The Bologna Process and its implications for medical education

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Notes

1. Advances in biomedicine with changes in the knowledge base of the medical curricula along with the developments in information technology require a new educational framework. Additional factors are the changing perceptions as to the role of the doctor and the required competencies and emerging developments in health care, for example, in relation to preventative and personalised medicine. The Bologna Process can serve as a catalyst alongside national initiatives for a review of the curricula in the context of international dimensions of medical practice in the twenty-first century.

2. While the implementation of a fully adaptive curriculum in medicine may be some time off, a move in this direction based on the principles of instructional design and the use of learning technologies is now possible. The result can be a curriculum tailored in some respects to the needs of the individual learner while maintaining the concept of a core curriculum.

3. The learning outcomes specified will reflect the key features of each cycle (e.g. the difference between a bachelor and a master degree) and the core abilities of the learner expected by the end of the cycle. While the need for some common core learning outcomes is accepted, the learning outcomes in a medical school will also reflect the curriculum of the individual medical school. Adoption of an agreed set of common core outcomes does not require an identical curriculum in each school or loss of diversity, but can be crucial in protecting patient safety in the face of free mobility of doctors in Europe.

4. The value of introducing students to clinical experiences early in their studies is now well established (see, e.g. Dornan et al. 2006). The concept of a spiral curriculum (Figure 1), as proposed for the first two-cycles, is discussed in Harden and Stamper (1999).

5. Students graduating with a Bachelor degree and not continuing into the second cycle may take up master degree in another academic field or a career that makes use of their medical science and clinical abilities. Examples are medical journalism and communication systems, medico-legal work, the pharmaceutical industry and other health related occupations.