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December 2003 Reporter Home

Medical School Applications Increase

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ViewPoint: Crossing Boundaries with International Medical Education

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Scott Harris
sharris@aamc.org

Viewpoint: Crossing Boundaries with International Medical Education

By M. Brownell Anderson, Senior Associate Vice President, AAMC Division of Medical Education

I have just completed the first part of an amazing adventure. I am taking a six-month sabbatical over the course of 20 months at the Arabian Gulf University (AGU) in Manama, Kingdom of Bahrain, smack in the middle of the Arabian Gulf. What am I doing in this part of the world if I'm not a journalist or TV reporter? I am working as a faculty member at the Arabian Gulf University School of Medicine and Medical Sciences, coordinating and teaching a Master's in Health Professions course, serving on the curriculum committee, writing papers with medical school faculty, and working with graduate students.

I was at AGU in January, before the Iraq war, and returned again in September. As a visitor in the Arab world immediately before and during this conflict, I have learned a great deal about the warmth and dignity of the people there. I have also learned about the similarity of the issues faced in medical education here and in the Middle East. In addition to sharing some impressions of my adventure, I want to describe in broader terms AAMC's interests and activities in international medical education.

Medical education crosses political, religious, and ideological boundaries; the issues faced by medical school faculty and administrations in creating educational programs to prepare physicians to practice medicine are universal and, I believe, offer a place in the global dialogue where we can come together around common issues. Let me explain.

The Arabian Gulf University is a leading example of collaboration in international medical education. The medical school has a full-time faculty of 35 and a student body of 700. While the university is situated in Manama, in the Kingdom of Bahrain, it is governed by the Gulf Cooperative Countries (GCC), which include Bahrain, Kuwait, Saudi Arabia, Oman, United Arab Emirates, and Qatar. The GCC Council elects one of its member deans to serve as chair of the council, and the group meets regularly. Currently they are developing a five-year strategic plan for the Gulf region medical schools. The medical students come from all six GCC countries as well as Iraq, Iran, and India.

International medical education is a source of hope as well as collaboration. I met the associate dean for education from a medical school in Baghdad. He told me that before the war started, he and his colleagues were trying to determine how to squeeze students into overcrowded labs and find the resources to mount small-group learning sessions with hundreds of students. During the war, the school's president was shot because he was a member of the Baath Party and the college was ransacked, so the priorities have shifted from the typical educational issues to the fundamental question of how to rebuild the medical school. But rebuild they will, and the associate dean was visiting AGU to learn how they might share resources to accelerate their efforts aimed at educating future physicians in Iraq.

But why is the AAMC involved in international medical education? In September 2001, Jordan Cohen charged a group of AAMC staff to explore the impact of globalization on the AAMC and its constituents. We found that global economic and political environments increasingly affect academic medicine via lowered trade barriers, enhanced diffusion of cultural values, the Internet, and increasing population movement associated with travel and immigration. Expertise, services, and products find their way across permeable national borders in unprecedented ways. In medicine and in public health, global outreach efforts have been prioritized to improve the lives of populations across the world as was illustrated during the SARS outbreak. More recently, U.S. health systems analysts have placed increased value on international comparisons, shedding new light on our country's healthcare delivery challenges and potential solutions.

In medical education similar opportunities exist, yet we have only begun to explore them. The forces for change in many schools outside the United States and Canada have become significant. These schools often seek infor- mation and experience from others who have successfully made changes. At the same time, global economic and political environments increasingly affect academic medicine and the AAMC, so it is important for American medical students to be exposed to healthcare problems and systems outside of the United States.

Through the exchange of ideas and information, an international discourse on medical education will benefit all parties involved. The AAMC is in a unique position to both enhance this discourse and catalyze activities that can benefit colleagues throughout the world. The work with the Arabian Gulf University is one example of the kinds of projects the AAMC will be engaged in as the international medical education activities evolve. AAMC will collaborate with organizations like the Foundation for Advancement of International Medical Education and Research and the China Medical Board to promote international medical education and provide opportunities for U.S. medical students and faculty.

My experiences have been gained by teaching at the Arabian Gulf University, but the lessons I have learned come from the warmth and dignity I have experienced, and the spirit of mutual cooperation around medical education. These lessons apply to contexts other than the Arab world, and while we will not achieve world peace through our work in international medical education, we will contribute to movement in that direction and it is a source of considerable hope.

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