International medical education: establishing a framework for comparison of different systems with common goals

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Introduction: The American and European medical education systems vary vastly in their history and structure. Currently, there is no algorithm or framework for comparison between the two systems. Since best practice in education calls for competency-based educational experiences, can a framework for comparison between the American and European systems be created such that the competency frameworks are appropriately mapped?

Methods: We selected the AAMC competencies to represent the American framework and the CanMEDs 2015 framework to represent the European system. To connect the systems, we subjectively matched each AAMC competency with its correlating CanMEDs competencies. We then identified and mapped the USMLE objectives and the Tuning Project outcomes to our initial mappings to connect the testable and desired outcomes, respectively. Finally, we demonstrated the feasibility of this framework by mapping the learning objectives from the musculoskeletal block at the University of Minho to the learning objectives at Sidney Kimmel Medical College (SKMC), which were already labeled with their corresponding AAMC competencies.

Results: The resultant mappings between the USMLE outcomes, AAMC competencies, CanMEDs 2015 competencies, and the Tuning Project outcomes are depicted in the form of a table. The second mapping between the musculoskeletal block learning objectives is also demonstrated in a table and shows how easily the learning objectives can tie into the main mappings.

Discussion: The resultant tables demonstrate a framework for comparison between the American and European systems; specifically, on how the student experience, competencies, and desired outcomes relate. Through the example of one block’s learning objectives, we can see how it would be possible to allow for level-appropriate student placement for meaningful student exchanges. These results could also assist in defining expected competencies of students in similar training points while also enabling international collaboration in the development and evaluation of learning opportunities.



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