Workshop on ECTS

J. Winand (Brussels, Belgium), R. Möllby (Stockholm, Sweden), K. van Liempt (Antwerp, Belgium), M. Vijande (Oviedo, Spain) and J.P. Wauters (Lausanne, Switzerland)

The Workshop was attended by 42 participants from 15 European countries representing 34 different medical schools. The session was presided by J. Winand with the aid of R. Möllby, K. van Liempt, M. Vijande and J.P. Wauters, members of the ECTS Medical Club.

The first speaker was K. van Liempt from the University of Antwerp who explained that a good preparation of the study programme for a leaving ECTS student is an essential move towards success! He made the following conclusions: ECTS can only be successful when it is considered in the faculty as an important item. The departmental co-ordinator is the key-person in the ECTS system. Only when he or she is doing the job well , the system works. It means that this task is rather time-consuming and takes more or less of 15 % of the assignment of the academic responsible . The assistance of a part-time secretary is also indispensable (in Strasbourg with more than 100 incoming students a full-time secretary is working).A good selection procedure for applying students is crucial. A carefully prepared study-program can lead to the conclusion that a proposed stay abroad can not take place (or has to be postponed for one year or another destination has to be chosen). The agreed study program has to be clarified and established before the departure of the student and with his implication.

A first question from the audience (Giessen) concerned the changes that could be made to a learning agreement . Of course, the learning agreement can be changed once the student arrives at the host faculty. Often the student realises once he/she is in his/her new faculty that his choice was not the best. Together with the two co-ordinators (home and host ) an adaptation of the agreement can be performed illustrating one of the main rules of ECTS, flexibility. Clearly what should be avoided is that the student decreases the courses he/she should take without compensation. Bureaucratic difficulties can be resolved if there are regular meetings of departmental and institutional co-ordinators.

A main problem in the ECTS system concerns the grading system. The only correct way to communicate the ECTS grade is to transmit the exact rank of the student in the promotion for one particular course (e.g. 15th out of 125 students). This is very easy to perform in faculties quoting the students upon 20 points or 30 points, because the exact place of the student in the promotion is easy to determine. Things are much more difficult in faculties where the quotation is mainly fail/pass or limited to only a few items (A to D; or 1 to 6). What should be avoided is to correlate automatically one note (e.g. B to B in the ECTS system : indeed, if the student with B is the best in his promotion then he merits a grade of A in the ECTS classification).The utilisation of the guidelines of the EC on grades could also be useful at this level. In case of the "pass/ no pass" system, the local co-ordinator can ask his professors to indicate the value of the ECTS student as excellent, very good, good, etc. This should be done for home faculties where grades are important. This again stresses the importance of the role of the co-ordinators and of their knowledge of what is needed in the host university. Other possibilities to find a correct grade are the comparison with previous studies performed by the outgoing student. A special exam for the student can also be forwarded.

The situation in Germany is complicated by the fact that there is a higher instance which eventually gives the grade of the examination. Several interventions stressed the necessity to insist upon these instances to make an application of the European rules and not of the local rules. Once Germany decided to join Erasmus and Socrates their political power should accept the rules ! It seems that the position of the different "Landern" is different and that e.g. Stuttgart recognises automatically the subjects studied abroad.

Roland Möllby from the Karolinska Faculty explained some easy ways to apply the ECTS system. Karolinska exchanges students through ECTS as well as through ICPs with equal success. Nevertheless, he thinks that ECTS makes things easier and not more complicated. Annalena Paulsson explained the feed-back used by Karolinska from students who went abroad . The students upon their return write a report on the following topics: preparation prior to departure, arrival and registration, finances (cost of living, rent,...), accommodation, studies , language, leisure and social activities,...This information is sometimes more valuable than the information package. For this reason, in Brussels, these student reports are joined to the information packages of the different universities. The names, addresses and telephone numbers of students who went away are also very interesting in this view. Roland Möllby then developed the idea that personal solutions often are necessary to have favourable exchanges. He advises to contact the course director of the outgoing student in advance to find out what is essential to evaluate the available course plan. When a course is given in more than one year, the solution is to jump between years. Sometimes theory and clinical practice are used at home while in the host university only theoretical courses are available : the solution is to give extra clinical practice at host or at home . Finally, when all required parts of a course are not available, complementary studies in theory as well as in practice can be performed at home together with the examination. In more than 80 % of the cases a personal solution must be found.

Jacques Winand insisted upon the fact that sometimes you have to tell the student that he/she has to take some examinations when he/she comes back. The important thing is that the students have to know that before they leave. In most cases, this will not arrest the students from going abroad.

Professor Pfeiffer (Erlangen) insisted upon the language preparation: in his view, a student should not go away without being fluent in the language of the host university. He estimates that in his university this lack of language knowledge is one of the big obstacles to exchange. J. Winand agrees with the importance of the language knowledge but thinks that , as the learning agreements are made in March - April and as the student does not leave before September- October , 6 months are sufficient to prepare for the exchange. This means however that the student should start to learn the language in March - April and not later. A perfect knowledge of the language before leaving is not necessary especially when the student leaves for one year. Of course when the outgoing student wants to perform clinical attachments from his first day on , his language knowledge must be optimal. Faculties situated in countries with less spoken languages have more difficulties to integrate in the European exchange programs. This can easily be seen when exchange statistics are shown. One way to increase these exchanges is to have part of the learning program given in English. This could also be a way to increase the possibilities to study abroad in English. At the level of clinical attachments where a contact with the patient is necessary, the formation of binomes between an incoming student and a local student could offer a solution (like is done in Stockholm).

In conclusion, the workshop stressed the important elements for the co-ordination of an ECTS program. When the workload for the co-ordinator is considered, the time devoted to co-ordination is very elevated. At the beginning of the year, the files of the outgoing students have to be set up. This is a considerable job and it is followed by the follow-up of the dossier once it has been transmitted to the host university. A great deal of time is devoted to find the personal solution of the outgoing student. Once the student has left for the host university, the co-ordinator has to follow the learning agreement and has to remain in contact to make the return back of the student easy. He/she has to collect the grades and credits of the student and transmit them to the Academic Authorities. In the meantime, the co-ordinator has to be present to integrate the incoming students in the local system. This necessitates several hours of work every week. The organisation of clinical attachments and of particular exams, the integration in the cultural and social life , the help with language , accommodation, the preparation of the Transcript of Records and often of other documents needed in the home university are also time consuming. Another time consuming job is the redaction of the information package and to bring it up to date. Calculation and transmission of credits and grades has to be done at the right moment. The co-ordinator must be aware of the particularities and expectations of the exchange partner and transmit the data in such a way that they are very precious to his partner. In other words, when the home university principally works with grades and not credits, a reasonable transmission of grades should be performed even if the host university attaches no importance to grades. On the other hand, when the home university principally needs credits, a very correct evaluation should be made of these credits. This evaluation is easier than that of grades as it has normally been decided in the learning agreement .

Student exchanges at the level of medical schools are a necessity! Our future doctors should be aware that medical education can very much differ from one country to another. They are capable once they are doctors to import the good things from abroad in the national education. This is even likely to happen as the selection of the outgoing students should be principally based on quality: so, chances are high that many of these doctors having been present in the ECTS exchange programs will make academic careers and will be effectively able to interfere with medical curriculum.

An important factor is that co-ordinators should have the possibility to meet regularly. The experience of the authors of this report shows that effective comprehension, adequate exchanges and rapid reactions to novelty can be obtained by these personal contacts. The ECTS Medical Club has decided to continue with annual meetings with a well-defined program where all new developments in medical curricula in the participating faculties are presented and discussed.

The exchange program, to function optimally, needs that quality at all levels and flexibility at all levels are present. The system cannot live without common sense of all participants. It is also important to know that every exchange is a particular one and that every time personal solutions have to be found!

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