全球医学教育基本要求

全球医学教育基本要求（GMER）1999年6月9日，经纽约中华医学基金会（CMB）资助，成立了国际医学教育专门委员会（IIME），为制定“全球医学教育最基本要求（由14个国际医学教育组织的主席或高级代表组成IIME“基本要求”是指世界各地医学院校培养的医生都必须具备的基本素质，包括医学知识、临床技能、职业态度、行为和职业道德等。制定“基本要求”的任务由IIME的核心委员会承担，该委员会由世界各地的医学教育专家组成。八位具有丰富经验的医学教育和卫生政策资深专家组成IIME的指导委员会，指导IIME的总体工作，也指导核心委员会的工作。由14个国际医学教育组织的主席或高级代表组成IIME咨询委员会，为IIME提供咨询意见。GMER的7个领域，60条标准为：1．职业价值、态度、行为和伦理医生的职业观和伦理道德对于医学实践工作是很重要的。医生的伦理观不仅包括医学知识和技能，而且还有对共同价值的认识、对这些价值观的认可和强化，以及坚持这些价值观的责任。医科毕业生必须表现出：认识到医学职业的基本组成部分，包括道德、伦理原则和医学职业中所包含的法律责任；职业价值包括工作优秀、为他人利益着想、责任感、同情心、移情、诚实、团结和遵守科学的方法；能够理解每一个医生都有义务为了病人、社会上的大多数人和医学职业本身的利益，促进、保护和加强这些部分；意识到良好的医学实践基于医生、患者和患者家庭成员之间对于患者的财产、文化传统、信仰和自治能力上的相互理解和相互关系；在处理有关医学伦理、法律和专业问题，包括那些由于经济发展停滞、健康医疗的商业化和科学进步所带来的矛盾时具备的把握符合道德原则和决断力的能力；自我调节能力，懂得因为个人的能力有限，包括个人的医学知识有限而不断要求自我提高的意识；尊重同事和其他医务人员，并且有能力与他们保持积极的合作关系；懂得医生有道德上的义务为病人提供临终关怀，包括缓解症状的治疗；懂得在书写抄录病人的病史资料、个人隐私和知识产权方面的伦理和医学问题；有效计划和管理个人时间的能力，处理不确定性的行为能力和适应变化的能力；照顾个别病人的责任。2．医学的科学基础医科毕业生必须掌握医学专业所要求的坚实的科学基础知识，并有能力运用这些知识解决医学问题。毕业生必须要理解隐含在医学判断和行为中的原则，并能够适应时代的变化。为了达到这些要求，毕业生们必须证明他（她）们已理解如下的知识点：正常的人体结构和功能，作为一个复杂但有适应能力的生物系统；疾病状态下身体结构和功能的异常；人们的正常和异常行为；健康、疾病以及人与物理、社会环境间相互作用中的决定因素和危险因素；保持人体内环境稳定的分子、细胞、生物化学和生理机制；人类的生命周期和生长、发育、衰老在个体、家庭和社区上的反映；急慢性疾病的病因和自然史；流行病学、卫生经济和卫生管理知识；药物的作用机制与用途，以及在不同治疗中的效果；在急慢性病、康复和临终关怀间的相关生化、药理、外科、心理、社会以及其它治疗干预措施。3．交流沟通技能医生应该通过有效的交流沟通创造一个在病人、家属、医务人员和同事，以及与公众间互相学习的环境。为了形成更正确的医疗决定和使病人更满意，医科毕业生必须具备如下能力：仔细倾听，掌握并综合所有问题的相关信息，理解它们的内容；运用交流沟通技能理解病人及其家属，使他（她）们能从共同决策参与者的角度执行医疗决定；能有效地与同事、职员、社区、其它部门和媒体沟通交流；在治疗病人方面，以有效的团队形式，与其它的专业人士共事；在教育他人方面显示出基本能力和积极的态度；在有助于提高与病人、社区相互交流的文化因素和个人因素上显示出敏锐的能力；能够用口头和书面两种形式进行有效的交流沟通；创造和保持良好的医学记录；能够综合和表达符合病人需求的信息，并且探讨优先考虑病人和社区利益的卓有成效、可接受的行动计划。4．临床技能医科毕业生必须能够有效地诊断和治疗病人。为了做到这一点，他（她）们必须要：正确地采集病史，包括致病的社会因素，例如职业病；进行完整的体格检查和精神状态的检查；运用基本的诊断和技术操作，分析和解释诊断结果，并找出问题的实质；以挽救病人生命和运用循证医学的原则为重点，采用适当的诊断和治疗策略；做出临床诊断和治疗；能意识到直接威胁生命的情况；能处理常见的医疗急诊；有效和合乎伦理要求地治疗病人，包括保健和预防；评价健康问题，建议病人考虑生理、心理、社会和文化因素；了解在人力资源、诊断干预、治疗模式和医疗设施方面的适当运用。5．人群健康和卫生系统医科毕业生应该知道他（她）们担负着采取适当方法保护和促进整个人群健康的责任。他（她）们应该了解组织健康系统的原则和其中的经济和法律基础。他（她）们也应该对医疗系统的有效管理有一个基本认识。毕业生应能显示具有如下知识：Itwasunderstoodfromthebeginningthatdefiningsuchcompetenciesoroutcomesofthemedicaleducationprocesswouldhavesignificantimplicationsformedicalschoolcurricula.Medicalschoolgraduatesshoulddemonstrateprofessionalcompetencieswhichwillensurethathighqualitycarecouldbeprovidedwithempathyandrespectforpatients'well-being.

Graduatesshouldbeabletointegratemanagementofillnessandinjurywithhealthpromotionanddiseasepreventionandbeabletoworkinmulti-professionalteams.Inaddition,theyshouldbeabletoteach,adviceandcounselpatients,familiesandthepublicabouthealth,illness,riskfactorsandhealthylifestyles.Theyshouldbeabletoadapttochangingapatternofdiseases,conditionsandrequirementsofmedicalpractice,medicalinformationtechnology,scientificadvances,andchangingorganizationofhealthcaredeliverywhileupholdingthehigheststandardsofprofessionalvaluesandethics.

TheIIMEProjectConsistsofThreePhases:

Thefirstphase(PhaseI)'DefiningEssentials',beganwiththeestablishmentoftheInstituteforInternationalMedicalEducation.Itstaskwastodevelopasetof'globalminimumessentialrequirements'('GMER')drawninpartfromstandardsthatcurrentlyexist.Thesestandardsweretoincludethesciencesbasictomedicine,clinicalexperiences,knowledge,skills,professionalvalues,behaviorandethicalvalues.These'essentials'weretorepresentonlythecoreofamedicalcurriculumsinceeachcountry,regionandmedicalschoolalsohasuniquerequirementsthattheirindividualcurriculamustaddress.Hence,eachschool'seducationalprogramwillbedifferentbutallwillpossessthesamecore.

Inthesecondphase(PhaseII),the'ExperimentalImplementation'ofthe'GMER'willbeusedtoevaluatethegraduatesoftheleadingmedicalschoolsinChina.Theschoolswillusetheevaluationmethodsthatareconsistentwiththeirexperience,andhavetocoverallsevendomainsand60learningoutcomes,toidentifythestrengthsanddeficiencieseventuallyfoundintheschoolsparticipatinginthisexperiment.Effortsthenwillbemadetoimproveallareasofweaknessbeforeasecondevaluationismade.Ifaschoolmeetsallofthe'Essentials',itwillbecertifiedaccordingly.

Inthethird(PhaseIII),or'DisseminationPhase',thelessonslearnedandtheprocessusedwillbemodifiedandofferedtotheglobalmedicaleducationcommunityforitsuse.Hopefullythe'essentials'willserveasatoolforimprovingthequalityofmedicaleducationandafoundationforaninternationalassessmentofmedicaleducationprograms.

Background

Globalizationforcesarebecomingincreasinglyevidentinmedicaleducation.Thisisquitenaturalasmedicineisaglobalprofessionandmedicalknowledgeandresearchhavetraditionallycrossednationalboundaries.Physicianshavealsostudiedmedicineandprovidedservicesinvariouscountriesoftheworld.Furthermore,humancreativitydemandsthatglobalizationincludesactivitiesintheintellectualandculturaldomains.Variousmultilateralagreementsandconventionsareopeningthedoorstoglobalmobilityandencouragingthedevelopmentofcommoneducationalstandards,mutualrecognitionofqualifications,andcertificationprocessesbywhichprofessionalsareallowedtopracticetheirvocation.

Presently,thereareaboutsixmillionsphysiciansworldwide,servingoversixbillioninhabitants.Theyreceivetheireducationandtraininginover1800medicalschoolsthroughouttheworld.Although,atfirstglance,globalmedicalcurriculaappearsimilar,theircontentvariesgreatly.Whiletherehavebeenanumberofnear-successfuleffortstoevaluatetheprocessleadingtotheMDoritsequivalentdegree,fewofthesehavefocusedontheoutcomesoftheireducationaleffort.However,therehasneverbeenanattempttodefinethecoreorminimalcompetenciesthatallphysiciansshouldpossessatthecompletionoftheirmedicalschooltrainingandbeforetheyentertheirspecialtyorpostgraduatetraining.Finally,insomecountries,therehasbeenaproliferationofnewmedicalschoolswithoutproperassuranceofeducationalquality.

Atthesametime,healthservicesandmedicalpracticeareundergoingprofoundchangesforcedbyeconomicdifficultiesinfinancinghealthcaresystems.Theincreasingcostofhealthinterventionsandrelatedcost-containmentpoliciescouldthreatenphysician'shumanismandvalues.Asaresult,thereisaneedtopreservethegoalsofsocialbenefitandequityinthefaceoftheseincreasingeconomicpressureandconstraints.

Rapidadvancesareoccurringinbiomedicalsciences,informationtechnologyandbiotechnology.Theseadvancespresentnewethical,socialandlegalchallengesfortheprofessionofmedicineandcallforpreservationofabalancebetweenscienceandtheartofmedicine.Animportanttaskofmedicaleducationistopreparefuturedoctorstobeabletoadapttotheconditionsofmedicalpracticeinarapidlychanginghealthcareenvironment.Thechallengebeforethemedicaleducationcommunityistouseglobalizationasaninstrumentofopportunitytoimprovethequalityofmedicaleducationandmedicalpractice.

Indefiningtheessentialcompetenciesthatallphysiciansmusthave,anincreasingemphasisneedstobeplacedonprofessionalism,socialsciences,healtheconomicsandthemanagementofinformationandthehealthcaresystem.Thismustbedoneinthecontextofsocialandculturalcharacteristicsofthedifferentregionsoftheworld.Theexactmethodsandformatforteachingmayvaryfromschooltoschoolbutthecompetenciesrequiredmustbethesame.Thus,theconceptof'essentials'doesnotimplyaglobaluniformityofmedicalcurriculaandeducationalprocesses.Furthermore,theglobalessentialrequirementsarenotathreattothefundamentalprinciplethatmedicaleducationhastoidentifyandaddressthespecificneedsinsocialandculturalcontextwherethephysicianiseducatedandwillpractice.Finallyinpursuingthe'globalminimumessentialrequirements',medicalschoolswilladopttheirownparticularcurriculumdesign,butindoingso,theymustensurethattheirgraduatespossessthecorecompetenciesenvisionedintheminimumessentials.Theymustinshort'thinkgloballyandactlocally.'

TheCoreCommitteegroupedthe'essentials'underfollowingseven,broadeducationaloutcome-competencedomainsshowninFigure1:

ProfessionalValues,Attitudes,BehaviorandEthicsFigure1.DomainsofglobalessentialrequirementsProfessionalismandethicalbehaviorareessentialtothepracticeofmedicine.Professionalismincludesnotonlymedicalknowledgeandskillsbutalsothecommitmenttoasetofsharedvalues,theautonomytosetandenforcethesevalues,andresponsibilitiestoupholdthem.Themedicalgraduatemustdemonstrate:

·

recognitionoftheessentialelementsofthemedicalprofession,includingmoralandethicalprinciplesandlegalresponsibilitiesunderlyingtheprofession;

·

professionalvalueswhichincludeexcellence,altruism,responsibility,compassion,empathy,accountability,honestyandintegrity,andacommitmenttoscientificmethods,

·

anunderstandingthateachphysicianhasanobligationtopromote,protect,andenhancetheseelementsforthebenefitofpatients,theprofessionandsocietyatlarge;

·

recognitionthatgoodmedicalpracticedependsonmutualunderstandingandrelationshipbetweenthedoctor,thepatientandthefamilywithrespectforpatient'swelfare,culturaldiversity,beliefsandautonomy;

·

anabilitytoapplytheprinciplesofmoralreasoninganddecision-makingtoconflictswithinandbetweenethical,legalandprofessionalissuesincludingthoseraisedbyeconomicconstrains,commercializationofhealthcare,andscientificadvances;

·

self-regulationandarecognitionoftheneedforcontinuousself-improvementwithanawarenessofpersonallimitationsincludinglimitationsofone'smedicalknowledge;

·

respectforcolleaguesandotherhealthcareprofessionalsandtheabilitytofosterapositivecollaborativerelationshipwiththem;

·

recognitionofthemoralobligationtoprovideend-of-lifecare,includingpalliationofsymptoms;

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recognitionofethicalandmedicalissuesinpatientdocumentation,plagiarism,confidentialityandownershipofintellectualproperty;

·

abilitytoeffectivelyplanandefficientlymanageone'sowntimeandactivitiestocopewithuncertainty,andtheabilitytoadapttochange;

·

personalresponsibilityforthecareofindividualpatients.

ScientificFoundationofMedicine

Thegraduatemustpossesstheknowledgerequiredforthesolidscientificfoundationofmedicineandbeabletoapplythisknowledgetosolvemedicalproblems.Thegraduatemustunderstandtheprinciplesunderlyingmedicaldecisionsandactions,andbeabletoadapttochangewithtimeandthecontextofhis/herpractice.Inordertoachievetheseoutcomes,thegraduatemustdemonstrateaknowledgeandunderstandingof:

·

thenormalstructureandfunctionofthebodyasacomplexofadaptivebiologicalsystem;

·

abnormalitiesinbodystructureandfunctionwhichoccurindiseases;

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thenormalandabnormalhumanbehavior;

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importantdeterminantsandriskfactorsofhealthandillnessesandofinteractionbetweenmanandhisphysicalandsocialenvironment;

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themolecular,cellular,biochemicalandphysiologicalmechanismsthatmaintainthebody'shomeostasis;

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thehumanlifecycleandeffectsofgrowth,developmentandagingupontheindividual,familyandcommunity;

·

theetiologyandnaturalhistoryofacuteillnessesandchronicdiseases;

·

epidemiology,healtheconomicsandhealthmanagement;

·

theprinciplesofdrugactionandituse,andefficacyofvariestherapies;

·

relevantbiochemical,pharmacological,surgical,psychological,socialandotherinterventionsinacuteandchronicillness,inrehabilitation,andend-of-lifecare.

Communicationskills

Thephysicianshouldcreateanenvironmentinwhichmutuallearningoccurswithandamongpatients,theirrelatives,membersofthehealthcareteamandcolleagues,andthepublicthrougheffectivecommunication.Toincreasethelikelihoodofmoreappropriatemedicaldecisionmakingandpatientsatisfaction,thegraduatesmustbeableto:

·

listenattentivelytoelicitandsynthesizerelevantinformationaboutallproblemsandunderstandingoftheircontent;

·

applycommunicationskillstofacilitateunderstandingwithpatientsandtheirfamiliesandtoenablethemtoundertakedecisionsasequalpartners;

·

communicateeffectivelywithcolleagues,faculty,thecommunity,othersectorsandthemedia;

·

interactwithotherprofessionalsinvolvedinpatientcarethrougheffectiveteamwork;

·

demonstratebasicskillsandpositiveattitudestowardsteachingothers;

·

demonstratesensitivitytoculturalandpersonalfactorsthatimproveinteractionswithpatientsandthecommunity;

·

communicateeffectivelybothorallyandinwriting;

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createandmaintaingoodmedicalrecords;

·

synthesizeandpresentinformationappropriatetotheneedsoftheaudience,anddiscussachievableandacceptableplansofactionthataddressissuesofprioritytotheindividualandcommunity.

ClinicalSkillsThegraduatesmustdiagnoseandmanagethecareofpatientsinaneffectiveandefficientway.Inordertodoso,he/shemustbeableto:

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takeanappropriatehistoryincludingsocialissuessuchasoccupationalhealth;

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performaphysicalandmentalstatusexamination;

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applybasicdiagnosticandtechnicalprocedures,toanalyzeandinterpretfindings,andtodefinethenatureofaproblem;

·

performappropriatediagnosticandtherapeuticstrategieswiththefocusonlife-savingproceduresandapplyingprinciplesofbestevidencemedicine;

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exerciseclinicaljudgmenttoestablishdiagnosesandtherapies;

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recognizeimmediatelife-threateningconditions;

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managecommonmedicalemergencies;

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managepatientsinaneffective,efficientandethicalmannerincludinghealthpromotionanddiseaseprevention;

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evaluatehealthproblemsandadvisepatientstakingintoaccountphysical,psychological,socialandculturalfactors;

·

understandtheappropriateutilizationofhumanresources,diagnosticinterventions,therapeuticmodalitiesandhealthcarefacilities.

PopulationHealthandHealthSystems

Medicalgraduatesshouldunderstandtheirroleinprotectingandpromotingthehealthofawholepopulationandbeabletotakeappropriateaction.Theyshouldunderstandtheprinciplesofhealthsystemsorganizationandtheireconomicandlegislativefoundations.Theyshouldalsohaveabasicunderstandingoftheefficientandeffectivemanagementofthehealthcaresystem.Thegraduatesshouldbeabletodemonstrate:

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knowledgeofimportantlife-style,genetic,demographic,environmental,social,economic,psychological,andculturaldeterminantsofhealthandillnessofapopulationasawhole;

·

knowledgeoftheirroleandabilitytotakeappropriateactionindisease,injuryandaccidentpreventionandprotecting,maintainingandpromotingthehealthofindividuals,familiesandcommunity;

·

knowledgeofinternationalhealthstatus,ofglobaltrendsinmorbidityandmortalityofchronicdiseasesofsocialsignificance,theimpactofmigration,trade,andenvironmentalfactorsonhealthandtheroleofinternationalhealthorganizations;

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acceptanceoftherolesandresponsibilitiesofotherhealthandhealthrelatedpersonnelinprovidinghealthcaretoindividuals,populationsandcommunities;

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anunderstandingoftheneedforcollectiveresponsibilityforhealthpromotinginterventionswhichrequirespartnershipswiththepopulationserved,andamultidisciplinaryapproachincludingthehealthcareprofessionsaswellasintersectoralcollaboration;

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anunderstandingofthebasicsofhealthsystemsincludingpolicies,organization,financing,cost-containmentmeasuresofrisinghealthcarecosts,andprinciplesofeffectivemanagementofhealthcaredelivery;

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anunderstandingofthemechanismsthatdetermineequityinaccesstohealthcare,effectiveness,andqualityofcare;

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useofnational,regionalandlocalsurveillancedataaswellasdemographyandepidemiologyinhealthdecisions;

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awillingnesstoacceptleadershipwhenneededandasappropriateinhealthissues.

ManagementofInformation

Thepracticeofmedicineandmanagementofahealthsystemdependsontheeffectiveflowofknowledgeandinformation.Advancesincomputingandcommunicationtechnologyhaveresultedinpowerfultoolsforeducationandforinformationanalysisandmanagement.Therefore,graduateshavetounderstandthecapabilitiesandlimitationsofinformationtechnologyandthemanagementofknowledge,andbeabletouseitformedicalproblemsolvinganddecision-making.Thegraduateshouldbeableto:

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search,collect,organizeandinterprethealthandbiomedicalinformationfromdifferentdatabasesandsources;

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retrievepatient-specificinformationfromaclinicaldatasystem;

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useinformationandcommunicationtechnologytoassistindiagnostic,therapeuticandpreventivemeasures,andforsurveillanceandmonitoringhealthstatus;

·

understandtheapplicationandlimitationsofinformationtechnology;

·

maintainrecordsofhis/herpracticeforanalysisandimprovement.

CriticalthinkingandresearchTheabilitytocriticallyevaluateexistingknowledge,technologyandinformationisnecessaryforsolvingproblems,sincephysiciansmustcontinuallyacquirenewscientificinformationandnewskillsiftheyaretoremaincompetent.Goodmedicalpracticerequirestheabilitytothinkscientificallyandusescientificmethods.Themedicalgraduateshouldthereforebeableto:

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demonstrateacriticalapproach,constructiveskepticism,creativityandaresearch-orientedattitudeinprofessionalactivities;

·

understandthepowerandlimitationsofthescientificthinkingbasedoninformationobtainedfromdifferentsourcesinestablishingthecausation,treatmentandpreventionofdisease;

·

usepersonaljudgmentsforanalyticalandcriticalproblemsolvingandseekoutinformationratherthantowaitforittobegiven;

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identify,formulateandsolvepatients'problemsusingscientificthinkingandbasedonobtainedandcorrelatedinformationfromdifferentsources;

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understandtherolesofcomplexity,uncertaintyandprobabilityindecisionsinmedicalpractice;

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formulatehypotheses,collectandcriticallyevaluatedata,forthesolutionofproblems.

Toretainandadvancecompetenciesacquiredinmedicalschool,graduatesmustbeawareoftheirownlimitations,theneedforregularlyrepeatedself-assessment,acceptanceofpeerevaluationandcontinuousundertakingofself-directedstudy.Thesepersonaldevelopmentactivitiespermitthecontinuedacquisitionanduseofnewknowledgeandtechnologiesthroughouttheirprofessionalcareers.

The'Essentials'alonearenotlikelytochangegraduates'competenciesunlesstheyarelinkedtoevaluationofstudents'competencies.Therefore,assessmenttoolsfortheevaluationofeducationaloutcomesareessentialfortheimplementationofthisdocument.Thiswillensurethatgraduates,wherevertheyaretrainedintheworld,havesimilarcorecompetenciesatthestartoffurthergraduatemedicaleducation(specialtytraining)orwhentheybegintopracticemedicineundertheappropriate,nationallydeterminedsupervision.SuchtoolsareunderdevelopmentbythespeciallyestablishedIIMETaskForceforAssessment.

Thepresented'GlobalMinimumEssentialRequirements'areconsideredaninstrumentforimprovementofthequalityofthemedicaleducationandindirectlyofthemedicalpractice.ItishopedthattheIIMEprojectwillhavesignificantinfluenceonmedicalschoolcurriculaandeducationalprocesses,pavingtheroadtothecompetence-orientedmedicaleducation.

NotesonContributors

ElizabethG.ArmstrongisDirectorofMedicalEducationatHarvardMedicalSchool,Boston,MA,USA.

RajaC.BandaranayakeisProfessorandChairmanoftheDepartmentofAnatomy,ArabianGulfUniversityCollegeofMedicine&MedicalSciences,Manama,Bahrain.

AlbertoOriolIBoschisDirectoroftheInstituteofHealth,DepartmentofHealthandSocialSecurityoftheCatalanGovernment,Barcelona,Spain.

AlejandroCraviotoisDeanoftheFacultyofMedicineoftheNationalAutonomousUniversityofMexico,Mexico.

CharlesDohnerisProfessorEmeritusofMedicalEducationattheUniversityofWashington,Seattle,WA,USA.

MarvinR.DunnisChairmanoftheCoreCommitteeoftheInstituteforInternationalMedicalEducationandDirectorofResidencyReviewCommitteeActivitiesfortheAccreditationCouncilforGraduateMedicalEducation,Chicago,IL,USA.

JosephS.GonnellaisDirectoroftheCenterforResearchinMedicalEducationandHealthCareandDeanEmeritusofJeffersonMedicalCollegeinPhiladelphia,PA,USA.

JohnD.HamiltonisAcademicDirector,UndergraduateCurriculuminMedicineattheUniversityofDurham,StocktonCampus,Stockton-on-Tees,UKandformerlyProfessorofMedicineattheUniversityofNewcastle,Australia.

RonaldM.HardenisViceDeanforMedicalEducationandDirectoroftheCenterforMedicalEducationattheUniversityofDundee.HealsoholdsthepostofSecretaryGeneraloftheAssociationforMedicalEducationinEurope,Dundee,Scotland,UK.

DavidHawkinsisExecutiveDirectoroftheAssociationofCanadianMedicalCollegesinOttawa,Canada.

JoséFelixPatiñoisPresidentoftheNationalAcademyofMedicine,Bogotá,Colombia.

M.RoySchwarzisPresidentoftheChinaMedicalBoardofNewYork,Inc.andProfessorattheUniversityofWashingtonandUniversityofCaliforniaatSanDiego.HeisalsoChairmanoftheIIMESteeringandAdvisoryCommitteesinNewYork,USA.

DavidT.SternisChairmanoftheTaskForceforAssessmentfortheInstituteforInternationalMedicalEducation.HealsoholdsthepositionsofAssistantProfessorofMedicineandDirectorofStandardizedPatientProgramsattheUniversityofMichiganMedicalCenterinAnnArbor,MI,USA.

PrasongTuchindaisDeanoftheFacultyofMedicineofRangsitUniversityandPresidentoftheGeneralPractitioners/FamilyPhysiciansAssociationsThailand,Bangkok,Thailand.

J.P.DeV.VanNiekerkisDeanEmeritusofUniversityofCapeTown,CapeTown,SouthAfrica.

AndrzejWojtczakisDirectoroftheInstituteforInternationalMedicalEducationinNewYorkandProfessorintheSchoolofPublicHealthandSocialMedicineinWarsaw.Previously,hewasDirectoroftheWHOResearchCentreforHealthinKobe,JapanandheldthepositionofAMEEPresident.

ZhouTongfuisViceDirectoroftheBureauofEducationofSichuanProvinceandProfessorofSichuanUniversityMedicalCenterinChengdu,People'sRepublicofChina.

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