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Self eval report english final for printing, 28.09.2011last for printing

  1. 1. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 ASSOCIATION FOR MEDICAL SCHOOL OF MEDICNE EDUCATON WESTERN PACIFIC HEALTH SCIENCE UNIVERSITY REGION OF MONGOLIA SELF- EVALUATION REPORT BASIC MEDICAL EDUCATION PROGRAMME FOR “MEDICAL DOCTOR” (D720300) ULAANBAATAR 2011 1
  2. 2. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Working group Director Ts.Lkhagvasuren Academician, MD, PhD, ScD President of HSUM R.Otgonbayar MD, PhD, MPH Dean School of Medicine Deputy Director D.Amarsaikhan MD, PhD, Vice President for Academic affairs Secretary D.Otgonbayar MD, PhD Head of Division of Educational Policy and Management, HSUM 1. MISSION AND OBJECTIES Ts.Sarantuya, MD, PhD, M.B.A-P.M. Deputy Dean School of Medicine for Academic affairs V.Nyamtsengel MD, Lecturer of Department of Infectious diseases 2. EDUCATIONAL PROGRAMME D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM B.Bayarmagnai MD, PhD, Coordinator Division of Educational Policy and Management, HSUM B.Solongo MD, PhD Head Department of Pulmonology T.Navchaa MD, PhD Lecturer of Department of General practice and Preventive Medicine D.Baigalmaa MD, Lecturer Department of Pediatrics 3. ASSESSMENT OF STUDENTS B.Oyungoo MD, PhD, Coordinator Division of Educational Policy and Management, HSUM Ch.Chinzorig MD, Coordinator Division of Educational Policy and Management, HSUM S.Sainbileg MD, Lecturer Department of Endocrinology Kh.Delgerdalai MD, Coordinator School of Medicine B.Oyuntugs MD, Lecturer Department of Endocrinology 4. STUDENT AFFAIRS A.Gurbadam PhD, Dean of Student Services Kh.Delgerdalai MD, Coordinator School of Medicine B.Oyuntugs MD, Lecturer Department of Endocrinology E.Enkhtamir MD, Lecturer Department of Nephrology 5. ACADEMIC STAFF / FACULTY S.Naranchimeg MD, PhD, Head Department of Professional Basic Skills 2
  3. 3. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 A.Otgonbat MD, Head Department of Hematology B.Ariunzaya MD, Lecturer Department of Pharmacology 6. EDUCATIONAL RESOURCES P.Tseden MD, PhD, MBA Vice President for Finance and Monitoring R.Oyungerel MD, PhD Deputy Dean School of Medicine for Research and Foreign affairs D.Ichinnorov MD, PhD, Assoc Prof, Deputy Dean School of Medicine for Clinical affairs B.Erdenebulgan MD, PhD Lecturer Department of Oncology S.Ariunaa, Accounts Department 7. PROGRAM EVALUATION D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM Ts.Erdembileg MD, PhD Lecturer Department of Radiology 8. GOVERNANCE AND ADMINISTRATION N.Sumberzul MD, PhD Vice President for Research and Information Technology G.Ariuntuul D.D.S.,PhD, FICD Dean of Graduate Training Center of HSUM D.Tsogt-Ochir MD, Coordinator School of Medicine V.Byambasuren MD, Coordinator of International Relations of HSUM 9. CONTINUOUS RENEWAL D.Amarsaikhan MD, PhD, Vice President for Academic affairs D.Baigalmaa MD, Lecturer Department of Pediatrics Translation team Indermohan S Narula, MD, MPH (Hawaii) MTropMed (Liverpool) Consulting Editor R.Otgonbayar MD, PhD, MPH Dean School of Medicine Ts.Sarantuya, MD., PhD, M.B.A-P.M. Vice Dean of Academic affairs D.Baigalmaa MD, Lecturer Department of Pediatrics D.Narantungalag MD, PhD, Lecturer Department of Pharmacology N.Khaliun MD, Lecturer Department of Pharmacology S.Alimansaran MD, Lecturer Department of Neurology D.Byambasuren MD, PhD, Lecturer Department of Neurology P.Munkhbaatar MD, Lecturer Department of Otolaryngology Kh.Erdenedelger MD, Lecturer Department of Dermatology D.Densenbal MD, Lecturer Department of Pulmonology N.Bayalagmaa MD, Lecturer Department of Hematology s.Duurenjargal MD, Lecturer Department of Hematology E.Enkhtamir MD, Lecturer Department of Nephrology N.Bat-Erdene MD, Lecturer Department of Cardiology V.Byambasuren MD, Coordinator of International Relations of HSUM 3
  4. 4. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 CONTENT FOREWORD.........................................................................................................................................6 AKNOWLEDGEMENT........................................................................................................................7 MESSAGE FROM THE DEAN............................................................................................................8 The management of the School of Medicine acknowledges the contribution of the many people involvedin the development of the self-evaluation report for the accreditation by the Association of Medical Education,Western Pacific Region. First and foremost, I would like to express my deep appreciation to J.Tsolmon,member of the Management Board of the HSUM, T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan,Vice president for academic Affairs, D.Otgonbayar, Head of the Division of Education Policy Coordination,A.Gurdadam, Head of the Division for Student affairs, and all former presidents for management andmethodological guidance to successfully accredit the Basic medical education program self-evaluation reportby the internal accreditation.........................................................................................................................8 I would like also to express my gratitude to the HSUM management council for valuable comments andthoughts........................................................................................................................................................9 I also grateful to other professional staff from the School of medicine, Biomedical school and Publichealth school for active participation in the development of the report despite busy schedule and heavyworkload. The financial and methodological support by the Ministry of Education, Culture and Science was avaluable contribution to our work................................................................................................................9 I would like to express my gratitude to our main stakeholders such as primary health care management,doctors and practitioners on behalf of the School of Medicine.....................................................................9 Let me share with you what I learned most about the School and our training program during thepreparation to the evaluation. ......................................................................................................................9 1.Our “Basic medical education” medical degree program is very high quality. We should be proud of theprogram and our graduates who are competent and able to meet health sector needs, while ready to work hardon improving the program even further........................................................................................................9 2.We also have very good data that shows high level of student satisfaction. We also identified areas thatwill benefit from further improvement.........................................................................................................9 3.The School of Medicine is a leading medical school in Mongolia, independent organization with fullydeveloped structure 70 years of history, with leading academic staff, professors and medical professionals ofthe health sector...........................................................................................................................................9 4.Our school functions very successfully. This is shown in the results of the Health Department, theGovernment implementing agency under the MoH, license examination and employment status of graduates......................................................................................................................................................................9 5.During 3 year of development and 12 year of implementation, the integrated program has undergone 4times revisions and improvements, to become international standard program for the training of medicalpractitioner with broad knowledge, high skills and adequate attitude..........................................................9 6.It is not secret that the self-evaluation process resulted in our self-development too. We identified areasfor improvement and we need to work on them in the near future. ............................................................9 My colleagues, our professors, teachers and students of the Health Sciences University of Mongolia, Ilook forward to working with you more to make our medical school and a truly great medical school.......9 R.Otgonbayar, Ass. Professor, PhD.......................................................................................................9 .......................................................................................................................................................10 EXECUTIVE SUMMARY ................................................................................................................11 INTRODUCTION .............................................................................................................................13 4
  5. 5. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1. MISSION AND OBJECTIVES ......................................................................................................13 1.1. Statement of Mission and Objectives....................................................................................13 1.2 Participation in Formulation of Mission and Objectives........................................................15 1.3 Academic Autonomy.............................................................................................................17 1.4 Educational Outcome.............................................................................................................18 Reference chapter 1.....................................................................................................................21 2. EDUCATIONAL PROGRAM.......................................................................................................23 2.1. Curriculum Models and Instructional Methods ....................................................................23 2.2 Scientific methods..................................................................................................................29 2.3 Basic Biomedical science.......................................................................................................32 2.4. Behavioral and Social Sciences and Medical Ethics.............................................................34 2.5. Clinical Sciences and skills ..................................................................................................38 2.6. Curriculum structure, composition and duration...................................................................40 2.7. Program management ..........................................................................................................52 2.8 Linkage with Medical Practice and Health Care System........................................................55 Reference chapter 2.....................................................................................................................60 3. ASSESSMENT OF STUDENTS.....................................................................................................63 3.1. Assessment methods.............................................................................................................63 3.2 Relation between Assessment and Learning....................................................................69 Reference chapter 3.....................................................................................................................72 4. STUDENT.......................................................................................................................................73 4.1. Admission Policy and Selection ...................................................................................................73 4.2. Student Intake .....................................................................................................................74 4.3 Student Support and Counseling...........................................................................................75 4.4Student Representation...........................................................................................................80 Basic standard:.............................................................................................................................80 Reference chapter 4. ....................................................................................................................82 5. ACADEMIC STAFF/FACULTY ...................................................................................................84 5.1 Recruitment policy ................................................................................................................84 5.2. Staff policy and development................................................................................................86 Reference chapter 5.....................................................................................................................92 6. EDUCATIONAL RESOURCES...................................................................................................93 6.1 Physical facilities ..................................................................................................................93 6.2. Clinical training resources .................................................................................................101 6.3. Information technology ......................................................................................................105 6.4. Research..............................................................................................................................108 6.6 Education exchange.............................................................................................................117 Reference chapter 6....................................................................................................................119 7. PROGRAM EVALUATION.........................................................................................................121 5
  6. 6. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 7.1 Mechanism for Program evaluation.....................................................................................121 7.2 Teacher and student feedback..............................................................................................122 7.3 .Student performance...........................................................................................................128 Reference chapter 7....................................................................................................................134 8. GOVERNANCE AND ADMINISTRATION...............................................................................136 8.1. Governance.........................................................................................................................136 8.2. Administration....................................................................................................................138 Reference chapter 8. ..................................................................................................................140 ..........................................................................................................................................................140 9. CONTINUOUS RENEWAL.........................................................................................................141 Reference chapter 9....................................................................................................................142 FOREWORD 6
  7. 7. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 AKNOWLEDGEMENT 7
  8. 8. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 MESSAGE FROM THE DEANThe management of the School of Medicine acknowledges the contribution of the many peopleinvolved in the development of the self-evaluation report for the accreditation by theAssociation of Medical Education, Western Pacific Region. First and foremost, I would like toexpress my deep appreciation to J.Tsolmon, member of the Management Board of the HSUM, 8
  9. 9. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan, Vice president for academicAffairs, D.Otgonbayar, Head of the Division of Education Policy Coordination, A.Gurdadam,Head of the Division for Student affairs, and all former presidents for management andmethodological guidance to successfully accredit the Basic medical education program self-evaluation report by the internal accreditation.I would like also to express my gratitude to the HSUM management council for valuablecomments and thoughts.I also grateful to other professional staff from the School of medicine, Biomedical school andPublic health school for active participation in the development of the report despite busyschedule and heavy workload. The financial and methodological support by the Ministry ofEducation, Culture and Science was a valuable contribution to our work.I would like to express my gratitude to our main stakeholders such as primary health caremanagement, doctors and practitioners on behalf of the School of Medicine.Let me share with you what I learned most about the School and our training program duringthe preparation to the evaluation. 1. Our “Basic medical education” medical degree program is very high quality. We should be proud of the program and our graduates who are competent and able to meet health sector needs, while ready to work hard on improving the program even further. 2. We also have very good data that shows high level of student satisfaction. We also identified areas that will benefit from further improvement. 3. The School of Medicine is a leading medical school in Mongolia, independent organization with fully developed structure 70 years of history, with leading academic staff, professors and medical professionals of the health sector. 4. Our school functions very successfully. This is shown in the results of the Health Department, the Government implementing agency under the MoH, license examination and employment status of graduates. 5. During 3 year of development and 12 year of implementation, the integrated program has undergone 4 times revisions and improvements, to become international standard program for the training of medical practitioner with broad knowledge, high skills and adequate attitude. 6. It is not secret that the self-evaluation process resulted in our self-development too. We identified areas for improvement and we need to work on them in the near future.My colleagues, our professors, teachers and students of the Health Sciences University ofMongolia, I look forward to working with you more to make our medical school and a trulygreat medical school.R.Otgonbayar, Ass. Professor, PhD 9
  10. 10. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 10
  11. 11. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 EXECUTIVE SUMMARYThe Self-evaluation report was written based on Guideline of Association of Medical Education, West PacificRegion.Chapter one:Shows how the mission, objectives, values, and the HSUM and School of Medicine development master planadheres to the goal and objectives of the “Basic medical education” program, as well as compliance with thesegoal and objectives and with the medical doctor’s model, job description and accreditation.Chapter two:Shows that the “Basic medical science” program content is consistent with regulations and standards of theeducation sector, as well as with the educational organization policy, meets the local market needs, iscontinuously upgraded in line with human, scientific, technological developments and achievements. It alsoreflects the progress in the teaching method and technologies to meet international standards, programmanagement system and its activities.Chapter three:Covers information on the evaluation of the teaching and learning processes, methods to assess studentknowledge, skills and attitude. Reflects and summarizes how this evaluation and assessment promotes studentlearning process and how it links to the training methodologies employed in the program.Chapter four:Informs about regulations for student admission, legal environment for educational services for students,tuition fees, student movement, direct and indirect costs per student, activities to support the development ofstudents into members of the society, ethical and other norms of health institutions and the information on theemployment status of the graduates.Chapter five:Reflects information on “Basic medical science” program’s human resource policy, planning, structure,situation in academic grades, its development; appraisal of the teacher’s educational, research and specialtyactivities; salaries and other sources of income.Chapter six:Describes the general requirements and standards for classrooms, strengthening of material basis, activities toimprove the training environment, establishment of new laboratories, listing of financial sources, sponsorshipsand support and development perspectives. The chapter is based on evidence of the establishment ofconnections with related departments of foreign universities to learn from their experience in planning andimplementing similar programs; implementation of student and teacher exchange program and its futuredirections.Chapter seven:Describes and concludes about the program evaluation and its development mechanism, evaluation methodsused, evaluation status, graduates competency evaluation as its main product and graduates’ employmentstatus. 11
  12. 12. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Chapter eight:Informs about the SOM structure, governance and management.Chapter nine:Summarizes the training program development to meet international standards, the development processes,and innovations. 12
  13. 13. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 INTRODUCTIONHealth Sciences University of Mongolia (HSUM) is the state university. It was founded in 1942 as the Facultyof the Mongolian State University and then established as the independent Medical Institute in 1961. It wasnext extended as the Medical University in 1995; and in 2002 it was designated as the University of HealthSciences and currently includes ten constituent schools.As the oldest and largest university, HSUM has been the main source to produce medical professionals for thenation and has so far produced 10,000 medical graduates and other health care providers.The School of Medicine (SOM) was reorganized as a constituent institution of HSUM in 2003 and has, sincethen produced over 1900 graduate alumni with a Bachelor degree in medical sciences. 1. MISSION AND OBJECTIVES 1.1. Statement of Mission and ObjectivesBasic StandardThe medical school must define its mission and objectives and make them known to itsconstituency. The mission statements and objectives must describe the educational processresulting in a medical doctor competent at a basic level, with an appropriate foundation forfurther training in any branch of medicine and in keeping with the roles of doctors in thehealth care system.Quality developmentThe mission and objectives should encompass social responsibility, research attainment,community involvement, and address readiness for postgraduate medical training.The Vision of the School of Medicine is to be recognized internationally as the leading Mongolian medicalschool to deliver academically excellence medical education, high quality research and health services.Mission and ObjectivesHSUM mission is to be recognized as the leading national university which produces future graduatehealth care professionals capable of meeting the national, regional and global, healthcare demands;to integrate research, education and health care delivery; and to compete in competency basedsociety.SOM mission is to be recognized as the leading national medical school which is distinguished by itsinnovative educational approach and methods; introducing international standard higher medicaleducation, world-class level of medical research, and promote the proper use of modern medicaltechnology in health care services.Core value 13
  14. 14. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • Democracy and Liberty • Integrated curriculum • Historical Experience • Professional Human Resource • Academic Autonomy • Highly Valued GraduatesStrategiesWe are confident in the advancement of our strategies to achieve the establishment of our mission andobjectives of School of MedicineStrategy 1. Development of a quality medical education program • To develop a quality medical education program including academic autonomy, curriculum content and outcome, innovative teaching methods, modern evaluation and student assessment techniques • To produce high quality graduate professionals with the required competencies to meet health care challenges and needs of society • To develop teacher – student friendly environmentStrategy 2. To improve the quality of medical education and to aim for a world-class level ofeducation. • To encourage and support attendance of young lecturers in educational and research exchange programs in developed countries and prepare younger lecturer’s generation and enhance the human resource capacity • To establish research laboratories which meets international standards with high technological tools and implement national and international research activities in diagnosis, treatment and in screening. • To establish effective international collaborations in science and technology • To provide and support international student exchange programs. 14
  15. 15. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Strategy 3. Contribution of modern medical technology in health care service • To develop the capacity of the Erkhes outpatient clinic through building high technology research – teaching – service • “To obtain the national medical accreditation certification for the SOM outpatient Clinic” • To expand the number of university teaching hospitalsThe mission statement and strategies are derived from following government policy documents,national programs and HSUM strategies: • Health Law • Higher Education Law • Science and Technology Master Plan, MECS 2007-2020 • Health Sector Master Plan, MOH 2006-2015 • Primary Health Care Development Project, World Health Organization • Third Health Sector Development Program, Asian Development Bank • Health Project, Millennium Challenge Account • Strategic Plan, HSUM 2007-2016 • HSUM Development Program 2010-2012School of Medicine through a 6 year Integrated Curriculum of Basic Medical Education is producingmedical doctors, who meets the main job description requirements of soum health centres and FGPs.SOM is cooperating with Postgraduate Training Institute and Masters’ and Doctorate Department ofHSUM on the postgraduate, residency training and continuing medical education. The whole systemchallenges the doctors and provides an opportunity for graduates as medical doctors to continuespecialist and continuing training. 1.2 Participation in Formulation of Mission and ObjectivesBasic standard 15
  16. 16. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011The mission statement and objectives of a medical school must be defined by its principalstakeholders.Quality developmentFormulation of mission statements and objectives should be based on input from a wider rangeof stakeholder.The mission and objectives are defined by the participation of principal and a wide range ofstakeholders such as members of HSUM board, academic staff and students. School of Medicine alsoworked closely with following partners in the development of its Mission Statement and Objectives: • Patients and Community • Primary Health Care Facilities • Curriculum Committee • Faculty and Student Development Committee • SOM Administrative Committee • HSUM Administrative Council • HSUM Steering committee • Academic counselThe main principles are to implement and achieve the mission and objectives of the curriculumthrough the involvement and representation of students, employers or health managers and graduatesin the curriculum management process along with harmonizing our mission and objectives to addressthe health needs of the public and also reflecting comments and opinions of graduates, employerswhen updating the mission and objectives by undertaking the following activities: • Joint meeting of graduates and employers, inter universities and professional organizations joint workshops and meetings, conferences. • Joint Meeting with Ministry of Health, and its clinical hospitals and district and aimag health departments and hospitals, affiliated hospitals managers. • Organizing “Professors and graduates meeting” with rural doctors and specialists. • "Altan Gagnuur" annual meeting of professors and graduates from generation to generation • (each year all graduates with same last number of graduation year with 10 years gap are celebrating they graduation, such as all graduates 1951, 1961, 1971, 1981, 1991, 2001. 2011). 16
  17. 17. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1.3 Academic Autonomy Basic standard There must be policy for which the administration and faculty / academic staff of the medical schoolare responsible, within which they have freedom to design the curriculum and allocate the resourcenecessary for its implementation. Quality development The contributions of all academic staff should address the actual curriculum and the educationalresources should be distributed in relation to the educational needs.According to Higher Education Law the HSUM has the authority to define its educational policiesand strategies. The main body responsible for ensuring curricular autonomy is Division of MedicalEducational Policy and Management (DMEPM), HSUM which is responsible for establishment,direction and oversight of the general educational policy at HSUM, monitoring the broad scope ofthe curriculum and the overall coordination and implementation of the program schedule.In accordance with HSUM policy, SOM has the overall responsibility for the implementation andfurther development of the basic medical education program. Academic freedom and institutionalautonomy is enshrined in the SOM policy and operationalised through the activities of its CurriculumCommittee. The Curriculum Committee of SOM determines its own policies and procedures forteaching, institutional management and accountability within the framework of the HSUM MasterPlan, Educational rules and regulations in close coordination with DMEPM, HSUM. The CurriculumCommittee, SOM has the responsibility for developing, governing, maintaining and monitoring theBME curriculum through the cooperative work of all faculty staff and students operating through itsthree subcommittees.The Curriculum Committee has three subcommittees each with its specific role and participating inthe process of curriculum development. The Curriculum Strategy Subcommittee has theresponsibility to define the goals, objectives and outcome of the BME curriculum in accordance withHSUM strategy and social accountability. The Curriculum Standards Subcommittee hasresponsibility for defining the goals, objectives and standards of the curriculum for individual block,line and clerkship and for the courses. The Curriculum Evaluation Subcommittee is responsible forthe creation of a curriculum quality system to ensure continuous curricular improvement and refinement.Each department plays an important role in formulation of curriculum content, course objectives andcourse standards. Academic staffs in the each department of SOM engage in the curriculumdesigning, planning, implementing and monitoring processes through determining specific needs ofthe program, identifying and introducing innovative methods of teaching.Also, there are 73 faculty staffs from Biomedical School and 21 Public Health School of HSUM thatparticipate in the development and implementation of the integrated curriculum of basic medicaleducation program at SOM (See Chapter 5).To develop continuing training of our graduates, SOM also has the responsibility to providegraduate; residency; postgraduate; and specialized medical programs, along with Master andDoctoral Degree programs. These activities are facilitated with strong collaboration of PostgraduateInstitute, HSUM and City Health Department as well as Family Health Centers, Central Hospitalsand Health Centers. 17
  18. 18. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1.4 Educational OutcomeBasic standardThe medical school must define the competencies that students should exhibit on graduation inrelation to their subsequent training and future roles in the health care system.Quality developmentThe linkage of competencies to be acquired by graduation with that to be acquired inpostgraduate training should be specified. Measures of, and information about, competenciesof the graduates should be used as feedback to program development.The goal of the basic medical education program is to prepare a competent medical doctor who isbroadly educated and capable to work ethically and effectively at primary health care service toprovide personal, primary and continuing health care in Mongolia.The outcome of basic medical education program at SOM is to produce a medical graduate (generalphysician) who possesses scientific knowledge, adequate clinical and communication skills to meetthe health care delivery requirements in Mongolia and be capable of pursuing continuousprofessional development.The departments of School of Medicine have the primary purpose to prepare specialists with superiorcharacteristics by implementing the Integrated Curriculum which consists of basic sciences 12subjects, 21 basic professional blocks (1 block curriculum with 4-8 departments participating), andprofessional training or clerkship with 16 rotations and 18 elective courses.The educational outcome of Basic Medical Education Curriculum is graduates, medical doctors witha Bachelor Degree in Medicine. The graduates of SOM meets the Mongolian health sector needswith obtained basic health science knowledge and clinical skills and attitude and is capable to furtherdevelop through continuing postgraduate training.The specialty focus of the graduates of Integrated Curriculum study has been defined as follows:“The Bachelor degree in medicine is directed to be obtain knowledge and skills to provide publichealth care, to solve socio-psychological problems, to diagnose and treat common diseases,prevention from diseases and provide palliative and rehabilitation care within the population”Knowledge, skills and attitude of medical doctors by Basic Medical Education program are definedas follows: 18
  19. 19. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Graduate must be knowledgeable and understand the scientific basis of medicine: 1. Basic knowledge of the modern biology, physiology and behavioral and social sciences 2. Knowledge of the normal structure and function of the human body and mind with an understanding of stages of human life 3. Knowledge of the mechanisms by which pathology modifies normal structure and function to generate symptoms, signs and abnormal laboratory findings 4. Knowledge of the various causes and mechanisms underlying diseases among children, adolescents and adults. 5. Diagnostic tools, efficacy and adverse effects of therapeutic interventions 6. Knowledge of clinical pharmacology, nutrition, behavior and rehabilitation therapies 7. Knowledge of management of the primary health care 8. Reproductive health, family planning, pregnancy planning and counseling, primary health care in reproductive diseases and pathology, urgent and emergency obstetrics 9. Health education, preventive medicine 10. Understanding of individual, family, socio-economic, cultural, religious and environmental determinants of causes of health problems 11. Knowledge of the organization and delivery of healthcare service, financing, health insurance, health related legal documentation 12. Concept of demographic classification of health status 13. Knowledge of ethical behavior and professionalism 14. Understanding of the epidemiology of common communicable and non-communicable diseases in various population groups 15. Understanding and identification of important determinants of health and the economic, psychosocial, and cultural factors that contribute to disease. 16. Understanding of approaches useful in reducing the incidence and prevalence of diseaseGraduate must be highly skilled in providing care to patients: 1. Ability to obtain an appropriate and accurate medical history 2. Ability to perform both a general and an organ system specific physical examination 3. Ability to perform common clinical procedures in relevant situations 4. Ability to appropriately investigate the patient’s problem 5. Ability to choose appropriate and available diagnostic tools for patients 19
  20. 20. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 6. Ability to understand and interpret the results of commonly used investigations and laboratory manifestations of both common and important diseases 7. Ability to apply clinical reasoning in solving diagnostic and treatment problems 8. Ability to communicate and to inform with patients, their family, and medical staffs 9. Ability to advise patients and to obtain informed consent before providing any kind of clinical procedures 10. Ability to conclude what is a life-threatening condition and to provide emergency medical care for unconscious patient 11. Ability to manage the medical tools and equipments at the primary care under antiseptic and aseptic rules. 12. Understanding of approaches useful in reducing the incidence and prevalence of disease, and intervention during infectious disease outbreaks, and provide epidemiological supervision. 13. To organize primary and secondary diseases prevention interventions, promote behavior change and conduct health education activities among population 14. Ability to collaborate with a wide range of stakeholders to manage family medicine practice 15. Ability to use information technology 16. The ability to retrieve, manage, and utilize relevant information for solving medical problemsGraduates must be able to demonstrate ethical behavior and professional attitude: 1. Honesty and integrity in all professional interactions 2. Maintenance of confidentiality 3. Respect for patients’ right to self-determination, privacy and dignity 4. Compassionate management of patients 5. Commitment to advocate the interests of patients 6. Understanding and respect for cultural, religious and racial differences 7. Understanding of the special needs of minority groups and those with disabilities 8. Understanding of the ethical basis of medical practice and major ethical issues in medicine 9. Ability to recognize and analyze the ethical content of clinical situations 10. Tolerance of clinical and ethical uncertainty 11. Understanding of, and respect for, the roles of all health care professionals 12. Acknowledge personal strengths and weakness, recognizing when to seek counsel and assistance 20
  21. 21. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 13. Commitment to critically assess and continuously improve personal knowledge and skillsCurrently, SOM has had its sixth graduation and will have graduated a total of 1921 graduates with aBachelor’s degree in medical sciences. The employment rate for SOM graduates has constantly been over94.8% for the past 5 years. This shows the high demand for these graduates in the health care industry. Dataon continuing training of our graduates in recent 5 years shows that 54.8% (1044graduates) have successfullycompleted their residency programs and 43.6% (837 graduates) have passed the specialized medical programsin 21 disciplines. From these, 370 graduates (19.3%) pursued a M.A. degree and 36 (0.2%) pursued a PhDdegree while they were in the health care service working closely with their academic supervisors. In addition,the number of graduates pursuing the graduate programs abroad has been growing year by year. Reference chapter 1Statement of mission and objectives of School of Medicine 1. Health Law , Mongolia 2. Education Law, Mongolia 3. Higher Education Law, Mongolia 4. Science and Technology Development Master Plan, MECS 2007-2020 5. Health Sector Strategic Master Plan, 2006-2015 6. Third Health Sector Development Program, Ministry of Health of Mongolia, 7. Asian Development Bank 8. Health Project of the Millennium Challenge Corporation, 9. HSUM Strategic Master Plan, 2007-2016 10. “HSUM Development” Midterm Program 2010-2012Statement of lecturer, student, supporter, employee, interest and donor participating informulating mission and objectives 1. The book “Health Science University of Mongolia”, Ulaanbaatar city, “Erkhes” printing, 2010, 29p. 2. Annual Reports of School of Medicine, 2006-2010 3. Discussions and meeting protocols of Departments presented to the administration committee of School of Medicine, 2006-2010 4. Reports and e-database of Departments of School of Medicine, 2006-2010 5. Training reports of “Education integrated environment – integrated curriculum standard ” 6. The alumni annual conventional booklet of “Roseroot” lecturers and graduate students of HSUMAcademic autonomy 21
  22. 22. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1. Formulary of rules and regulations for Education Policy and management. Ulaanbaatar city, Erkhes printing, 2010, 84p 2. “Establish Education Department” School of Medicine, Dean order 3. “Establish Division for Education Policy and Management” HSUM, president order 4. The to “Establish Faculty and Student development committee” School of Medicine, Dean order №A/3, 2011.09.20 5. “Establish Curriculum Committee” School of Medicine, Dean order №A/4, 2011.09.22 6. Questionnaires of lecturers’ opinion and suggestion about curriculum plan, administration, implementation and evaluation.Statement of the accrediting curriculum is compatible with requirements for specialist, modelof specialist and job descriptions. 1. “Special license for medical training” provided to HSUM, №960003, 15 September,2010 2. The development document for Medical specialists, 2008 3. “The job description standard model of medical professionals”, Minister of Health order # 442, 2009, www.moh.mn 4. “Regulation of assistant doctor employment” Minister of Health order # 90, 2008, www.moh.mn 22
  23. 23. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 20112. EDUCATIONAL PROGRAM 2.1. Curriculum Models and Instructional MethodsBasic standard:The medical school must define the curriculum models and instructional methods employed.Quality development:The curriculum and instructional methods should ensure the students have responsibility for theirlearning process and should prepare them for lifelong, self-directing learning.Implementation of the project TACIS/Tempus European union “Developing Medical EducationalFramework” since 1995, Canada, Netherlands, Australia, Great Britain, Japan, Taiwan, Thailand, Malaysia,Korea have introduced integrated curriculum for providing basic medical education. During 1997-1999, theMedical University initiated the implementation of a model curriculum from the University of the Groningen(Netherlands) and the University of Leeds (England). The integrated curriculum was developed andimplemented since 2000-2001 with a purpose to train basic doctors who are humane and compassionate, andhave an ethical code, flexible and capable to meet the needs and expectations of the Mongolian society andthe international standards.Gaining the membership of Asia Pacific Countries’ Medical Education Association (APC MEA) in 2006,Asia Pacific Countries’ Qualification Network (APQN) in 2008, and Asian Medical Education Association(AMEA) in 2009 was a step forward to become closer to sustainably implementing the changes recommendedin international education and innovation, science and technology, medical development orientation and interms of meeting the demands of today’s health care sector.Basic medical education program conceptHealth care strategies of medical science in XXI century are to prevent diseases instead of treating them aftertheir onset, to implement guidelines for preventing and managing chronic diseases, to improve capacity ofdiagnostic laboratory, to conduct research work, to implement evidence based diagnosis and treatmentapproaches, to change unhealthy behavior for individuals, to avoid abusing drugs (Table 2.1). Table 2.1. Comparison between medical education program concepts № Indicators Traditional education program Integrated education program To focus on curative medicine To focus on public health and prevention 1 Concepts and treatment of diseases of diseases Acute and communicable To reduce risk factors for non- 2 Disease diseases communicable diseases Diagnosis and treatment based Diagnosis based on symptoms and 3 Diagnosis on causes of disease individual To focus on treatment for Not only treatment of diseases in 4 Treatment diseases individual 23
  24. 24. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Chemical drugs Healthy lifestyle 5 Prevention Antibiotics Unhealthy habits Vaccine Rehabilitation 6 Profession Specialization General practitionerBasic medical education technologyEducation technology is one of the main instruments to improve the quality of basic medical education e andduring the implementation of an integrated curriculum, we are using the following education technologies:Global strategy on medical educationOur university’s traditional approach for medical education has been completely renewed by the implementedinternational strategy for medical education.The concepts of the traditional approach for medical education is mainly focused on scientific knowledge, anddoes not refer much to the socio-physical aspects and learning; is lecturer centered, content oriented, lecturesdominated, all students participating and participation of students for planning and assessing of learning isinadequate. Learning is also separately obtained in the various branches of medical science. We conductedSPICES-T approach for implementing integrated curriculum (Table 2.2). Our strategy SPICES – T approach Lecturer centered Student centered • Student centered Lecture based Problem based • Problem based • Integrated Separated knowledge Integrated knowledge • Community oriented Hospital oriented Community oriented • Elected Standard learning Elective learning • Systematic • Team work Tutored Systematic Figure 2.1. Global strategy for integrated curriculum on medical educationCoil shaped integrated curriculumWe defined the integration between lessons in accordance with the recommendation of Association forMedical Education in the Western Pacific Region (AMEWPR) “Curriculum TIPS-Trends, Innovation, Priorityand Strategy” as follows (Figure 2.1): • Horizontal integration • Vertical integration 24
  25. 25. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • Integrated interdisciplinary medical science By this coil shaped medical curriculum students combine 2 basic purposes, theoretical and medical science,medical and communication skill, and until they become doctors, students study continually the 3 levelprograms I. Healthy constitution, activity and characteristics II. Path anatomy, activities and characteristicsIII. Medical practices) (Figure 2.2). Course goal 3rd stage Implementing into Branch sciences the clinics2nd stage Morphology Pathology, path physiology, Physiology Genetics behavior Surgery Pediatrics 1st stage Normal morphology, physiology, behavior Organ Clinical study (line) system Figure 2.2. Coil shaped curriculum (R.H.Harden “Practical guide for medical teachers”, 1997.)The integrated curriculum model is organized to accommodate the integration of basic science and medicalscience and tutor these to all years. In the earlier years basic knowledge is predominated, in the middle yearsthis ratio is equal, and in final years subjects of medical science dominate. But until graduation students willacquire knowledge of the basic sciences The integrated curriculum is a:• Move from problem informing to problem solving• Training is brought closer to clinical practice• From didactic method of teaching to self learning and student centered training• Multidisciplinary• Students able to undertake lifelong and continuous training• Able to work as a team and with effective interpersonal communication skillsThe advantage of integrated medical curriculum is providing the opportunity to medical students to studyclinical skills early and we try to build their capacities in both theoretical and clinical skills.The integratedmedical curriculum includes studying the basic sciences in first 2 years of study and clinical courses withinthe framework of interdisciplinary approach through the active communication by lectures and studentslearning in small group discussions.Main principlesThe curriculum policy is to implement the training in evidence-based medicine using modern informationtechnology (Figure 2.3). 25
  26. 26. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Evidence Quality Info Integrated tech curriculum Figure 2.3. Basic medical education policy (R.H.Harden “Practical guide for medical teachers”,1997.)Also, the integrated medical curriculum has been using new trends in medical education technology such asinformation technology, lifelong learning methods, evidence-based medical science, research methodology,information management of medical science, communication skills consistent with the curriculum standards(Figure 2.4). Figure 2.4. Integrated curriculum (R.H.Harden “Practical guide for medical teachers”,1997.)Integrated curriculum modelEven though the traditional system was teaching general sciences until 4th year and giving clinical lessonsfrom 4th year onward.(curriculum H model). H model is based on the medical theory and clinical skilldevelopment (Figure 2.5). Curriculum content is mainly focused on the basic information of the sciences andhealth and psychosocial issues. The course is teacher oriented and information flow is from teacher to student,mainly using the lecture and mini-lecture as teaching methods. One model course covering all students, andstudents’ participation was not enough in the course planning and evaluation. The main disadvantage of thismodel is that the course teaches medical sciences in very high level and teaches basic medical educationseparately. 26
  27. 27. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Z type H type Clinics Theor Clinics Theory Figure 2.5. Curriculum model Student assessment technologyBased on Miller’s methodology, SOM has implemented a wide range of new assessment methods of student’sachievement including knowledge, skill and attitude such as multiple choice tests based on different types ofclinical cases, objective structured procedural examinations OSCE, OSCE checklist, objective structuredprocedural examinations OSPE, and DOPS, Mini-CEX (Figure 2.6). Job place Skill lab Figure 2.6. Miller’s model of student achievement (Miller G.E., 1990)The “Basic medical education program” integrated curriculumThe “Basic medical education” integrated curriculum is a complex document which corresponds to the articlesand amendments of the Mongolian Education Law such as “General requirements needed for higher educationinstitutions”, to the orders and decisions on implementation of higher education by the Minister of Educationand Science, and to the Medical University Regulations developed by the Academic Committee in line withthe above mentioned law and regulations to meet the peculiarities of the HSUM and also be in line with theorders and regulations of the president of the Medical University.The integrated curriculum is based on integration of biomedical and medical training, as well as theintegration of practice and theory, improvement of the ability for critical thinking and decision making,facilitation of self-directed learning processes, enabling learning from advances and achievements in medicalscience and technology; enabling the students to choose an interesting field of study; directed towardsreducing the reiterations in a program context; based on an integrated organ level medical skills training;ensuring the widening of the training context with advanced grades; ultimately based on a problem solvingand student-centered approach. “Basic medical education” curriculum model is showed in Figure 2.7. 27
  28. 28. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Figure 2.7. Integrated curriculum modelThe “Basic medical education” curriculum that has been implemented since 2000 is based on the principles ofan integrated training program, which improves students learning abilities, focuses on integrating knowledge,practice and attitude training, and corresponds, with the current trends in medical training.The aim of the curriculum is to train medical doctors who following their graduation are able to improvingthe sanitation and hygiene for the population, take actions on preventing illnesses, through organizing publichealth interventions, diagnose and manage common diseases, be competent in using various methods oftreatment, possess the capabilities for providing emergency medical care, demonstrate high level of medicalethics, abide by the laws and legal requirements and be capable of working at the primary care level.Basic science courses for freshmen are intended to give the students basic knowledge on general scienceneeded for undertaking higher education, for person development to be humane and to lay the foundation forfurther study of professional courses. From second to fifth year, students study in various forms of integratedtraining programs which consist of 21 blocks of basic professional and skill development lessons (Table 2.2).Professional courses are generally studied during years I, II and these give them the capacity to undertakebasic medical education. The content, the selection and the sequence of the courses are decided by thestipulations of the educational policy of the Medical University, the aim of the department that is responsiblefor teaching that specific course, the needs and requirements of employers and the reinforcement of the linksbetween the professional groups.Clinical courses are focused on giving the students the capacity to meet social needs and employer’srequirements. The graduating specialist is the purpose of implementing of our program. We apply thecurriculum model to improve the content, and the listing of the courses is to comply with the requirementsregarding today’s needs. We always do research for continuing development. Based on the new program, over4 years, besides the basic clinical courses, students are assisted to possess the knowledge, capacity andinclination towards studying the medical science. 28
  29. 29. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Table 2.2. General structure of curriculum I grade II grade III grade IV V VI grade grade gradeGenaral Must 1-6 block 7-11 12-16 17-21 GeneralBasic Study block block block BasicLesson Assimilate Assimilate abilities of clinical training basic abilities of program clinical training program Selectiv Basic professional, selective learning, e practicing lessons OSPEI, II lessons United OSCEI OSCEII OSCEIIIexaminationClerkship is a clinical self directed program that plays an important role in improving the application of theirtheoretical knowledge, gained from the block lessons, gaining practical experience, developing their clinicalskills and capabilities, and formulates the structure of their medical ethics and motivations required to becomea competent doctor.General rules for organization of training activities:In accordance to training curriculum in basic science and basic professional courses students acquiringknowledge and skills in following 3 stages: • Preclinical training to acquire basic clinical knowledge and skills (1-6 blocks) • Clinical training to acquire main clinical (7-21 blocks) • Clinical training (Line training and clerkship)The Medical University’s educational approach is changing from a teacher-centered learning to student-centered learning. The curriculum achieves this using the following types of teaching lessons: • According to confirmed standards, lectures are being taught as traditional, clinical and interactive forms. • Seminars are being held as solving problems, discussing case reports and presentations. • Small group practice trains students solving case study, training in the clinical skill laboratory, taking history from patient with lecturers, assessing test results, submitting diagnostic and treatment plan and counseling about treatment and prevention. • Self-practice time is included in time table because to train self-study and improve education quality. The students train under lecturer as self-study. • III, IV and V year students select and study up to 2 credit subjects via the training program as own interest. 2.2 Scientific methods Basic standard 29
  30. 30. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Must reflect the basic principles of scientific methods and evidence-based medicine, teach the abilityto analyze and cogitate in the curriculum development. Quality development Curriculum should include lessons for training students in scientific thinking and research methods.To convey the professional educational content to students, avoiding explaining the meaning by the use ofbooks, but presenting basic knowledge through creative, rational methods and promote new ideas anddifferent scientific opinions by linking specific scientific development and future trends. Tutors also try toreach the students by explaining, contradictory perspectives of evidence-based medical science and surveyresults.To meet this requirement, every tutor must also be a researcher, thus help develop critical and creativethinking. The integrated medical curriculum is focused on the student’s skills to do independent work,developing student-centered curriculum, integrate training, research, health care, clinical communication andmanagement skills and students ability to learn independently.With this purpose in mind, we are providing training by using following methods: • Case based training • Integrated seminars • Use internet information’s and distance learning • Problem based learning and bedside training.The PBL training method has become one of the most successful methods using in training. Also by usingcase based and role play methods in professional training of the students, their involvement in these activitiesis improving the clinical and evidence based decision making skills.Self directed learning studyPurpose of self learning at the Medical school is to promote a student centered approach, developcommunication and practical skills in students. Self-directed learning (SDL) has been identified as animportant skill for medical graduates. To meet the challenges in todays healthcare environment, self-directedlearning is most essential. The Medical School has made SDLs a central part of the curriculum. In self-directed learning, students take the initiative in making use of resources rather than simply react totransmissions from resources, thus helping students to learn more and learn better. The main purpose ofeducation is to develop the skills of inquiry, and more importantly to go on acquiring new knowledge easilyand skillfully the rest of his or her life.Specializing lessons, using leaning methods such as take medical decisive initiative, role play, motivatesstudent’s learning force, medical ability, capacity to solve evidence-based problem, are improving.Considering student’s assignment, selective learning in 3d, 4th and 5th year students are provided withpossibility to choose from interested professional or specialized lessons and take 2 credit training.The encouraged curriculum processes are mentioned in the following: • Widen specific lesson’s theoretical subject or chapter, read materials from other books, write thesis and summaries and evaluate • As a trainee learn handling methods of specific operation from the tutors of departments, masters and residents • Resolve clinical issues given by the tutor and observe the results • Organize training program focusing on single person or collective people in order to educate them about taking preventive actions on diseases or medical educational program 30
  31. 31. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • In order to widen the framework of the surveyed subject, verify the essence of theories by practice, work on given clinical issue and evaluate • Participate in national and international Olympiads • Debate in conferences, organized at school, nationwide or internationally • Conducted by a teacher, learn the methodology of research works and master the abilities in handling in laboratories • Students should work as trainees in the province hospitals and score Research methodologyThe integrated medical curriculum conducts disciplines of research methodology from early years of study.During all academic year, students acquire the knowledge, concepts, methods, skills and attitudes necessaryfor provide medical research in the field of socio-economic, demographic and cultural determinants of causes,distribution and consequences of health problems.The introductory session on scientific methodology starts with Block 5, Society and the Physician. ScientificMethod and Methods of Health Education. The aim of this course is to teach medical and other research skillsand to encourage an interest in medical research in their future careers. Also students should know how toorganize and conduct health education courses for population and target groups. Students will achieve abovementioned goal through the clinical problem-solving tasks, problem-based tutorials and exercises in evidence-based practice, as well as student research projects and assignments.The main block to teach basic medical research methodology is Block 20, Research Methodology, which isworth 5 credits. The Department of Epidemiology and Biostatistics is responsible for this course. Studentslearn theoretical and practical knowledge, and the basic skills to conduct medical research work, to developdecision making abilities using data from evidence based medicine, and to demonstrate research and surveyskill. Students are required to write research papers and projects. Research activitiesResearch activities become an important factor affecting the content and the quality of the training. There isan independent association for students and tutors teach research methodology and conduct their researchworks.The results of research activities of students and tutors are regularly presented and published in the followingways: • Organizing conferences and seminars, presentations at the joint seminars, and abstract publications • Report of results of studies in medical magazines and newspapers • Publishing a summary of students work • Reporting research work and results on the school websiteThe Medical University organizes activities such as establishing professional clubs among students, tutoringstudents on selected topic, debating about selected essays from the clubs, organizing Olympiads and formgroups of chosen students and preparing them using specialized program to participate in National Olympiads.Annually, the Medical University also organizes a conference “Students’ scientific convention”, from wherestudents can be chosen and given awards, and also provided with the needed laboratories and researchequipment. The students of the Medical University can be selected from 15 students’ clubs and associationsaccording to their field of interest and also provided with the opportunity to participate in various conferences.The Medical University students annually organize “Specialty promotion days” to promote interest in themedical profession and also they participate successfully in many events such as World Health Days. 31
  32. 32. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Students’ clubs, which are focused on supporting students in their learning process to help improve foreignlanguage skills and research methodology, are functioning efficiently. Clubs were originally established togive their members and students of the Medical University the opportunity to enhance their knowledge andskills, and enable them to acquire knowledge on modern science and technology outside the formal curriculartraining. Clubs and associations of the Medical University are coordinated by researchers and teachers ofSOM departments.Club and associations, have as their main purpose, the organization activities that give students opportunity towork independently or in teams, in activities focusing on humanitarian, and public deeds that enable studentsto spend their leisure time efficiently. Association and clubs that have received ratification from the Student’sOffice are shown in Annex 1. 2.3 Basic Biomedical science Basic standards: The School of Medicine must identify and incorporate in the curriculum the contributions of thebasic biomedical sciences to create understanding of the scientific knowledge, concepts and methodsfundamental to acquiring and applying clinical science. Quality development:The contributions in the curriculum of the biomedical science should be adapted to the scientific,technological and clinical developments as well as to the health of the society.Integrated curriculum is a process to accommodate the integration of basic medical and clinical science and toteach basic biomedical science to all students.Integrated curriculum is implemented in form of branch science and covers various medical science subjects,particularly, in the first year of curriculum during which basic theoretical courses are covered. In thesubsequent years, clinical science courses will be taught, which would contain integrated subject areas andthe, training methods focuses on interaction between student and teacher, small group training, cooperativeteacher in theoretical and clinical science and share experiences.Medical science has been developing rapidly since the 2nd half of the XX century and students study thehuman body at molecular and genetic levels, about diagnosing disease at early stages (being aided bymolecular and cellular sciences) and about new treatment methodologies focusing on molecules. 1st and 2ndlevel preventive actions, social-psychological health, healthy environment are also considered to be important.We prepare professionals, who will be working as XXI century doctors, thus it becomes indispensible toinclude new directions into the curriculum, and so continuous changes are being constantly made. Forexample, “Human, health and clinical science” block teaches general understanding of human, human health,clinical appearance and state, social, biological, psychological factors that affect humans, and preventivemedical science. In the block “Molecule to cell” lessons such as structures of organism, organization of cellsand molecules as basic units for functioning, micro level circulation of biochemical reactions, lifecycle of acell, distinguish between circulating or non circulating destruction of a cell, give basic knowledge of medicineand introduce new methodologies of bio analyzes, and also allow students to combine these with otherlessons. After having studied these two blocks, the process of basic unit cell becoming a tissue of a humanbody functioning, functions of early stage reproduction system with other science such as physiology,biochemistry, immunology, branches of pathology are taught in blocks “Cell to tissue” and “Systems oforgans”. The purpose of “Society and environment”, “Society and doctor” blocks are to provide bachelordegree level education on preventive medical science, by relating the processes of society with the doctor toestablish the role, responsibilities, professional habits and qualities expected from professional actions, suchas interactions between doctor and patient, jurisprudence, health care systems and development of requiredattitudes.Basic biomedical science is the basis of clinical science lessons and consists of the following. : 32
  33. 33. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 20111. Anatomy of human body (8 credits)Student will possess knowledge about the normal human body anatomy of skeleton, ligaments, muscles,respiratory, digestive, urinary, male and female reproductive, nervous, sensory, cardiovascular, endocrinesystems. Also gain knowledge about its composition, organ size, shape, function, development, embryogenicnorms, age related characteristics, commonly occurring anomalies, normal organ location, innervation andvascular supply.2. Physiology of human body (6 credits)Students gain knowledge about normal human tissue, organ and system, central nervous, endocrine, blood,cardiovascular, respiration, metabolism, excretion, acid base balance, reproduction, sensory organ’sphysiology, human body physiological mechanism, their regulation, principle of adaptation, physiologicalbasis of experiments, laboratory and instrumental analysis, understanding of bioethical issues.3. Histology (4 credits)Gain knowledge about human embryo development stages, early manifestation of histological action, humaneucaryot cell structure, determining ultra structure of cells by using electron microscope. Tissue classification,structure, their relation, understanding structure and functional units on a micro scale, distinguishing humantissue, cell structure in micro preparations.4. Pathologic anatomy (4 credits)To study understanding of general pathology, cell tissue reaction against any disease, adaptation, regenerationand cancer changes.To determine macro and micro changes in systemic disease, disease etiology, pathophysiology, complication,death and differential diagnosis based on general histological concept and clinical thinking.5. Pathologic physiology (4 credits)Basic theoretic concepts of disease, etiology of disease, development of conditions, pathophysiologicalprogression of a disease, general principles, causes, and prognosis of the common diseases of population6. Biochemistry and nutrition (3 credits)The structure, characteristics and mechanism of macromolecules that form the basic components of body andfoods such as proteins, nucleic acids, carbohydrate, fat, vitamins, enzymes and their exchange, regulation anddeficiency.7. Microbiology (2 credits)The structure, forms, development and mutation of microbes and mechanism of pathology of tissues anddetection and laboratory analysis of pathological microbes, basic methods of analysis and knowledge aboutprevention form infections8. Immunology (2 credits)General understandings about immunology and immunology system, specific and non specific immunologicalreactions, antibodies, immune cells, organs, interactions of cells in immune reactions, immune mechanism9. Molecular biology (2 credits)Principles of molecular biology, genetics mechanism in molecular pathology, diagnostic molecular andbiological methods, causes of pathology and origins, pathophysiology, intracellular research, modern researchmethodologies in molecular biology, genetic engineering and basics of cellular biology10. Genetics (2 credits) 33
  34. 34. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Skills to use the genetics textbooks and journals, think about diseases in genetic terms, know about heredity ofdiseases, define the forms of heredity and develop skills in genetic prognosis, genetic counseling, referral ofpatients with right indication for genetic analysis, advocacy about genetics with the public11. Pharmacology (4 credits)To know about essential medicines which are used for prevention, diagnosis and treatment, public and clinicalpackage of services and their chemical structure, poisoning and coping mechanism in a human body andcounseling skills and about rational drug use. 2.4. Behavioral and Social Sciences and Medical Ethics Basic standards: The School of Medicine must identify and incorporate in the curriculum the contributions of thebehavioral sciences, social sciences, medical ethics and medical jurisprudence that enable effectivecommunication, clinical decision making and ethical practices. Quality development: The contributions of the behavioral and social sciences should be adapted to scientific developmentsin medicine, to changing demographics and cultural contexts and to health needs of society.The main responsibility of organizations and institutions granting higher education is not only prepareprofessional experts but also set up people, who have sense of responsibility for their profession, who areactive in the society, and are skilled in communication. In the section “General requirements for graduatingstudents” of the Higher education model standards, it is stated: • Demonstrate the ability to observe the ethics, adhere to legislative rules in taking action to coordinate the interactions between environment, society and people • Demonstrate the ability to live healthy lifestyle and improve one’own physical conditions • Acquire the knowledge of ethics, of democracy, and the demonstrate the ability to comprehend the historical and cultural heritage and abide by the traditions of humanity • Possess the ability of working as a team, be participative and respectful towards other ‘s viewpoints and taking responsibilities for one’s own self and for others • Possess the ability to debate and summarize in Mongolian • Possess the ability to work independently in a constantly changing environmentIn accordance with Order #481 of the Minister of Education, Culture and Science of Mongolia signed on 29December, 2006, modifications have been brought about in the content of bachelor degree training program.According to this new content, new lessons on social, humanitarian and natural sciences have been includedinto the curriculum. Besides the general requirements expected by employers in terms of professional skills,they place emphasis on improved communication skills, ability to work independently and in a team.Therefore, School of Medicine is striving to train skilled professional graduates, who are also excellent socialindividuals and civilians with high sense of civic responsibilities. The main aim of the School of Medicine isto train doctors, who are humane and caring, who possess the qualities of compassion high ethical standards,values, and are flexible as experts and doctors who conform with international standards. To accomplishthese, lessons in communication, social sciences, medical ethics and law have been included in thecurriculum.One. Subjects areas in the domain of Humanitarian Sciences1.1. Fundamentals of Philosophy (3 credits) 34
  35. 35. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011This subject focuses on main branches and theories of philosophy, ontology, theory of epistemology and mainelements of philosophy, philosophy of morality, esthetics, humanitarianism and religion. It also discussesissues in social philosophy, etc.1.2. Mongolian history (3 credits)This subject focuses on periods of Mongolian history, nomadic and modern civilization, society, state, culture,periods of development, features of regional zones of Mongolia etc.1.3. Culture study (2 credits)This subject examines the issues in the cultural history of Mongolia, overview of culture, main duties ofculture, main factors of influencing culture, communication and culture, and history of world culture, culturalmonuments, and ideology of famous representatives.1.4. Ecology and environmental protection (3 credits)Ecology is the scientific study of the relation of living organisms with each other and their environment arecovered in this course During this course students will learn about relationship of ecology and other sciences,factors influencing ecology, fundamentals of ecology, ecological systems, human ecology, social ecology,community ecology, natural resources, classification and utilization of resources, environmental pollution,prevention from pollution, environment protection, and restoration of nature and legal issues of ecology.1.5. Human development (2 credits)Topics include information on fundamental principles of human development, human developmentperspectives, equity, inequality, poverty, human safety, human development and globalization, humandevelopment and gender, human development and economics, policy, political organizations and humandevelopment.1.6. Syntax of the Mongolian language. (2 credits)Focuses on basic concepts of syntax: principles and rules for constructing sentences, classification of syntax,specific features of syntax, vocabulary and choice, how to use words and expressions, vocabulary andexpression limitation, specific characteristics of idioms, combination of words, word order in sentences, orderof the parts of a sentence, difference in the scripts, genres and script types, literacy, structure of script and etc.Two. Subjects areas in the domain of Social Sciences2.1 Basics and theory of Economics (3 credits) 35
  36. 36. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011Focuses on basic theories of economy, methods of study, micro-economics, factors affecting the market,macroeconomics, development of economy, (foreign trade, payment balance, international moneyconfiguration, economy development)2.2 Fundamentals of Political Studies (2 credits)Emphasizes the principles and objectives of political sciences, research methods, roles of political sciences,political life and governing communication, role of politics in a modern social life, history of politicalthought, main types of political doctrine/teaching/, civil society, essential characteristics of civil society,specific features of Mongolian civil society, political institutions, political system and political organization,composition of political organizations and their role, mechanism of their activities and interrelations, politicalgovernance, political regimes, party politics, election systems, historical types of state associations, politicalinteractions and processes, political culture and its components, types of political culture, political values,political culture of society, class, group and individuals, political socialization and political contribution.2.3 Fundamentals of Sociology (3 credits)Students will learn about objects of sociological sciences, research methods, society and its types, elements ofa society, social institutions, social groups, social context of individuals, evaluation of social events, andsociology research methods.2.4 Fundamentals of Psychology (3 credits)This course covers several areas of psychology including learning, motivation, emotion, developmentalchanges, personality, abnormal behavior, psychotherapy, and social behavior with special attention to thephysiological and neurological basis of human behavior.Students will learn about psychology of behaviorism, neobehaviorism, and gestalt, branches of freudism andneofreudism, structures of the brain and mentality, how we sense and perceive the world around us, how welearn, and what motivates us, instincts, mental functioning, and assessment of mentality. The course willreview the scientific basis of psychology and learn how scientific research is conducted in psychology. Learnabout research principles and methods, major approaches to understanding human thought and behaviorincluding biological, cognitive and behavioral models of human functioning, human temperament, humantalent, motivation physiology, principles of society and psychology.2.5 Fundamentals of management (3 credits)This course covers scientific basis of management and objectives of management, institution or organizationalgovernance and manager’s activities, management thinking development, governance strategy and plan,institution’s social responsibilities, leadership, ethics, communication, decision making, human resources 36
  37. 37. Self-Evaluation Report, SOM, HSUMBME program evaluation by WFME/AMEWPR Standards 26 September, 2011management, structure of organization, institution change management, conflict management, managementof an institution’s monitoring system.Three. Communication skills, ethics, medical jurisprudence and legal norms3.1. Communication skills (2 credits)This subject is intended for first grade students of HSUM to give fundamental knowledge on communicationskills, ethics and legal norms. During this course medical students will learn about fundamental principles ofcommunication, communication culture and its types, communication and attitude intrinsic characters, valueof profession of doctor, medical pedagogy, specific features of adult learning, teaching and learning process,duties and responsibilities of learners, paper or report presentation skills, ethics and its norms. Also studentsachieve knowledge about UNIFACE student program, student rules and HSUM rules.3.2 Ethics for a PractitionerEmphasizes the doctor’s values, humanity, flexibility, fairness, ethics, special features of the medicalprofession, image of practitioner /doctor/ and its negative and positive factors, group work and groupcommunication, cooperative activities, types of group, treatment and patient groups, group mentality, topicson communication between practitioners /doctors/, practitioner and patient communication, practitioner-practitioner communication, practitioner and society communication. Students frequenting these subjectsthrough following blocks:” Society and practitioner”, “Nursing”, “Mental health”, “Society and environment”Also in each blocks, as a part of clinical skill education program, there are topics of communication skills withpatients, pediatric patients, seniors, patients in the terminal stage of disease and their families.3.3 Medical jurisprudence and legislationDiscusses the following topics: practitioner’s error, its legal basis; mental preparedness to communicate withsuspect, victim and criminals, lawyers and medical workers, and examining cadavers; comply with biomedicalethics, learn how to justify and show fairness in forensic decision making and drawing expert conclusions.Students also encounter these subjects through following blocks: “Society and practitioner”, “Mental health”,“Society and environment”3.4 Scientific method and Methods of health education (2 credits)This 2 credit course is designed to teach second year students health education methods, communication andconsultation skills. The course is based on the self-learning method to acquire knowledge and skills on how toconduct health education research, how to organize health education courses for general population and targetgroups. During the course students will improve their presentation skills. Students will achieve abovementioned goals through the clinical problem-solving tasks, problem-based tutorials and exercises inevidence-based practice, as well as student research projects and assignments. In 2009-2010 academic year343 students (85.3% of all students) from School of Medicine had participated in a Health education program.3.5 Training for assistant practitioners.During this course students learn about methods of team work, PBL, how to identify the problems, skills indecision making and critical thinking, complex problem solving, determine ways for solving problems, andother ways of individual development to enable the person to work harmoniously in society and community.Focuses on: • human actions intended to benefit the patient or others, ethical principles and appropriate attitudes and professional caring for patients, and in relating to patient’s families and to others involved in the care of patients • Learn skills of being just and fair, respect for institutional and patient privacy • Learn team working skills to work with medical staff and colleagues. Learn skills in ethical decision- making within the context of the complex issues and act effectively. 37

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