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Egypt Prescribes Changes for Doctors in Training

ASSIUT—Future doctors in Egypt will complete their basic medical-education course work in five years instead of six, and then will get two years of clinical training instead of just one, under a system that will be phased in at all of the country’s medical schools, at both public and private universities, starting next week.

“Many countries in the world, such as the United States, Canada, England and Australia, do not recognize the graduates of Egyptian medical schools,” said Hussein Khaled, head of the Supreme Council of Universities’ Medical Sector Committee and a former minister of higher education. “We need to modernize our education system to keep pace with the global medical teaching system.”

Annually, the World Health Organization announces the names of recognized medical schools worldwide, in accordance with accreditation standards set by the World Federation for Medical Education to ensure that colleges are teaching the minimum required medical information according to a credit system, regardless of the number of academic years.

This global recognition system has been in place for about 10 years, Khaled said, but countries were given until 2023 to make sure their medical schools met the standards. After that, he added, certificates issued by schools that do not meet the standards will no longer be recognized internationally.

“This prompted us to start adopting the new system this year,” Khaled said.

Only new students first enrolling in the academic year that begins next week will follow the new system. Previously enrolled students will complete their studies according to the old system. However, students graduating under the old system who want to practice medicine abroad will have to undergo additional testing in their destination country to prove their skills and knowledge are equivalent to those taught under the new system.

The new system will integrate practical and theoretical courses throughout the first five years, so that students will begin getting training in the hospitals during their first academic year. Under the old system, students study theoretical courses like anatomy and physiology for three years before being allowed to start the clinical courses in hospitals.

Reducing the academic phase of the curriculum from six years to five will require curricular changes that include merging materials from some courses and canceling  courses that repeat  information presented in other courses.

It will also mark a historic change in the structure of medical education in Egypt. The six-year period for academic study has been in place since 1911, Hussein Khaled said.

“There is no problem in reducing the number of academic years,” said Khaled Samir, a professor of cardio-thoracic surgery at Ain Shams University’s Faculty of Medicine. “The essence of medical education worldwide depends on providing students with diagnostic and therapeutic skills through specific courses and hours.”

Some aspects of implementing the new system will be difficult, however. The large number of students attending medical schools each year makes the clinical training almost impossible. Egypt’s 20 public medical schools accept more than 9,000 students a year, with more than 6,000 graduates annually, according to statistics from the Supreme Council of Universities. In addition, about 1,000 students graduate from the country’s three private medical schools annually.

The average cost of teaching a medical student in European countries, the United States and Canada ranges from $20,000 to $25,000 a year, while in Egypt it does not exceed $350 per year, according to Samir.

Manal Al-Sawaf, a professor of anatomy and embryology at Tanta University’s Faculty of Medicine, agrees that the “huge number of students” presents challenges.

Al-Sawaf has previously taught in a number of Arab countries that already use the new system, such as Saudi Arabia and the United Arab Emirates. Medical students in those countries typically are divided into groups of up to 12 students who follow a particular professor throughout the academic year. Such class sizes are impossible in Egypt’s medical schools, she said.

“Students’ numbers are very big here,” Al-Sawaf said. “Even if we divide students into four groups, each group will have at least 250 students,” she said.

Al-Sawaf believes the new system will face other challenges, too, including increasing the teaching burden on educators without any increase in salaries. “The change is not easy and we will need time to come up with the best way to apply it,” she said. “The experience will be the best proof of its success or failure.”

Students, however, are welcoming the new system, especially the aspect of increasing hands-on training time.

“The new students are lucky, as the current system provides us with one year only of practical training and that is never enough,” said Mohammed Salem, a student under the old system at Mansoura University’s Medical Faculty. “They will have the opportunity to work in hospitals since the first year under the supervision of professors.”

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