MED-NET Conference 1997. Rotterdam, the Netherlands.
Proceedings 5.1.

Student exchange with ECTS

J. Winand (Brussels, Belgium)

Introduction

The present report is realised as a list of practical advice to implement the ECTS system (European Community Credit Transfer System) in medical faculties , which do not yet use the system. It is based on the experience of the 28 members of the ECTS Medical Inner Cycle who have used the system since 1989. Similar experience has probably also be gathered by other faculties not belonging to the Group but using the system e.g. in ICPs.

Starting points

When you want to start the ECTS system in your faculty, you have first to convince your faculty board about the usefulness and the applications of the system : it is not realistic to exchange students without at the same time recognising the studies done abroad. This means that the faculty has to agree on the principles of the exchange   programs at a general level and not at the level of each course separately. In other words, the faculty recognises the value of Faculty X and not the value of the course of  anatomy in Faculty X.

After the adaptation of the principle (it seems better to agree with countries rather than with single universities), an academic co-ordinator should be designed : the choice is important as the co-ordinator will be the link between all partners : faculty, professors, students of the home university and faculty , professors and students from the host university. The academic co-ordinator has also to collaborate intensively with the institutional co-ordinator whose importance is stressed by the structure of the Socrates program.

The most important detail has then to be performed , i.e. the redaction of the information package. This package has to contain general information about the university, the faculty, the living conditions and facilities of students and the academic curriculum (the EU has provided a format for the redaction of this information package). The curriculum makes use of credits : each study year is equivalent to 60 credits. The calculation of the credits given to each course is in theory based upon the workload of each course. Practically, I would suggest to beginners in the system to determine the relative importance of lectures, practical work, clinical attachments, seminars, personal work, etc. in each study year and to calculate the credits in function of the hours given to each course. Table  1 gives a very simplified example of such calculation. If there is an agreement between the faculty members about the relative difficulties of several courses of the same nature (e.g. lectures), than correction coefficients can be used but this situation will not occur very often . In most cases the introduction of correction coefficients can lead to irritation between faculty members and retardation of the implementation of the ECTS system.

The description of the courses with the use of the ECTS format has to give an overview of the content , the prerequisites, the objectives , the learning method and the assessment of the course. The description of the course should be complete, as in modern medical faculties terms such as anatomy, histology, embryology are not always found back in the titles of the courses and a term such as pathology can have quite different meanings  in different faculties.

Selection of partners in exchange

Once all this preliminary work has been performed the time has come to send students abroad. But, to what universities ? In preclinical years, the choice will be rather limited as in general medical curricula differ enormously from one university to another. The co-ordinator has to find faculties in which the curriculum  corresponds to something like 80 %. This does not mean that 80 % of a comparable study year must fit but that in the receiving faculty the incoming student can readily follow 80 % of the   courses in one or different study years without too much collapsing. It means also that the student has to find solutions for the ± 20 % courses he cannot follow : solutions are to transfer to the following study year in the home university (easier if the student has obtained some extra credits in the host faculty), assessment in home or host university after personal work, participation in written exams in the home university by fax under the responsibility of the co-ordinator, examinations in second sessions at home, etc.

The exchange period

It is clear from experience with the ECTS group that in the preclinical years it is necessary to perform a stay abroad for one year. Sometimes a student can come for one semester but this is rarely a success. The duration of one year is imposed by the following facts: the study programs are so different that finding several comparable courses in the same semester is utopic; the examinations in preclinical years often are written  assessments where a good knowledge of the language is necessary ( the language knowledge of incoming students increases with time and is much better after one year than after one semester). In clinical years the duration of the stay can vary from three months to one year. In those years it is easier to find correspondence between courses: cardiology will always be cardiology!

The students to be exchanged

The next step will be the choice of the outgoing students. It is important at the beginning of a partnership to send only very good students. The quality of the incoming students will convince the host university of the quality of the home university and further contacts will be much easier. If you start by sending a "tourist", the reputation of your faculty will suffer and it will take years to recover this situation. The knowledge of the language of the host faculty is also important but in my opinion the   quality of the student is of prime importance. Nevertheless, the co-ordinator should also insist upon learning of the foreign language not at the moment of departure but several months before. It is also true that  some young people have a tremendous capacity to learn new languages. The choice of the host university is of course important as already stressed above : programs should correspond . The academic co-ordinator should ask for the co-operation of a local selection committee in the selection of the outgoing students. In my faculty, this committee is made of the presidents  of the different study years.

The learning agreements

The preparation of the learning agreement , another important partner in ECTS, will be the next step. On the special forms, student and co-ordinator indicate the courses that should be followed by the outgoing student. These courses can be given in the receiving institution in different study years. The number of credits is also  indicated and must grossly correspond to about 60 credits for one study year. It is not necessary to really have exactly 60 credits as credits for the same course can differ enormously from one faculty to another (dermatology is good for 17 credits in Vienna and for 2.5 credits in Brussels). A range from 50 to 75 credits seems reasonable.

The host university agrees with the learning agreement and then your student is ready to leave. Many times once he or she has arrived at the host institution , the student will see that his learning program is not the best one he could do. It is indeed difficult in another country to be aware of all the subtleties in the courses , the way of teaching , in a given university. In such a case , a revision of the learning program must be done in agreement with the two co-ordinators.

Feedback and assessment

Then a period follows where the local co-ordinator has only scarce information of his outgoing students: sometimes they send an Email, sometimes they come to say hello during holidays, but do not think that he is not busy during that period : the incoming students very often come to receive information about all the  academic life and the host co-ordinatoris the only person they can rely on.

At the end of the year, students sit their examinations. The ECTS system  recommends that examinations should be taken together with the local students. This is not always possible as the incoming students, as indicated, are sometimes obliged to take exams in different study years leading to incompatibility in examination time schedules. In my faculty ,  students are obliged to take common exams in their principal study year and can take exams at the moment of their choice for the courses of the other study years. I must recognise that there are problems at this level as ECTS students prefer to take private exams in which the professor often is going to be more generous to a foreign student than in a general examination. It is difficult to make this system understandable to incoming students, who prefer to think about good notes. With some authority of the co-ordinator and information of the professors and the students acceptable solutions can however be found.

After the examinations the co-ordinator has a last job, the redaction of the transcript of records. In this transcript the results of the students are described and for each course the credits and grades are indicated. The ECTS system describes the way grades should be calculated. For each course,  a Gauss curve is constructed on the basis of all results from students who did succeed, with the A grade meaning that the student is in the upper 10 % of the promotion, the E grade meaning that the student is in the lower 10 %. One condition is that the incoming student should take the exam with the  home students. Often this is not the case as the incoming student has to follow courses in different study years and is unable to follow the normal exam schedules. Private exams are then necessary for the incoming students who generally try to extend all of their exams to that kind of exams. Indeed, often normal exams consist of multiple choice exams where the knowledge of the language is crucial and this constitutes a handicap for ECTS students.

Finally, when the student leaves, you have to send a transcript of records to the home university. The calculation of the credits is easy to perform as they were designed in the learning agreement : the only verification you have to make is to see that the student has succeeded in all the proposed courses. The calculation of the grades is much more complicated as you need  the Gauss curve of all the students who succeeded the exam. Often you have these results only at the end of September while your colleague (and its student ) call out for  them in July! A good way to answer to this difficulty is to use the Gauss curve from the proceeding year. This can be done when the teaching was not significantly different between the two  years. Another good advice is to know exactly what your partner in the home university expects from you: faculties principally working with grades and less with credits will appreciate a nice description of the rank of the student in the promotion (see Table 2). On the other hand faculties attaching less importance to credits will not mind if you do not insist too much upon them. So even at the level of exchanges of information between co-ordinators, some differences may appear.

Conclusions

In conclusion, the implementation of the ECTS system in medical faculties needs some important elements : the desire of the whole faculty to participate in the system, the redaction of the information package,  the designation of an active and motivated academic co-ordinator, who efficiently collaborates with the institutional co-ordinator, the choice of outgoing students on quality, the flexibility in the taking of decisions at all levels, the knowledge that each outgoing student is a different story. The reward is nevertheless very high: the satisfaction of your students when they come back and the gratitude of the students when they return to their home faculty.

Table 1 : How to calculate credits?

Table 2 : How to transmit grades?

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