учебные заведения, без учета специфики медицинского образования - сдача единого национального тестирования для выпускников школ текущего года и комплексного тестирования абитуриентов для выпускников школ прошлых лет. Отсутствует профессиональный отбор абитуриентов в медицинские вузы. В соответствии с действующей редакцией Закона Республики Казахстан «Об образовании» единое национальное тестирование — одна из форм итоговой аттестации обучающихся в организациях общего среднего образования, совмещенной со вступительными экзаменами в организации образования, дающей послесреднее или высшее образование. Для поступления на медицинские специальности выпускники школ сдают профилирующий предмет - биологию. На специальность «фармация» - химия. В общую сумму баллов (в н. время - максимум 100 баллов) включены три обязательных предмета (математика, история Казахстана, казахский или русский язык) и один профилирующий.
До 2005 года пороговый уровень баллов для поступающих в медицинские вузы также был единым для всех вузов страны и составлял 40.
Практика прошлых лет показывает, что низкие требования к приему в медицинские вузы абитуриентов являются одной из причин снижения качества подготовки специалистов с высшим медицинским и фармацевтическим образованием.
К настоящему времени в целях повышения требований к приему в медицинские организации образования, совместно с Министерством образования и науки РК (далее - МОН РК) достигнуты следующие результаты:
с 2005 года повышен пороговый уровень баллов для зачисления на платное отделение по медицинским специальностям и определен в 60 баллов (из 120) (на 20% выше, чем на немедицинские специальности);
с 2010 года увеличен проходной балл присуждения образовательного гранта на специальность «Общая медицина» до 55 баллов из 100 (на 5 баллов выше, чем другие специальности).
Соотношение приема по государственному образовательному гранту и договору за 6 лет в динамике представлено на схеме: