Introduction

S. Willemstein (Rotterdam, The Netherlands) and
J. de Koning (Nijmegen, The Netherlands)

In this paper the proceedings of the first MED-NET Conference (Rotterdam May 1997) are presented. It provides an overview of the current state of affairs of the Thematic Network.

MED-NET is a thematic network, offering a forum for discussion and communication on actual topics and issues in Medical Education in Europe.
It facilitates information exchange and mobility for those involved in medical education: faculties of medicine, medical schools, hospitals, teachers, education managers and students.

MED-NET acts in a context full of movements. The contemporary setting is characterized by technological and economic developments and by the development of a European, multicultural society. The European dimension is increasingly present in science, in the labour market, as well as in health care. This context necessitates an optimal functioning network for exchange of information in particular in a multidisciplinary encounter of all role players in mobility. MED-NET acts as such a network.

Medical education in itself forms a dynamic entity. The contents of undergraduate education depend on the knowledge level students have acquired at secondary education, on the definition of the final objectives of undergraduate studies, and last but not least, the effectiveness and quality of the educational process. The levels at the commencement of the medical education as well as the final examinations vary to such an extent that at European scale, the final aims of medical education can only be described very roughly. Due to the fact that medical knowledge, measured as the number of scientific publications, doubles every ten years, medical education (also undergraduate) has to be evaluated continuously with regard to the requested contents.

The differences and variations in education require curriculum comparison, in order to allow students to plan study periods abroad, and to enable the teachers to assess the content and quality of the medical education.

Finding your way in medical education in Europe has become complicated and several systems have been set up to guide the traveller. The International Federation of Medical Student Associations (IFMSA) launched the European Medical School Information System (EMSIS). EMSIS provides a database of addresses and general information of medical educational institutes, participation in exchange networks and extensive curriculum information. Dr. Eysenbach elaborates on this in Chapter 2.2. The reference group Education Survey of MED-NET developed another approach, particularly with regard to the collection of data. MED-NET focuses more on the arrangement of education, the educational objectives and goals, and the policy to obtain professional medical competence, rather then just giving a list of disciplines and numbers of lecture hours and practical training. Professor Molina discusses this in detail in Chapter 2.1.

The limited time available for undergraduate medical training forces us to think about the most efficient way to educate students. Many innovative experiments in educational approaches have recently been undertaken. An initial survey is given by Dr. Albano and Dr. Majoor in chapter 3.3. An inventory of activities by the various institutes in Europe is made by the reference group Curriculum Innovation. Dr. Majoor reports on the activities. In the case history of Dr. Holdrinet et. al. (Chapter 3.2) the careful considerations for creating a new curriculum at the Faculty of Medical Sciences in Nijmegen are described.

Limited time available to offer high quality medical education necessitates us to reconsider the required Professionalisation of teachers. Dr. de Koning reports on the first basic discussions by the reference group 'Professionalisation of Teachers' (chapter 4.1). Dr. Patricio reports on the state of the art in Portugal as Dr. Fluit does for the Netherlands and Dr. Playdon for the United Kingdom.

Increased mobility of students and teachers in Europe has led to the European Credit Transfer System. It was launched by the European Commission and now the ECTS for medical studies acts on its own. Implementation in faculties of medicine is discussed by Dr. Winand.

In-depth specialization becomes inevitable in order to keep pace with the current explosion of medical knowledge. The question rises when and where during the learning process, general undergraduate medical education terminates and specialization starts, and how adequate continuing education and vocational training has to be achieved. Postgraduate education therefore needs special attention. In chapter 6.1 Dr. Costigliola reports on the difficulties in identifying European activities in this field. Mr. Antepohl (chapter 6.2) gives a survey of post-graduate education in Germany. A survey of the present state of the art in Europe is given by Dr. Costigliola (chapter 6.3). The extending knowledge of medical sciences forces doctors to lifelong learning. Systems of continuing medical education are developed. Open and distant learning in this case seems very promising. A survey of the activities of EuroTransMed is presented by Dr. Young (chapter 6.4).

Medical education in a multicultural society becomes extensive reality in Europe. International Health education should therefore be part of undergraduate medical training. Health in global perspective is illustrated by Dr. Rosling. A European orientation is given by Dr. Torres (chapter 7).

In combining all efforts as reported on by the authors in this volume, the reference groups of MED-NET find their way in the current challenging and turbulent environment, guiding us towards the complete picture of medical education in Europe.

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