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Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                 26 September, 2011




        ASSOCIATION FOR MEDICAL                      SCHOOL OF MEDICNE
       EDUCATON WESTERN PACIFIC                   HEALTH SCIENCE UNIVERSITY
               REGION                                   OF MONGOLIA




                   SELF- EVALUATION REPORT


              BASIC MEDICAL EDUCATION PROGRAMME
                               FOR
                       “MEDICAL DOCTOR”
                             (D720300)




                                  ULAANBAATAR
                                      2011




                                                                                 1
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                 26 September, 2011

   Working group
   Director
   Ts.Lkhagvasuren Academician, MD, PhD, ScD President of HSUM
   R.Otgonbayar MD, PhD, MPH Dean School of Medicine


   Deputy Director
   D.Amarsaikhan MD, PhD, Vice President for Academic affairs


   Secretary
   D.Otgonbayar MD, PhD Head of Division of Educational Policy and Management, HSUM


   1. MISSION AND OBJECTIES
   Ts.Sarantuya, MD, PhD, M.B.A-P.M. Deputy Dean School of Medicine for Academic affairs
   V.Nyamtsengel MD, Lecturer of Department of Infectious diseases


   2. EDUCATIONAL PROGRAMME
   D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM
   B.Bayarmagnai MD, PhD, Coordinator Division of Educational Policy and Management, HSUM
   B.Solongo MD, PhD Head Department of Pulmonology
   T.Navchaa MD, PhD Lecturer of Department of General practice and Preventive Medicine
   D.Baigalmaa MD, Lecturer Department of Pediatrics


   3. ASSESSMENT OF STUDENTS
   B.Oyungoo MD, PhD, Coordinator Division of Educational Policy and Management, HSUM
   Ch.Chinzorig MD, Coordinator Division of Educational Policy and Management, HSUM
   S.Sainbileg MD, Lecturer Department of Endocrinology
   Kh.Delgerdalai MD, Coordinator School of Medicine
   B.Oyuntugs MD, Lecturer Department of Endocrinology


   4. STUDENT AFFAIRS
   A.Gurbadam PhD, Dean of Student Services
   Kh.Delgerdalai MD, Coordinator School of Medicine
   B.Oyuntugs MD, Lecturer Department of Endocrinology
   E.Enkhtamir MD, Lecturer Department of Nephrology


   5. ACADEMIC STAFF / FACULTY
   S.Naranchimeg MD, PhD, Head Department of Professional Basic Skills

                                                                                                 2
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                   26 September, 2011

   A.Otgonbat MD, Head Department of Hematology
   B.Ariunzaya MD, Lecturer Department of Pharmacology
   6. EDUCATIONAL RESOURCES
   P.Tseden MD, PhD, MBA Vice President for Finance and Monitoring
   R.Oyungerel MD, PhD Deputy Dean School of Medicine for Research and Foreign affairs
   D.Ichinnorov MD, PhD, Assoc Prof, Deputy Dean School of Medicine for Clinical affairs
   B.Erdenebulgan MD, PhD Lecturer Department of Oncology
   S.Ariunaa, Accounts Department
   7. PROGRAM EVALUATION
   D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM
   Ts.Erdembileg MD, PhD Lecturer Department of Radiology
   8. GOVERNANCE AND ADMINISTRATION
   N.Sumberzul MD, PhD Vice President for Research and Information Technology
   G.Ariuntuul D.D.S.,PhD, FICD Dean of Graduate Training Center of HSUM
   D.Tsogt-Ochir MD, Coordinator School of Medicine
   V.Byambasuren MD, Coordinator of International Relations of HSUM
   9. CONTINUOUS RENEWAL
   D.Amarsaikhan MD, PhD, Vice President for Academic affairs
   D.Baigalmaa MD, Lecturer Department of Pediatrics


   Translation team
   Indermohan S Narula, MD, MPH (Hawaii) MTropMed (Liverpool) Consulting Editor
   R.Otgonbayar MD, PhD, MPH Dean School of Medicine
   Ts.Sarantuya, MD., PhD, M.B.A-P.M. Vice Dean of Academic affairs
   D.Baigalmaa MD, Lecturer Department of Pediatrics
   D.Narantungalag MD, PhD, Lecturer Department of Pharmacology
   N.Khaliun MD, Lecturer Department of Pharmacology
   S.Alimansaran MD, Lecturer Department of Neurology
   D.Byambasuren MD, PhD, Lecturer Department of Neurology
   P.Munkhbaatar MD, Lecturer Department of Otolaryngology
   Kh.Erdenedelger MD, Lecturer Department of Dermatology
   D.Densenbal MD, Lecturer Department of Pulmonology
   N.Bayalagmaa MD, Lecturer Department of Hematology
   s.Duurenjargal MD, Lecturer Department of Hematology
   E.Enkhtamir MD, Lecturer Department of Nephrology
   N.Bat-Erdene MD, Lecturer Department of Cardiology
   V.Byambasuren MD, Coordinator of International Relations of HSUM

                                                                                                   3
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                                                                        26 September, 2011




      CONTENT
      FOREWORD.........................................................................................................................................6
      AKNOWLEDGEMENT........................................................................................................................7
      MESSAGE FROM THE DEAN............................................................................................................8
     The management of the School of Medicine acknowledges the contribution of the many people involved
in the development of the self-evaluation report for the accreditation by the Association of Medical Education,
Western Pacific Region. First and foremost, I would like to express my deep appreciation to J.Tsolmon,
member of the Management Board of the HSUM, T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan,
Vice president for academic Affairs, D.Otgonbayar, Head of the Division of Education Policy Coordination,
A.Gurdadam, Head of the Division for Student affairs, and all former presidents for management and
methodological guidance to successfully accredit the Basic medical education program self-evaluation report
by the internal accreditation.........................................................................................................................8
    I would like also to express my gratitude to the HSUM management council for valuable comments and
thoughts........................................................................................................................................................9
    I also grateful to other professional staff from the School of medicine, Biomedical school and Public
health school for active participation in the development of the report despite busy schedule and heavy
workload. The financial and methodological support by the Ministry of Education, Culture and Science was a
valuable contribution to our work................................................................................................................9
    I would like to express my gratitude to our main stakeholders such as primary health care management,
doctors and practitioners on behalf of the School of Medicine.....................................................................9
    Let me share with you what I learned most about the School and our training program during the
preparation to the evaluation. ......................................................................................................................9
    1.Our “Basic medical education” medical degree program is very high quality. We should be proud of the
program and our graduates who are competent and able to meet health sector needs, while ready to work hard
on improving the program even further........................................................................................................9
    2.We also have very good data that shows high level of student satisfaction. We also identified areas that
will benefit from further improvement.........................................................................................................9
    3.The School of Medicine is a leading medical school in Mongolia, independent organization with fully
developed structure 70 years of history, with leading academic staff, professors and medical professionals of
the health sector...........................................................................................................................................9
      4.Our school functions very successfully. This is shown in the results of the Health Department, the
Government implementing agency under the MoH, license examination and employment status of graduates.
.....................................................................................................................................................................9
    5.During 3 year of development and 12 year of implementation, the integrated program has undergone 4
times revisions and improvements, to become international standard program for the training of medical
practitioner with broad knowledge, high skills and adequate attitude..........................................................9
     6.It is not secret that the self-evaluation process resulted in our self-development too. We identified areas
for improvement and we need to work on them in the near future. ............................................................9
    My colleagues, our professors, teachers and students of the Health Sciences University of Mongolia, I
look forward to working with you more to make our medical school and a truly great medical school.......9
      R.Otgonbayar, Ass. Professor, PhD.......................................................................................................9
           .......................................................................................................................................................10
      EXECUTIVE SUMMARY ................................................................................................................11
      INTRODUCTION .............................................................................................................................13

                                                                                                                                                                       4
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                                                              26 September, 2011

   1. MISSION AND OBJECTIVES ......................................................................................................13
          1.1. Statement of Mission and Objectives....................................................................................13
          1.2 Participation in Formulation of Mission and Objectives........................................................15
          1.3 Academic Autonomy.............................................................................................................17
          1.4 Educational Outcome.............................................................................................................18
          Reference chapter 1.....................................................................................................................21
   2. EDUCATIONAL PROGRAM.......................................................................................................23
          2.1. Curriculum Models and Instructional Methods ....................................................................23
          2.2 Scientific methods..................................................................................................................29
          2.3 Basic Biomedical science.......................................................................................................32
          2.4. Behavioral and Social Sciences and Medical Ethics.............................................................34
          2.5. Clinical Sciences and skills ..................................................................................................38
          2.6. Curriculum structure, composition and duration...................................................................40
          2.7. Program management ..........................................................................................................52
          2.8 Linkage with Medical Practice and Health Care System........................................................55
          Reference chapter 2.....................................................................................................................60
   3. ASSESSMENT OF STUDENTS.....................................................................................................63
          3.1. Assessment methods.............................................................................................................63
          3.2       Relation between Assessment and Learning....................................................................69
          Reference chapter 3.....................................................................................................................72
   4. STUDENT.......................................................................................................................................73
   4.1. Admission Policy and Selection ...................................................................................................73
          4.2. Student Intake .....................................................................................................................74
          4.3 Student Support and Counseling...........................................................................................75
          4.4Student Representation...........................................................................................................80
          Basic standard:.............................................................................................................................80
          Reference chapter 4. ....................................................................................................................82
   5. ACADEMIC STAFF/FACULTY ...................................................................................................84
          5.1 Recruitment policy ................................................................................................................84
          5.2. Staff policy and development................................................................................................86
          Reference chapter 5.....................................................................................................................92
   6. EDUCATIONAL RESOURCES...................................................................................................93
          6.1 Physical facilities ..................................................................................................................93
          6.2. Clinical training resources .................................................................................................101
          6.3. Information technology ......................................................................................................105
          6.4. Research..............................................................................................................................108
          6.6 Education exchange.............................................................................................................117
          Reference chapter 6....................................................................................................................119
   7. PROGRAM EVALUATION.........................................................................................................121

                                                                                                                                                           5
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                                                                    26 September, 2011

         7.1 Mechanism for Program evaluation.....................................................................................121
         7.2 Teacher and student feedback..............................................................................................122
         7.3 .Student performance...........................................................................................................128
         Reference chapter 7....................................................................................................................134
   8. GOVERNANCE AND ADMINISTRATION...............................................................................136
         8.1. Governance.........................................................................................................................136
         8.2. Administration....................................................................................................................138
         Reference chapter 8. ..................................................................................................................140
   ..........................................................................................................................................................140
   9. CONTINUOUS RENEWAL.........................................................................................................141
         Reference chapter 9....................................................................................................................142




   FOREWORD




                                                                                                                                                                   6
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards   26 September, 2011




   AKNOWLEDGEMENT




                                                                   7
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                           26 September, 2011




   MESSAGE FROM THE DEAN



The management of the School of Medicine acknowledges the contribution of the many people
involved in the development of the self-evaluation report for the accreditation by the
Association of Medical Education, Western Pacific Region. First and foremost, I would like to
express my deep appreciation to J.Tsolmon, member of the Management Board of the HSUM,
                                                                                           8
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                             26 September, 2011

T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan, Vice president for academic
Affairs, D.Otgonbayar, Head of the Division of Education Policy Coordination, A.Gurdadam,
Head of the Division for Student affairs, and all former presidents for management and
methodological guidance to successfully accredit the Basic medical education program self-
evaluation report by the internal accreditation.

I would like also to express my gratitude to the HSUM management council for valuable
comments and thoughts.

I also grateful to other professional staff from the School of medicine, Biomedical school and
Public health school for active participation in the development of the report despite busy
schedule and heavy workload. The financial and methodological support by the Ministry of
Education, Culture and Science was a valuable contribution to our work.

I would like to express my gratitude to our main stakeholders such as primary health care
management, doctors and practitioners on behalf of the School of Medicine.

Let me share with you what I learned most about the School and our training program during
the preparation to the evaluation.

      1. Our “Basic medical education” medical degree program is very high quality. We
         should be proud of the program and our graduates who are competent and able to
         meet health sector needs, while ready to work hard on improving the program even
         further.
      2. We also have very good data that shows high level of student satisfaction. We also
         identified areas that will benefit from further improvement.
      3. The School of Medicine is a leading medical school in Mongolia, independent
         organization with fully developed structure 70 years of history, with leading
         academic staff, professors and medical professionals of the health sector.
      4. Our school functions very successfully. This is shown in the results of the Health
         Department, the Government implementing agency under the MoH, license
         examination and employment status of graduates.
      5. During 3 year of development and 12 year of implementation, the integrated
         program has undergone 4 times revisions and improvements, to become
         international standard program for the training of medical practitioner with broad
         knowledge, high skills and adequate attitude.
      6. It is not secret that the self-evaluation process resulted in our self-development too.
         We identified areas for improvement and we need to work on them in the near
         future.

My colleagues, our professors, teachers and students of the Health Sciences University of
Mongolia, I look forward to working with you more to make our medical school and a truly
great medical school.



R.Otgonbayar, Ass. Professor, PhD




                                                                                              9
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards   26 September, 2011




                                                                  10
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                         26 September, 2011




    EXECUTIVE SUMMARY


The Self-evaluation report was written based on Guideline of Association of Medical Education, West Pacific
Region.
Chapter one:
Shows how the mission, objectives, values, and the HSUM and School of Medicine development master plan
adheres to the goal and objectives of the “Basic medical education” program, as well as compliance with these
goal and objectives and with the medical doctor’s model, job description and accreditation.


Chapter two:
Shows that the “Basic medical science” program content is consistent with regulations and standards of the
education sector, as well as with the educational organization policy, meets the local market needs, is
continuously upgraded in line with human, scientific, technological developments and achievements. It also
reflects the progress in the teaching method and technologies to meet international standards, program
management system and its activities.


Chapter three:
Covers information on the evaluation of the teaching and learning processes, methods to assess student
knowledge, skills and attitude. Reflects and summarizes how this evaluation and assessment promotes student
learning process and how it links to the training methodologies employed in the program.


Chapter four:
Informs about regulations for student admission, legal environment for educational services for students,
tuition fees, student movement, direct and indirect costs per student, activities to support the development of
students into members of the society, ethical and other norms of health institutions and the information on the
employment status of the graduates.


Chapter five:
Reflects information on “Basic medical science” program’s human resource policy, planning, structure,
situation in academic grades, its development; appraisal of the teacher’s educational, research and specialty
activities; salaries and other sources of income.


Chapter six:
Describes the general requirements and standards for classrooms, strengthening of material basis, activities to
improve the training environment, establishment of new laboratories, listing of financial sources, sponsorships
and support and development perspectives. The chapter is based on evidence of the establishment of
connections with related departments of foreign universities to learn from their experience in planning and
implementing similar programs; implementation of student and teacher exchange program and its future
directions.


Chapter seven:
Describes and concludes about the program evaluation and its development mechanism, evaluation methods
used, evaluation status, graduates competency evaluation as its main product and graduates’ employment
status.
                                                                                                            11
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                   26 September, 2011


Chapter eight:
Informs about the SOM structure, governance and management.


Chapter nine:
Summarizes the training program development to meet international standards, the development processes,
and innovations.




                                                                                                    12
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                       26 September, 2011


    INTRODUCTION

Health Sciences University of Mongolia (HSUM) is the state university. It was founded in 1942 as the Faculty
of the Mongolian State University and then established as the independent Medical Institute in 1961. It was
next extended as the Medical University in 1995; and in 2002 it was designated as the University of Health
Sciences and currently includes ten constituent schools.

As the oldest and largest university, HSUM has been the main source to produce medical professionals for the
nation and has so far produced 10,000 medical graduates and other health care providers.

The School of Medicine (SOM) was reorganized as a constituent institution of HSUM in 2003 and has, since
then produced over 1900 graduate alumni with a Bachelor degree in medical sciences.

    1. MISSION AND OBJECTIVES

    1.1. Statement of Mission and Objectives

Basic Standard
The medical school must define its mission and objectives and make them known to its
constituency. The mission statements and objectives must describe the educational process
resulting in a medical doctor competent at a basic level, with an appropriate foundation for
further training in any branch of medicine and in keeping with the roles of doctors in the
health care system.


Quality development
The mission and objectives should encompass social responsibility, research attainment,
community involvement, and address readiness for postgraduate medical training.
The Vision of the School of Medicine is to be recognized internationally as the leading Mongolian medical
school to deliver academically excellence medical education, high quality research and health services.
Mission and Objectives

HSUM mission is to be recognized as the leading national university which produces future graduate
health care professionals capable of meeting the national, regional and global, healthcare demands;
to integrate research, education and health care delivery; and to compete in competency based
society.



SOM mission is to be recognized as the leading national medical school which is distinguished by its
innovative educational approach and methods; introducing international standard higher medical
education, world-class level of medical research, and promote the proper use of modern medical
technology in health care services.


Core value

                                                                                                          13
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                 26 September, 2011


   •   Democracy and Liberty

   •   Integrated curriculum

   •   Historical Experience

   •   Professional Human Resource

   •   Academic Autonomy

   •   Highly Valued Graduates



Strategies


We are confident in the advancement of our strategies to achieve the establishment of our mission and
objectives of School of Medicine




Strategy 1. Development of a quality medical education program

   •   To develop a quality medical education program including academic autonomy, curriculum
       content and outcome, innovative teaching methods, modern evaluation and student
       assessment techniques

   •   To produce high quality graduate professionals with the required competencies to meet health
       care challenges and needs of society

   •   To develop teacher – student friendly environment



Strategy 2. To improve the quality of medical education and to aim for a world-class level of
education.

   •   To encourage and support attendance of young lecturers in educational and research
       exchange programs in developed countries and prepare younger lecturer’s generation and
       enhance the human resource capacity

   •   To establish research laboratories which meets international standards with high
       technological tools and implement national and international research activities in diagnosis,
       treatment and in screening.

   •   To establish effective international collaborations in science and technology

   •   To provide and support international student exchange programs.


                                                                                                  14
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                 26 September, 2011



Strategy 3. Contribution of modern medical technology in health care service

   •   To develop the capacity of the Erkhes outpatient clinic through building high technology
       research – teaching – service

   •   “To obtain the national medical accreditation certification for the SOM outpatient Clinic”

   •   To expand the number of university teaching hospitals



The mission statement and strategies are derived from following government policy documents,
national programs and HSUM strategies:

   •   Health Law

   •   Higher Education Law

   •   Science and Technology Master Plan, MECS 2007-2020

   •   Health Sector Master Plan, MOH 2006-2015

   •   Primary Health Care Development Project, World Health Organization

   •   Third Health Sector Development Program, Asian Development Bank

   •   Health Project, Millennium Challenge Account

   •   Strategic Plan, HSUM 2007-2016

   •   HSUM Development Program 2010-2012



School of Medicine through a 6 year Integrated Curriculum of Basic Medical Education is producing
medical doctors, who meets the main job description requirements of soum health centres and FGPs.



SOM is cooperating with Postgraduate Training Institute and Masters’ and Doctorate Department of
HSUM on the postgraduate, residency training and continuing medical education. The whole system
challenges the doctors and provides an opportunity for graduates as medical doctors to continue
specialist and continuing training.



   1.2 Participation in Formulation of Mission and Objectives

Basic standard


                                                                                                    15
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                  26 September, 2011

The mission statement and objectives of a medical school must be defined by its principal
stakeholders.


Quality development
Formulation of mission statements and objectives should be based on input from a wider range
of stakeholder.


The mission and objectives are defined by the participation of principal and a wide range of
stakeholders such as members of HSUM board, academic staff and students. School of Medicine also
worked closely with following partners in the development of its Mission Statement and Objectives:



   •   Patients and Community

   •   Primary Health Care Facilities

   •   Curriculum Committee

   •   Faculty and Student Development Committee

   •   SOM Administrative Committee
   •   HSUM Administrative Council

   •   HSUM Steering committee

   •   Academic counsel


The main principles are to implement and achieve the mission and objectives of the curriculum
through the involvement and representation of students, employers or health managers and graduates
in the curriculum management process along with harmonizing our mission and objectives to address
the health needs of the public and also reflecting comments and opinions of graduates, employers
when updating the mission and objectives by undertaking the following activities:
   •   Joint meeting of graduates and employers, inter universities and professional organizations
       joint workshops and meetings, conferences.
   •   Joint Meeting with Ministry of Health, and its clinical hospitals and district and aimag health
       departments and hospitals, affiliated hospitals managers.
   •   Organizing “Professors and graduates meeting” with rural doctors and specialists.

   •   "Altan Gagnuur" annual meeting of professors and graduates from generation to generation

   •   (each year all graduates with same last number of graduation year with 10 years gap are
       celebrating they graduation, such as all graduates 1951, 1961, 1971, 1981, 1991, 2001. 2011).


                                                                                                   16
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                    26 September, 2011

   1.3 Academic Autonomy
   Basic standard
    There must be policy for which the administration and faculty / academic staff of the medical school
are responsible, within which they have freedom to design the curriculum and allocate the resource
necessary for its implementation.
   Quality development
    The contributions of all academic staff should address the actual curriculum and the educational
resources should be distributed in relation to the educational needs.


According to Higher Education Law the HSUM has the authority to define its educational policies
and strategies. The main body responsible for ensuring curricular autonomy is Division of Medical
Educational Policy and Management (DMEPM), HSUM which is responsible for establishment,
direction and oversight of the general educational policy at HSUM, monitoring the broad scope of
the curriculum and the overall coordination and implementation of the program schedule.

In accordance with HSUM policy, SOM has the overall responsibility for the implementation and
further development of the basic medical education program. Academic freedom and institutional
autonomy is enshrined in the SOM policy and operationalised through the activities of its Curriculum
Committee. The Curriculum Committee of SOM determines its own policies and procedures for
teaching, institutional management and accountability within the framework of the HSUM Master
Plan, Educational rules and regulations in close coordination with DMEPM, HSUM. The Curriculum
Committee, SOM has the responsibility for developing, governing, maintaining and monitoring the
BME curriculum through the cooperative work of all faculty staff and students operating through its
three subcommittees.

The Curriculum Committee has three subcommittees each with its specific role and participating in
the process of curriculum development. The Curriculum Strategy Subcommittee has the
responsibility to define the goals, objectives and outcome of the BME curriculum in accordance with
HSUM strategy and social accountability. The Curriculum Standards Subcommittee has
responsibility for defining the goals, objectives and standards of the curriculum for individual block,
line and clerkship and for the courses. The Curriculum Evaluation Subcommittee is responsible for
the creation of a curriculum quality system to ensure continuous curricular improvement and refinement.

Each department plays an important role in formulation of curriculum content, course objectives and
course standards. Academic staffs in the each department of SOM engage in the curriculum
designing, planning, implementing and monitoring processes through determining specific needs of
the program, identifying and introducing innovative methods of teaching.

Also, there are 73 faculty staffs from Biomedical School and 21 Public Health School of HSUM that
participate in the development and implementation of the integrated curriculum of basic medical
education program at SOM (See Chapter 5).
To develop continuing training of our graduates, SOM also has the responsibility to provide
graduate; residency; postgraduate; and specialized medical programs, along with Master and
Doctoral Degree programs. These activities are facilitated with strong collaboration of Postgraduate
Institute, HSUM and City Health Department as well as Family Health Centers, Central Hospitals
and Health Centers.



                                                                                                       17
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                   26 September, 2011

   1.4 Educational Outcome

Basic standard
The medical school must define the competencies that students should exhibit on graduation in
relation to their subsequent training and future roles in the health care system.


Quality development
The linkage of competencies to be acquired by graduation with that to be acquired in
postgraduate training should be specified. Measures of, and information about, competencies
of the graduates should be used as feedback to program development.


The goal of the basic medical education program is to prepare a competent medical doctor who is
broadly educated and capable to work ethically and effectively at primary health care service to
provide personal, primary and continuing health care in Mongolia.


The outcome of basic medical education program at SOM is to produce a medical graduate (general
physician) who possesses scientific knowledge, adequate clinical and communication skills to meet
the health care delivery requirements in Mongolia and be capable of pursuing continuous
professional development.


The departments of School of Medicine have the primary purpose to prepare specialists with superior
characteristics by implementing the Integrated Curriculum which consists of basic sciences 12
subjects, 21 basic professional blocks (1 block curriculum with 4-8 departments participating), and
professional training or clerkship with 16 rotations and 18 elective courses.


The educational outcome of Basic Medical Education Curriculum is graduates, medical doctors with
a Bachelor Degree in Medicine. The graduates of SOM meets the Mongolian health sector needs
with obtained basic health science knowledge and clinical skills and attitude and is capable to further
develop through continuing postgraduate training.


The specialty focus of the graduates of Integrated Curriculum study has been defined as follows:
“The Bachelor degree in medicine is directed to be obtain knowledge and skills to provide public
health care, to solve socio-psychological problems, to diagnose and treat common diseases,
prevention from diseases and provide palliative and rehabilitation care within the population”
Knowledge, skills and attitude of medical doctors by Basic Medical Education program are defined
as follows:



                                                                                                    18
Self-Evaluation Report, SOM, HSUM
BME program evaluation by WFME/AMEWPR Standards                                     26 September, 2011

Graduate must be knowledgeable and understand the scientific basis of medicine:
   1. Basic knowledge of the modern biology, physiology and behavioral and social sciences
   2. Knowledge of the normal structure and function of the human body and mind with an
       understanding of stages of human life
   3. Knowledge of the mechanisms by which pathology modifies normal structure and function to
       generate symptoms, signs and abnormal laboratory findings
   4. Knowledge of the various causes and mechanisms underlying diseases among children,
       adolescents and adults.
   5. Diagnostic tools, efficacy and adverse effects of therapeutic interventions

   6. Knowledge of clinical pharmacology, nutrition, behavior and rehabilitation therapies

   7. Knowledge of management of the primary health care

   8. Reproductive health, family planning, pregnancy planning and counseling, primary health
       care in reproductive diseases and pathology, urgent and emergency obstetrics
   9. Health education, preventive medicine

   10. Understanding of individual, family, socio-economic, cultural, religious and environmental
       determinants of causes of health problems
   11. Knowledge of the organization and delivery of healthcare service, financing, health
       insurance, health related legal documentation
   12. Concept of demographic classification of health status
   13. Knowledge of ethical behavior and professionalism
   14. Understanding of the epidemiology of common communicable and non-communicable
       diseases in various population groups
   15. Understanding and identification of important determinants of health and the economic,
       psychosocial, and cultural factors that contribute to disease.
   16. Understanding of approaches useful in reducing the incidence and prevalence of disease


Graduate must be highly skilled in providing care to patients:
   1. Ability to obtain an appropriate and accurate medical history

   2. Ability to perform both a general and an organ system specific physical examination

   3. Ability to perform common clinical procedures in relevant situations

   4. Ability to appropriately investigate the patient’s problem

   5. Ability to choose appropriate and available diagnostic tools for patients


                                                                                                    19
Self-Evaluation Report, SOM, HSUM
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   6. Ability to understand and interpret the results of commonly used investigations and
       laboratory manifestations of both common and important diseases
   7. Ability to apply clinical reasoning in solving diagnostic and treatment problems

   8. Ability to communicate and to inform with patients, their family, and medical staffs

   9. Ability to advise patients and to obtain informed consent before providing any kind of
       clinical procedures
   10. Ability to conclude what is a life-threatening condition and to provide emergency medical
       care for unconscious patient
   11. Ability to manage the medical tools and equipments at the primary care under antiseptic and
       aseptic rules.
   12. Understanding of approaches useful in reducing the incidence and prevalence of disease, and
       intervention during infectious disease outbreaks, and provide epidemiological supervision.
   13. To organize primary and secondary diseases prevention interventions, promote behavior
       change and conduct health education activities among population
   14. Ability to collaborate with a wide range of stakeholders to manage family medicine practice

   15. Ability to use information technology

   16. The ability to retrieve, manage, and utilize relevant information for solving medical problems


Graduates must be able to demonstrate ethical behavior and professional attitude:
   1. Honesty and integrity in all professional interactions
   2. Maintenance of confidentiality

   3. Respect for patients’ right to self-determination, privacy and dignity

   4. Compassionate management of patients
   5. Commitment to advocate the interests of patients
   6. Understanding and respect for cultural, religious and racial differences
   7. Understanding of the special needs of minority groups and those with disabilities

   8. Understanding of the ethical basis of medical practice and major ethical issues in medicine
   9. Ability to recognize and analyze the ethical content of clinical situations
   10. Tolerance of clinical and ethical uncertainty
   11. Understanding of, and respect for, the roles of all health care professionals

   12. Acknowledge personal strengths and weakness, recognizing when to seek counsel and
       assistance

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    13. Commitment to critically assess and continuously improve personal knowledge and skills



Currently, SOM has had its sixth graduation and will have graduated a total of 1921 graduates with a
Bachelor’s degree in medical sciences. The employment rate for SOM graduates has constantly been over
94.8% for the past 5 years. This shows the high demand for these graduates in the health care industry. Data
on continuing training of our graduates in recent 5 years shows that 54.8% (1044graduates) have successfully
completed their residency programs and 43.6% (837 graduates) have passed the specialized medical programs
in 21 disciplines. From these, 370 graduates (19.3%) pursued a M.A. degree and 36 (0.2%) pursued a PhD
degree while they were in the health care service working closely with their academic supervisors. In addition,
the number of graduates pursuing the graduate programs abroad has been growing year by year.

   Reference chapter 1
Statement of mission and objectives of School of Medicine
    1. Health Law , Mongolia
    2. Education Law, Mongolia
    3. Higher Education Law, Mongolia
    4. Science and Technology Development Master Plan, MECS 2007-2020
    5. Health Sector Strategic Master Plan, 2006-2015
    6. Third Health Sector Development Program, Ministry of Health of Mongolia,
    7. Asian Development Bank
    8.   Health Project of the Millennium Challenge Corporation,
    9. HSUM Strategic Master Plan, 2007-2016
    10. “HSUM Development” Midterm Program 2010-2012


Statement of lecturer, student, supporter, employee, interest and donor participating in
formulating mission and objectives
    1. The book “Health Science University of Mongolia”, Ulaanbaatar city, “Erkhes” printing,
       2010, 29p.
    2. Annual Reports of School of Medicine, 2006-2010
    3. Discussions and meeting protocols of Departments presented to the administration committee
       of School of Medicine, 2006-2010
    4. Reports and e-database of Departments of School of Medicine, 2006-2010
    5. Training reports of “Education integrated environment – integrated curriculum standard ”
    6. The alumni annual conventional booklet of “Roseroot” lecturers and graduate students of
       HSUM
Academic autonomy
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   1. Formulary of rules and regulations for Education Policy and management. Ulaanbaatar city,
      Erkhes printing, 2010, 84p
   2. “Establish Education Department” School of Medicine, Dean order
   3.   “Establish Division for Education Policy and Management” HSUM, president order
   4. The to “Establish Faculty and Student development committee” School of Medicine, Dean
      order №A/3, 2011.09.20
   5.   “Establish Curriculum Committee” School of Medicine, Dean order №A/4, 2011.09.22
   6. Questionnaires of lecturers’ opinion and suggestion about curriculum plan, administration,
        implementation and evaluation.


Statement of the accrediting curriculum is compatible with requirements for specialist, model
of specialist and job descriptions.
   1. “Special license for medical training” provided to HSUM, №960003, 15 September,2010

   2. The development document for Medical specialists, 2008
   3.    “The job description standard model of medical professionals”, Minister of Health order #
        442, 2009, www.moh.mn
   4. “Regulation of assistant doctor employment” Minister of Health order # 90, 2008,
        www.moh.mn




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2. EDUCATIONAL PROGRAM

    2.1. Curriculum Models and Instructional Methods
Basic standard:

The medical school must define the curriculum models and instructional methods employed.

Quality development:

The curriculum and instructional methods should ensure the students have responsibility for their
learning process and should prepare them for lifelong, self-directing learning.

Implementation of the project TACIS/Tempus European union “Developing Medical Educational
Framework” since 1995, Canada, Netherlands, Australia, Great Britain, Japan, Taiwan, Thailand, Malaysia,
Korea have introduced integrated curriculum for providing basic medical education. During 1997-1999, the
Medical University initiated the implementation of a model curriculum from the University of the Groningen
(Netherlands) and the University of Leeds (England). The integrated curriculum was developed and
implemented since 2000-2001 with a purpose to train basic doctors who are humane and compassionate, and
have an ethical code, flexible and capable to meet the needs and expectations of the Mongolian society and
the international standards.

Gaining the membership of Asia Pacific Countries’ Medical Education Association (APC MEA) in 2006,
Asia Pacific Countries’ Qualification Network (APQN) in 2008, and Asian Medical Education Association
(AMEA) in 2009 was a step forward to become closer to sustainably implementing the changes recommended
in international education and innovation, science and technology, medical development orientation and in
terms of meeting the demands of today’s health care sector.

Basic medical education program concept

Health care strategies of medical science in XXI century are to prevent diseases instead of treating them after
their onset, to implement guidelines for preventing and managing chronic diseases, to improve capacity of
diagnostic laboratory, to conduct research work, to implement evidence based diagnosis and treatment
approaches, to change unhealthy behavior for individuals, to avoid abusing drugs (Table 2.1).


    Table 2.1. Comparison between medical education program concepts


      №       Indicators          Traditional education program       Integrated education program



                                  To focus on curative medicine        To focus on public health and prevention
      1       Concepts
                              and treatment of diseases           of diseases
                                  Acute and communicable             To reduce risk factors for non-
      2       Disease
                              diseases                            communicable diseases
                                  Diagnosis and treatment based        Diagnosis based on symptoms and
      3       Diagnosis
                              on causes of disease                individual
                                  To focus on treatment for            Not only treatment of diseases in
      4       Treatment
                              diseases                            individual




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                                       Chemical drugs                      Healthy lifestyle
      5           Prevention           Antibiotics                         Unhealthy habits
                                       Vaccine                             Rehabilitation
      6           Profession           Specialization                      General practitioner


Basic medical education technology

Education technology is one of the main instruments to improve the quality of basic medical education e and
during the implementation of an integrated curriculum, we are using the following education technologies:

Global strategy on medical education

Our university’s traditional approach for medical education has been completely renewed by the implemented
international strategy for medical education.

The concepts of the traditional approach for medical education is mainly focused on scientific knowledge, and
does not refer much to the socio-physical aspects and learning; is lecturer centered, content oriented, lectures
dominated, all students participating and participation of students for planning and assessing of learning is
inadequate. Learning is also separately obtained in the various branches of medical science. We conducted
SPICES-T approach for implementing integrated curriculum (Table 2.2).


                                  Our strategy                                          SPICES – T approach
              Lecturer centered              Student centered          •     Student centered

              Lecture based                   Problem based            •     Problem based

                                                                       •     Integrated
              Separated knowledge           Integrated knowledge
                                                                       •     Community oriented
              Hospital oriented              Community oriented
                                                                       •     Elected

              Standard learning              Elective learning         •     Systematic

                                                                       •     Team work
              Tutored                            Systematic



                        Figure 2.1. Global strategy for integrated curriculum on medical education


Coil shaped integrated curriculum

We defined the integration between lessons in accordance with the recommendation of Association for
Medical Education in the Western Pacific Region (AMEWPR) “Curriculum TIPS-Trends, Innovation, Priority
and Strategy” as follows (Figure 2.1):
        • Horizontal integration
          •    Vertical integration
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        •   Integrated interdisciplinary medical science
 By this coil shaped medical curriculum students combine 2 basic purposes, theoretical and medical science,
medical and communication skill, and until they become doctors, students study continually the 3 level
programs I. Healthy constitution, activity and characteristics II. Path anatomy, activities and characteristics
III. Medical practices) (Figure 2.2).



                                             Course goal



            3rd stage Implementing into
                                                                     Branch sciences
        the        clinics2nd     stage
                                                                  Morphology
        Pathology, path physiology,
                                                                  Physiology Genetics
        behavior
                                                                  Surgery    Pediatrics
           1st                   stage
        Normal             morphology,
        physiology, behavior


                                       Organ                 Clinical study (line)
                                       system



                                         Figure 2.2. Coil shaped curriculum
                             (R.H.Harden “Practical guide for medical teachers”, 1997.)


The integrated curriculum model is organized to accommodate the integration of basic science and medical
science and tutor these to all years. In the earlier years basic knowledge is predominated, in the middle years
this ratio is equal, and in final years subjects of medical science dominate. But until graduation students will
acquire knowledge of the basic sciences

    The integrated curriculum is a:
•   Move from problem informing to problem solving
•   Training is brought closer to clinical practice
•   From didactic method of teaching to self learning and student centered training
•   Multidisciplinary
•   Students able to undertake lifelong and continuous training
•   Able to work as a team and with effective interpersonal communication skills
The advantage of integrated medical curriculum is providing the opportunity to medical students to study
clinical skills early and we try to build their capacities in both theoretical and clinical skills.The integrated
medical curriculum includes studying the basic sciences in first 2 years of study and clinical courses within
the framework of interdisciplinary approach through the active communication by lectures and students
learning in small group discussions.

Main principles
The curriculum policy is to implement the training in evidence-based medicine using modern information
technology (Figure 2.3).
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                                                Evidence


                                                                            Quality
                                Info             Integrated
                            tech               curriculum



                                 Figure 2.3. Basic medical education policy
                            (R.H.Harden “Practical guide for medical teachers”,1997.)


Also, the integrated medical curriculum has been using new trends in medical education technology such as
information technology, lifelong learning methods, evidence-based medical science, research methodology,
information management of medical science, communication skills consistent with the curriculum standards
(Figure 2.4).




                                        Figure 2.4. Integrated curriculum
                            (R.H.Harden “Practical guide for medical teachers”,1997.)


Integrated curriculum model

Even though the traditional system was teaching general sciences until 4th year and giving clinical lessons
from 4th year onward.(curriculum H model). H model is based on the medical theory and clinical skill
development (Figure 2.5). Curriculum content is mainly focused on the basic information of the sciences and
health and psychosocial issues. The course is teacher oriented and information flow is from teacher to student,
mainly using the lecture and mini-lecture as teaching methods. One model course covering all students, and
students’ participation was not enough in the course planning and evaluation. The main disadvantage of this
model is that the course teaches medical sciences in very high level and teaches basic medical education
separately.




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                           Z type                                                H type


                                  Clinics
                                                                     Theor            Clinics
                 Theory


                                            Figure 2.5. Curriculum model
    Student assessment technology
Based on Miller’s methodology, SOM has implemented a wide range of new assessment methods of student’s
achievement including knowledge, skill and attitude such as multiple choice tests based on different types of
clinical cases, objective structured procedural examinations OSCE, OSCE checklist, objective structured
procedural examinations OSPE, and DOPS, Mini-CEX (Figure 2.6).




                                                                                                Job place




                                                                                         Skill lab




                     Figure 2.6. Miller’s model of student achievement (Miller G.E., 1990)


The “Basic medical education program” integrated curriculum

The “Basic medical education” integrated curriculum is a complex document which corresponds to the articles
and amendments of the Mongolian Education Law such as “General requirements needed for higher education
institutions”, to the orders and decisions on implementation of higher education by the Minister of Education
and Science, and to the Medical University Regulations developed by the Academic Committee in line with
the above mentioned law and regulations to meet the peculiarities of the HSUM and also be in line with the
orders and regulations of the president of the Medical University.

The integrated curriculum is based on integration of biomedical and medical training, as well as the
integration of practice and theory, improvement of the ability for critical thinking and decision making,
facilitation of self-directed learning processes, enabling learning from advances and achievements in medical
science and technology; enabling the students to choose an interesting field of study; directed towards
reducing the reiterations in a program context; based on an integrated organ level medical skills training;
ensuring the widening of the training context with advanced grades; ultimately based on a problem solving
and student-centered approach. “Basic medical education” curriculum model is showed in Figure 2.7.




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                                     Figure 2.7. Integrated curriculum model


The “Basic medical education” curriculum that has been implemented since 2000 is based on the principles of
an integrated training program, which improves students learning abilities, focuses on integrating knowledge,
practice and attitude training, and corresponds, with the current trends in medical training.

The aim of the curriculum is to train medical doctors who following their graduation are able to improving
the sanitation and hygiene for the population, take actions on preventing illnesses, through organizing public
health interventions, diagnose and manage common diseases, be competent in using various methods of
treatment, possess the capabilities for providing emergency medical care, demonstrate high level of medical
ethics, abide by the laws and legal requirements and be capable of working at the primary care level.

Basic science courses for freshmen are intended to give the students basic knowledge on general science
needed for undertaking higher education, for person development to be humane and to lay the foundation for
further study of professional courses. From second to fifth year, students study in various forms of integrated
training programs which consist of 21 blocks of basic professional and skill development lessons (Table 2.2).

Professional courses are generally studied during years I, II and these give them the capacity to undertake
basic medical education. The content, the selection and the sequence of the courses are decided by the
stipulations of the educational policy of the Medical University, the aim of the department that is responsible
for teaching that specific course, the needs and requirements of employers and the reinforcement of the links
between the professional groups.

Clinical courses are focused on giving the students the capacity to meet social needs and employer’s
requirements. The graduating specialist is the purpose of implementing of our program. We apply the
curriculum model to improve the content, and the listing of the courses is to comply with the requirements
regarding today’s needs. We always do research for continuing development. Based on the new program, over
4 years, besides the basic clinical courses, students are assisted to possess the knowledge, capacity and
inclination towards studying the medical science.




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    Table 2.2. General structure of curriculum
    I grade                  II grade               III grade        IV              V               VI grade
                                                                 grade           grade
Genaral       Must           1-6 block              7-11             12-16           17-21            General
Basic         Study                             block            block           block            Basic
Lesson                        Assimilate            Assimilate abilities of clinical training
                         basic abilities of     program
                         clinical training
                         program
              Selectiv                              Basic professional, selective learning,
              e                                 practicing lessons
                                                                                                     OSPEI, II
              lessons
   United                    OSCEI                  OSCEII                                           OSCEIII
examination


Clerkship is a clinical self directed program that plays an important role in improving the application of their
theoretical knowledge, gained from the block lessons, gaining practical experience, developing their clinical
skills and capabilities, and formulates the structure of their medical ethics and motivations required to become
a competent doctor.

General rules for organization of training activities:

In accordance to training curriculum in basic science and basic professional courses students acquiring
knowledge and skills in following 3 stages:

    •     Preclinical training to acquire basic clinical knowledge and skills (1-6 blocks)

    •     Clinical training to acquire main clinical (7-21 blocks)

    •     Clinical training (Line training and clerkship)

The Medical University’s educational approach is changing from a teacher-centered learning to student-
centered learning. The curriculum achieves this using the following types of teaching lessons:

    •     According to confirmed standards, lectures are being taught as traditional, clinical and interactive
          forms.
    •     Seminars are being held as solving problems, discussing case reports and presentations.
    •     Small group practice trains students solving case study, training in the clinical skill laboratory, taking
          history from patient with lecturers, assessing test results, submitting diagnostic and treatment plan and
          counseling about treatment and prevention.
    •     Self-practice time is included in time table because to train self-study and improve education quality.
          The students train under lecturer as self-study.
    •     III, IV and V year students select and study up to 2 credit subjects via the training program as own
          interest.

    2.2 Scientific methods

    Basic standard


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    Must reflect the basic principles of scientific methods and evidence-based medicine, teach the ability
to analyze and cogitate in the curriculum development.
    Quality development
    Curriculum should include lessons for training students in scientific thinking and research methods.
To convey the professional educational content to students, avoiding explaining the meaning by the use of
books, but presenting basic knowledge through creative, rational methods and promote new ideas and
different scientific opinions by linking specific scientific development and future trends. Tutors also try to
reach the students by explaining, contradictory perspectives of evidence-based medical science and survey
results.

To meet this requirement, every tutor must also be a researcher, thus help develop critical and creative
thinking. The integrated medical curriculum is focused on the student’s skills to do independent work,
developing student-centered curriculum, integrate training, research, health care, clinical communication and
management skills and students ability to learn independently.

With this purpose in mind, we are providing training by using following methods:

    •   Case based training
    •   Integrated seminars
    •   Use internet information’s and distance learning
    •   Problem based learning and bedside training.
The PBL training method has become one of the most successful methods using in training. Also by using
case based and role play methods in professional training of the students, their involvement in these activities
is improving the clinical and evidence based decision making skills.

Self directed learning study

Purpose of self learning at the Medical school is to promote a student centered approach, develop
communication and practical skills in students. Self-directed learning (SDL) has been identified as an
important skill for medical graduates. To meet the challenges in today's healthcare environment, self-directed
learning is most essential. The Medical School has made SDLs a central part of the curriculum. In self-
directed learning, students take the initiative in making use of resources rather than simply react to
transmissions from resources, thus helping students to learn more and learn better. The main purpose of
education is to develop the skills of inquiry, and more importantly to go on acquiring new knowledge easily
and skillfully the rest of his or her life.

Specializing lessons, using leaning methods such as take medical decisive initiative, role play, motivates
student’s learning force, medical ability, capacity to solve evidence-based problem, are improving.

Considering student’s assignment, selective learning in 3d, 4th and 5th year students are provided with
possibility to choose from interested professional or specialized lessons and take 2 credit training.

The encouraged curriculum processes are mentioned in the following:

    •   Widen specific lesson’s theoretical subject or chapter, read materials from other books, write thesis
        and summaries and evaluate
    •   As a trainee learn handling methods of specific operation from the tutors of departments, masters and
        residents
    •   Resolve clinical issues given by the tutor and observe the results
    •   Organize training program focusing on single person or collective people in order to educate them
        about taking preventive actions on diseases or medical educational program

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    •   In order to widen the framework of the surveyed subject, verify the essence of theories by practice,
        work on given clinical issue and evaluate
    •   Participate in national and international Olympiads
    •   Debate in conferences, organized at school, nationwide or internationally
    •   Conducted by a teacher, learn the methodology of research works and master the abilities in handling
        in laboratories
    •   Students should work as trainees in the province hospitals and score
    Research methodology
The integrated medical curriculum conducts disciplines of research methodology from early years of study.
During all academic year, students acquire the knowledge, concepts, methods, skills and attitudes necessary
for provide medical research in the field of socio-economic, demographic and cultural determinants of causes,
distribution and consequences of health problems.

The introductory session on scientific methodology starts with Block 5, Society and the Physician. Scientific
Method and Methods of Health Education. The aim of this course is to teach medical and other research skills
and to encourage an interest in medical research in their future careers. Also students should know how to
organize and conduct health education courses for population and target groups. Students will achieve above
mentioned goal through the clinical problem-solving tasks, problem-based tutorials and exercises in evidence-
based practice, as well as student research projects and assignments.

The main block to teach basic medical research methodology is Block 20, Research Methodology, which is
worth 5 credits. The Department of Epidemiology and Biostatistics is responsible for this course. Students
learn theoretical and practical knowledge, and the basic skills to conduct medical research work, to develop
decision making abilities using data from evidence based medicine, and to demonstrate research and survey
skill. Students are required to write research papers and projects.

    Research activities
Research activities become an important factor affecting the content and the quality of the training. There is
an independent association for students and tutors teach research methodology and conduct their research
works.

The results of research activities of students and tutors are regularly presented and published in the following
ways:

    •   Organizing conferences and seminars, presentations at the joint seminars, and abstract publications
    •   Report of results of studies in medical magazines and newspapers
    •   Publishing a summary of students work
    •   Reporting research work and results on the school website
The Medical University organizes activities such as establishing professional clubs among students, tutoring
students on selected topic, debating about selected essays from the clubs, organizing Olympiads and form
groups of chosen students and preparing them using specialized program to participate in National Olympiads.

Annually, the Medical University also organizes a conference “Students’ scientific convention”, from where
students can be chosen and given awards, and also provided with the needed laboratories and research
equipment. The students of the Medical University can be selected from 15 students’ clubs and associations
according to their field of interest and also provided with the opportunity to participate in various conferences.

The Medical University students annually organize “Specialty promotion days” to promote interest in the
medical profession and also they participate successfully in many events such as World Health Days.


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Students’ clubs, which are focused on supporting students in their learning process to help improve foreign
language skills and research methodology, are functioning efficiently. Clubs were originally established to
give their members and students of the Medical University the opportunity to enhance their knowledge and
skills, and enable them to acquire knowledge on modern science and technology outside the formal curricular
training. Clubs and associations of the Medical University are coordinated by researchers and teachers of
SOM departments.

Club and associations, have as their main purpose, the organization activities that give students opportunity to
work independently or in teams, in activities focusing on humanitarian, and public deeds that enable students
to spend their leisure time efficiently. Association and clubs that have received ratification from the Student’s
Office are shown in Annex 1.

    2.3 Basic Biomedical science
    Basic standards:
    The School of Medicine must identify and incorporate in the curriculum the contributions of the
basic biomedical sciences to create understanding of the scientific knowledge, concepts and methods
fundamental to acquiring and applying clinical science.
    Quality development:
The contributions in the curriculum of the biomedical science should be adapted to the scientific,
technological and clinical developments as well as to the health of the society.

Integrated curriculum is a process to accommodate the integration of basic medical and clinical science and to
teach basic biomedical science to all students.

Integrated curriculum is implemented in form of branch science and covers various medical science subjects,
particularly, in the first year of curriculum during which basic theoretical courses are covered. In the
subsequent years, clinical science courses will be taught, which would contain integrated subject areas and
the, training methods focuses on interaction between student and teacher, small group training, cooperative
teacher in theoretical and clinical science and share experiences.

Medical science has been developing rapidly since the 2nd half of the XX century and students study the
human body at molecular and genetic levels, about diagnosing disease at early stages (being aided by
molecular and cellular sciences) and about new treatment methodologies focusing on molecules. 1st and 2nd
level preventive actions, social-psychological health, healthy environment are also considered to be important.

We prepare professionals, who will be working as XXI century doctors, thus it becomes indispensible to
include new directions into the curriculum, and so continuous changes are being constantly made. For
example, “Human, health and clinical science” block teaches general understanding of human, human health,
clinical appearance and state, social, biological, psychological factors that affect humans, and preventive
medical science. In the block “Molecule to cell” lessons such as structures of organism, organization of cells
and molecules as basic units for functioning, micro level circulation of biochemical reactions, lifecycle of a
cell, distinguish between circulating or non circulating destruction of a cell, give basic knowledge of medicine
and introduce new methodologies of bio analyzes, and also allow students to combine these with other
lessons. After having studied these two blocks, the process of basic unit cell becoming a tissue of a human
body functioning, functions of early stage reproduction system with other science such as physiology,
biochemistry, immunology, branches of pathology are taught in blocks “Cell to tissue” and “Systems of
organs”. The purpose of “Society and environment”, “Society and doctor” blocks are to provide bachelor
degree level education on preventive medical science, by relating the processes of society with the doctor to
establish the role, responsibilities, professional habits and qualities expected from professional actions, such
as interactions between doctor and patient, jurisprudence, health care systems and development of required
attitudes.

Basic biomedical science is the basis of clinical science lessons and consists of the following. :


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1. Anatomy of human body (8 credits)

Student will possess knowledge about the normal human body anatomy of skeleton, ligaments, muscles,
respiratory, digestive, urinary, male and female reproductive, nervous, sensory, cardiovascular, endocrine
systems. Also gain knowledge about its composition, organ size, shape, function, development, embryogenic
norms, age related characteristics, commonly occurring anomalies, normal organ location, innervation and
vascular supply.

2. Physiology of human body (6 credits)

Students gain knowledge about normal human tissue, organ and system, central nervous, endocrine, blood,
cardiovascular, respiration, metabolism, excretion, acid base balance, reproduction, sensory organ’s
physiology, human body physiological mechanism, their regulation, principle of adaptation, physiological
basis of experiments, laboratory and instrumental analysis, understanding of bioethical issues.

3. Histology (4 credits)

Gain knowledge about human embryo development stages, early manifestation of histological action, human
eucaryot cell structure, determining ultra structure of cells by using electron microscope. Tissue classification,
structure, their relation, understanding structure and functional units on a micro scale, distinguishing human
tissue, cell structure in micro preparations.

4. Pathologic anatomy (4 credits)

To study understanding of general pathology, cell tissue reaction against any disease, adaptation, regeneration
and cancer changes.

To determine macro and micro changes in systemic disease, disease etiology, pathophysiology, complication,
death and differential diagnosis based on general histological concept and clinical thinking.

5. Pathologic physiology (4 credits)

Basic theoretic concepts of disease, etiology of disease, development of conditions, pathophysiological
progression of a disease, general principles, causes, and prognosis of the common diseases of population

6. Biochemistry and nutrition (3 credits)

The structure, characteristics and mechanism of macromolecules that form the basic components of body and
foods such as proteins, nucleic acids, carbohydrate, fat, vitamins, enzymes and their exchange, regulation and
deficiency.

7. Microbiology (2 credits)

The structure, forms, development and mutation of microbes and mechanism of pathology of tissues and
detection and laboratory analysis of pathological microbes, basic methods of analysis and knowledge about
prevention form infections

8. Immunology (2 credits)

General understandings about immunology and immunology system, specific and non specific immunological
reactions, antibodies, immune cells, organs, interactions of cells in immune reactions, immune mechanism

9. Molecular biology (2 credits)

Principles of molecular biology, genetics mechanism in molecular pathology, diagnostic molecular and
biological methods, causes of pathology and origins, pathophysiology, intracellular research, modern research
methodologies in molecular biology, genetic engineering and basics of cellular biology

10. Genetics (2 credits)
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Skills to use the genetics textbooks and journals, think about diseases in genetic terms, know about heredity of
diseases, define the forms of heredity and develop skills in genetic prognosis, genetic counseling, referral of
patients with right indication for genetic analysis, advocacy about genetics with the public

11. Pharmacology (4 credits)

To know about essential medicines which are used for prevention, diagnosis and treatment, public and clinical
package of services and their chemical structure, poisoning and coping mechanism in a human body and
counseling skills and about rational drug use.

    2.4. Behavioral and Social Sciences and Medical Ethics
    Basic standards:
   The School of Medicine must identify and incorporate in the curriculum the contributions of the
behavioral sciences, social sciences, medical ethics and medical jurisprudence that enable effective
communication, clinical decision making and ethical practices.
    Quality development:
    The contributions of the behavioral and social sciences should be adapted to scientific developments
in medicine, to changing demographics and cultural contexts and to health needs of society.
The main responsibility of organizations and institutions granting higher education is not only prepare
professional experts but also set up people, who have sense of responsibility for their profession, who are
active in the society, and are skilled in communication. In the section “General requirements for graduating
students” of the Higher education model standards, it is stated:

    •   Demonstrate the ability to observe the ethics, adhere to legislative rules in taking action to coordinate
        the interactions between environment, society and people
    •   Demonstrate the ability to live healthy lifestyle and improve one’own physical conditions
    •   Acquire the knowledge of ethics, of democracy, and the demonstrate the ability to comprehend the
        historical and cultural heritage and abide by the traditions of humanity
    •   Possess the ability of working as a team, be participative and respectful towards other ‘s viewpoints
        and taking responsibilities for one’s own self and for others
    •   Possess the ability to debate and summarize in Mongolian
    •   Possess the ability to work independently in a constantly changing environment
In accordance with Order #481 of the Minister of Education, Culture and Science of Mongolia signed on 29
December, 2006, modifications have been brought about in the content of bachelor degree training program.
According to this new content, new lessons on social, humanitarian and natural sciences have been included
into the curriculum. Besides the general requirements expected by employers in terms of professional skills,
they place emphasis on improved communication skills, ability to work independently and in a team.
Therefore, School of Medicine is striving to train skilled professional graduates, who are also excellent social
individuals and civilians with high sense of civic responsibilities. The main aim of the School of Medicine is
to train doctors, who are humane and caring, who possess the qualities of compassion high ethical standards,
values, and are flexible as experts and doctors who conform with international standards. To accomplish
these, lessons in communication, social sciences, medical ethics and law have been included in the
curriculum.

One. Subjects areas in the domain of Humanitarian Sciences

1.1. Fundamentals of Philosophy (3 credits)




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This subject focuses on main branches and theories of philosophy, ontology, theory of epistemology and main
elements of philosophy, philosophy of morality, esthetics, humanitarianism and religion. It also discusses
issues in social philosophy, etc.

1.2. Mongolian history (3 credits)



This subject focuses on periods of Mongolian history, nomadic and modern civilization, society, state, culture,
periods of development, features of regional zones of Mongolia etc.



1.3. Culture study (2 credits)



This subject examines the issues in the cultural history of Mongolia, overview of culture, main duties of
culture, main factors of influencing culture, communication and culture, and history of world culture, cultural
monuments, and ideology of famous representatives.



1.4. Ecology and environmental protection (3 credits)



Ecology is the scientific study of the relation of living organisms with each other and their environment are
covered in this course During this course students will learn about relationship of ecology and other sciences,
factors influencing ecology, fundamentals of ecology, ecological systems, human ecology, social ecology,
community ecology, natural resources, classification and utilization of resources, environmental pollution,
prevention from pollution, environment protection, and restoration of nature and legal issues of ecology.



1.5. Human development (2 credits)



Topics include information on fundamental principles of human development, human development
perspectives, equity, inequality, poverty, human safety, human development and globalization, human
development and gender, human development and economics, policy, political organizations and human
development.



1.6. Syntax of the Mongolian language. (2 credits)



Focuses on basic concepts of syntax: principles and rules for constructing sentences, classification of syntax,
specific features of syntax, vocabulary and choice, how to use words and expressions, vocabulary and
expression limitation, specific characteristics of idioms, combination of words, word order in sentences, order
of the parts of a sentence, difference in the scripts, genres and script types, literacy, structure of script and etc.

Two. Subjects areas in the domain of Social Sciences

2.1 Basics and theory of Economics (3 credits)


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BME program evaluation by WFME/AMEWPR Standards                                            26 September, 2011



Focuses on basic theories of economy, methods of study, micro-economics, factors affecting the market,
macroeconomics, development of economy, (foreign trade, payment balance, international money
configuration, economy development)



2.2 Fundamentals of Political Studies (2 credits)



Emphasizes the principles and objectives of political sciences, research methods, roles of political sciences,
political life and governing communication, role of politics in a modern social life, history of political
thought, main types of political doctrine/teaching/, civil society, essential characteristics of civil society,
specific features of Mongolian civil society, political institutions, political system and political organization,
composition of political organizations and their role, mechanism of their activities and interrelations, political
governance, political regimes, party politics, election systems, historical types of state associations, political
interactions and processes, political culture and its components, types of political culture, political values,
political culture of society, class, group and individuals, political socialization and political contribution.



2.3 Fundamentals of Sociology (3 credits)

Students will learn about objects of sociological sciences, research methods, society and its types, elements of
a society, social institutions, social groups, social context of individuals, evaluation of social events, and
sociology research methods.



2.4 Fundamentals of Psychology (3 credits)



This course covers several areas of psychology including learning, motivation, emotion, developmental
changes, personality, abnormal behavior, psychotherapy, and social behavior with special attention to the
physiological and neurological basis of human behavior.



Students will learn about psychology of behaviorism, neobehaviorism, and gestalt, branches of freudism and
neofreudism, structures of the brain and mentality, how we sense and perceive the world around us, how we
learn, and what motivates us, instincts, mental functioning, and assessment of mentality. The course will
review the scientific basis of psychology and learn how scientific research is conducted in psychology. Learn
about research principles and methods, major approaches to understanding human thought and behavior
including biological, cognitive and behavioral models of human functioning, human temperament, human
talent, motivation physiology, principles of society and psychology.



2.5 Fundamentals of management (3 credits)



This course covers scientific basis of management and objectives of management, institution or organizational
governance and manager’s activities, management thinking development, governance strategy and plan,
institution’s social responsibilities, leadership, ethics, communication, decision making, human resources

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BME program evaluation by WFME/AMEWPR Standards                                              26 September, 2011

management, structure of organization, institution change management, conflict management, management
of an institution’s monitoring system.

Three. Communication skills, ethics, medical jurisprudence and legal norms

3.1. Communication skills (2 credits)
This subject is intended for first grade students of HSUM to give fundamental knowledge on communication
skills, ethics and legal norms. During this course medical students will learn about fundamental principles of
communication, communication culture and its types, communication and attitude intrinsic characters, value
of profession of doctor, medical pedagogy, specific features of adult learning, teaching and learning process,
duties and responsibilities of learners, paper or report presentation skills, ethics and its norms. Also students
achieve knowledge about UNIFACE student program, student rules and HSUM rules.

3.2 Ethics for a Practitioner
Emphasizes the doctor’s values, humanity, flexibility, fairness, ethics, special features of the medical
profession, image of practitioner /doctor/ and its negative and positive factors, group work and group
communication, cooperative activities, types of group, treatment and patient groups, group mentality, topics
on communication between practitioners /doctors/, practitioner and patient communication, practitioner-
practitioner communication, practitioner and society communication. Students frequenting these subjects
through following blocks:” Society and practitioner”, “Nursing”, “Mental health”, “Society and environment”
Also in each blocks, as a part of clinical skill education program, there are topics of communication skills with
patients, pediatric patients, seniors, patients in the terminal stage of disease and their families.


3.3 Medical jurisprudence and legislation
Discusses the following topics: practitioner’s error, its legal basis; mental preparedness to communicate with
suspect, victim and criminals, lawyers and medical workers, and examining cadavers; comply with biomedical
ethics, learn how to justify and show fairness in forensic decision making and drawing expert conclusions.
Students also encounter these subjects through following blocks: “Society and practitioner”, “Mental health”,
“Society and environment”
3.4 Scientific method and Methods of health education (2 credits)
This 2 credit course is designed to teach second year students health education methods, communication and
consultation skills. The course is based on the self-learning method to acquire knowledge and skills on how to
conduct health education research, how to organize health education courses for general population and target
groups. During the course students will improve their presentation skills. Students will achieve above
mentioned goals through the clinical problem-solving tasks, problem-based tutorials and exercises in
evidence-based practice, as well as student research projects and assignments. In 2009-2010 academic year
343 students (85.3% of all students) from School of Medicine had participated in a Health education program.
3.5 Training for assistant practitioners.
During this course students learn about methods of team work, PBL, how to identify the problems, skills in
decision making and critical thinking, complex problem solving, determine ways for solving problems, and
other ways of individual development to enable the person to work harmoniously in society and community.
Focuses on:
    •   human actions intended to benefit the patient or others, ethical principles and appropriate attitudes and
        professional caring for patients, and in relating to patient’s families and to others involved in the care
        of patients

    •   Learn skills of being just and fair, respect for institutional and patient privacy

    •   Learn team working skills to work with medical staff and colleagues. Learn skills in ethical decision-
        making within the context of the complex issues and act effectively.
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Self eval report english final for printing, 28.09.2011last for printing

  • 1. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 ASSOCIATION FOR MEDICAL SCHOOL OF MEDICNE EDUCATON WESTERN PACIFIC HEALTH SCIENCE UNIVERSITY REGION OF MONGOLIA SELF- EVALUATION REPORT BASIC MEDICAL EDUCATION PROGRAMME FOR “MEDICAL DOCTOR” (D720300) ULAANBAATAR 2011 1
  • 2. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Working group Director Ts.Lkhagvasuren Academician, MD, PhD, ScD President of HSUM R.Otgonbayar MD, PhD, MPH Dean School of Medicine Deputy Director D.Amarsaikhan MD, PhD, Vice President for Academic affairs Secretary D.Otgonbayar MD, PhD Head of Division of Educational Policy and Management, HSUM 1. MISSION AND OBJECTIES Ts.Sarantuya, MD, PhD, M.B.A-P.M. Deputy Dean School of Medicine for Academic affairs V.Nyamtsengel MD, Lecturer of Department of Infectious diseases 2. EDUCATIONAL PROGRAMME D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM B.Bayarmagnai MD, PhD, Coordinator Division of Educational Policy and Management, HSUM B.Solongo MD, PhD Head Department of Pulmonology T.Navchaa MD, PhD Lecturer of Department of General practice and Preventive Medicine D.Baigalmaa MD, Lecturer Department of Pediatrics 3. ASSESSMENT OF STUDENTS B.Oyungoo MD, PhD, Coordinator Division of Educational Policy and Management, HSUM Ch.Chinzorig MD, Coordinator Division of Educational Policy and Management, HSUM S.Sainbileg MD, Lecturer Department of Endocrinology Kh.Delgerdalai MD, Coordinator School of Medicine B.Oyuntugs MD, Lecturer Department of Endocrinology 4. STUDENT AFFAIRS A.Gurbadam PhD, Dean of Student Services Kh.Delgerdalai MD, Coordinator School of Medicine B.Oyuntugs MD, Lecturer Department of Endocrinology E.Enkhtamir MD, Lecturer Department of Nephrology 5. ACADEMIC STAFF / FACULTY S.Naranchimeg MD, PhD, Head Department of Professional Basic Skills 2
  • 3. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 A.Otgonbat MD, Head Department of Hematology B.Ariunzaya MD, Lecturer Department of Pharmacology 6. EDUCATIONAL RESOURCES P.Tseden MD, PhD, MBA Vice President for Finance and Monitoring R.Oyungerel MD, PhD Deputy Dean School of Medicine for Research and Foreign affairs D.Ichinnorov MD, PhD, Assoc Prof, Deputy Dean School of Medicine for Clinical affairs B.Erdenebulgan MD, PhD Lecturer Department of Oncology S.Ariunaa, Accounts Department 7. PROGRAM EVALUATION D.Otgonbayar MD, PhD Head Division of Educational Policy and Management, HSUM Ts.Erdembileg MD, PhD Lecturer Department of Radiology 8. GOVERNANCE AND ADMINISTRATION N.Sumberzul MD, PhD Vice President for Research and Information Technology G.Ariuntuul D.D.S.,PhD, FICD Dean of Graduate Training Center of HSUM D.Tsogt-Ochir MD, Coordinator School of Medicine V.Byambasuren MD, Coordinator of International Relations of HSUM 9. CONTINUOUS RENEWAL D.Amarsaikhan MD, PhD, Vice President for Academic affairs D.Baigalmaa MD, Lecturer Department of Pediatrics Translation team Indermohan S Narula, MD, MPH (Hawaii) MTropMed (Liverpool) Consulting Editor R.Otgonbayar MD, PhD, MPH Dean School of Medicine Ts.Sarantuya, MD., PhD, M.B.A-P.M. Vice Dean of Academic affairs D.Baigalmaa MD, Lecturer Department of Pediatrics D.Narantungalag MD, PhD, Lecturer Department of Pharmacology N.Khaliun MD, Lecturer Department of Pharmacology S.Alimansaran MD, Lecturer Department of Neurology D.Byambasuren MD, PhD, Lecturer Department of Neurology P.Munkhbaatar MD, Lecturer Department of Otolaryngology Kh.Erdenedelger MD, Lecturer Department of Dermatology D.Densenbal MD, Lecturer Department of Pulmonology N.Bayalagmaa MD, Lecturer Department of Hematology s.Duurenjargal MD, Lecturer Department of Hematology E.Enkhtamir MD, Lecturer Department of Nephrology N.Bat-Erdene MD, Lecturer Department of Cardiology V.Byambasuren MD, Coordinator of International Relations of HSUM 3
  • 4. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 CONTENT FOREWORD.........................................................................................................................................6 AKNOWLEDGEMENT........................................................................................................................7 MESSAGE FROM THE DEAN............................................................................................................8 The management of the School of Medicine acknowledges the contribution of the many people involved in the development of the self-evaluation report for the accreditation by the Association of Medical Education, Western Pacific Region. First and foremost, I would like to express my deep appreciation to J.Tsolmon, member of the Management Board of the HSUM, T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan, Vice president for academic Affairs, D.Otgonbayar, Head of the Division of Education Policy Coordination, A.Gurdadam, Head of the Division for Student affairs, and all former presidents for management and methodological guidance to successfully accredit the Basic medical education program self-evaluation report by the internal accreditation.........................................................................................................................8 I would like also to express my gratitude to the HSUM management council for valuable comments and thoughts........................................................................................................................................................9 I also grateful to other professional staff from the School of medicine, Biomedical school and Public health school for active participation in the development of the report despite busy schedule and heavy workload. The financial and methodological support by the Ministry of Education, Culture and Science was a valuable contribution to our work................................................................................................................9 I would like to express my gratitude to our main stakeholders such as primary health care management, doctors and practitioners on behalf of the School of Medicine.....................................................................9 Let me share with you what I learned most about the School and our training program during the preparation to the evaluation. ......................................................................................................................9 1.Our “Basic medical education” medical degree program is very high quality. We should be proud of the program and our graduates who are competent and able to meet health sector needs, while ready to work hard on improving the program even further........................................................................................................9 2.We also have very good data that shows high level of student satisfaction. We also identified areas that will benefit from further improvement.........................................................................................................9 3.The School of Medicine is a leading medical school in Mongolia, independent organization with fully developed structure 70 years of history, with leading academic staff, professors and medical professionals of the health sector...........................................................................................................................................9 4.Our school functions very successfully. This is shown in the results of the Health Department, the Government implementing agency under the MoH, license examination and employment status of graduates. .....................................................................................................................................................................9 5.During 3 year of development and 12 year of implementation, the integrated program has undergone 4 times revisions and improvements, to become international standard program for the training of medical practitioner with broad knowledge, high skills and adequate attitude..........................................................9 6.It is not secret that the self-evaluation process resulted in our self-development too. We identified areas for improvement and we need to work on them in the near future. ............................................................9 My colleagues, our professors, teachers and students of the Health Sciences University of Mongolia, I look forward to working with you more to make our medical school and a truly great medical school.......9 R.Otgonbayar, Ass. Professor, PhD.......................................................................................................9 .......................................................................................................................................................10 EXECUTIVE SUMMARY ................................................................................................................11 INTRODUCTION .............................................................................................................................13 4
  • 5. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1. MISSION AND OBJECTIVES ......................................................................................................13 1.1. Statement of Mission and Objectives....................................................................................13 1.2 Participation in Formulation of Mission and Objectives........................................................15 1.3 Academic Autonomy.............................................................................................................17 1.4 Educational Outcome.............................................................................................................18 Reference chapter 1.....................................................................................................................21 2. EDUCATIONAL PROGRAM.......................................................................................................23 2.1. Curriculum Models and Instructional Methods ....................................................................23 2.2 Scientific methods..................................................................................................................29 2.3 Basic Biomedical science.......................................................................................................32 2.4. Behavioral and Social Sciences and Medical Ethics.............................................................34 2.5. Clinical Sciences and skills ..................................................................................................38 2.6. Curriculum structure, composition and duration...................................................................40 2.7. Program management ..........................................................................................................52 2.8 Linkage with Medical Practice and Health Care System........................................................55 Reference chapter 2.....................................................................................................................60 3. ASSESSMENT OF STUDENTS.....................................................................................................63 3.1. Assessment methods.............................................................................................................63 3.2 Relation between Assessment and Learning....................................................................69 Reference chapter 3.....................................................................................................................72 4. STUDENT.......................................................................................................................................73 4.1. Admission Policy and Selection ...................................................................................................73 4.2. Student Intake .....................................................................................................................74 4.3 Student Support and Counseling...........................................................................................75 4.4Student Representation...........................................................................................................80 Basic standard:.............................................................................................................................80 Reference chapter 4. ....................................................................................................................82 5. ACADEMIC STAFF/FACULTY ...................................................................................................84 5.1 Recruitment policy ................................................................................................................84 5.2. Staff policy and development................................................................................................86 Reference chapter 5.....................................................................................................................92 6. EDUCATIONAL RESOURCES...................................................................................................93 6.1 Physical facilities ..................................................................................................................93 6.2. Clinical training resources .................................................................................................101 6.3. Information technology ......................................................................................................105 6.4. Research..............................................................................................................................108 6.6 Education exchange.............................................................................................................117 Reference chapter 6....................................................................................................................119 7. PROGRAM EVALUATION.........................................................................................................121 5
  • 6. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 7.1 Mechanism for Program evaluation.....................................................................................121 7.2 Teacher and student feedback..............................................................................................122 7.3 .Student performance...........................................................................................................128 Reference chapter 7....................................................................................................................134 8. GOVERNANCE AND ADMINISTRATION...............................................................................136 8.1. Governance.........................................................................................................................136 8.2. Administration....................................................................................................................138 Reference chapter 8. ..................................................................................................................140 ..........................................................................................................................................................140 9. CONTINUOUS RENEWAL.........................................................................................................141 Reference chapter 9....................................................................................................................142 FOREWORD 6
  • 7. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 AKNOWLEDGEMENT 7
  • 8. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 MESSAGE FROM THE DEAN The management of the School of Medicine acknowledges the contribution of the many people involved in the development of the self-evaluation report for the accreditation by the Association of Medical Education, Western Pacific Region. First and foremost, I would like to express my deep appreciation to J.Tsolmon, member of the Management Board of the HSUM, 8
  • 9. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 T.Lkhagvasutren, President of the HSUM, D.Amarsaikhan, Vice president for academic Affairs, D.Otgonbayar, Head of the Division of Education Policy Coordination, A.Gurdadam, Head of the Division for Student affairs, and all former presidents for management and methodological guidance to successfully accredit the Basic medical education program self- evaluation report by the internal accreditation. I would like also to express my gratitude to the HSUM management council for valuable comments and thoughts. I also grateful to other professional staff from the School of medicine, Biomedical school and Public health school for active participation in the development of the report despite busy schedule and heavy workload. The financial and methodological support by the Ministry of Education, Culture and Science was a valuable contribution to our work. I would like to express my gratitude to our main stakeholders such as primary health care management, doctors and practitioners on behalf of the School of Medicine. Let me share with you what I learned most about the School and our training program during the preparation to the evaluation. 1. Our “Basic medical education” medical degree program is very high quality. We should be proud of the program and our graduates who are competent and able to meet health sector needs, while ready to work hard on improving the program even further. 2. We also have very good data that shows high level of student satisfaction. We also identified areas that will benefit from further improvement. 3. The School of Medicine is a leading medical school in Mongolia, independent organization with fully developed structure 70 years of history, with leading academic staff, professors and medical professionals of the health sector. 4. Our school functions very successfully. This is shown in the results of the Health Department, the Government implementing agency under the MoH, license examination and employment status of graduates. 5. During 3 year of development and 12 year of implementation, the integrated program has undergone 4 times revisions and improvements, to become international standard program for the training of medical practitioner with broad knowledge, high skills and adequate attitude. 6. It is not secret that the self-evaluation process resulted in our self-development too. We identified areas for improvement and we need to work on them in the near future. My colleagues, our professors, teachers and students of the Health Sciences University of Mongolia, I look forward to working with you more to make our medical school and a truly great medical school. R.Otgonbayar, Ass. Professor, PhD 9
  • 10. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 10
  • 11. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 EXECUTIVE SUMMARY The Self-evaluation report was written based on Guideline of Association of Medical Education, West Pacific Region. Chapter one: Shows how the mission, objectives, values, and the HSUM and School of Medicine development master plan adheres to the goal and objectives of the “Basic medical education” program, as well as compliance with these goal and objectives and with the medical doctor’s model, job description and accreditation. Chapter two: Shows that the “Basic medical science” program content is consistent with regulations and standards of the education sector, as well as with the educational organization policy, meets the local market needs, is continuously upgraded in line with human, scientific, technological developments and achievements. It also reflects the progress in the teaching method and technologies to meet international standards, program management system and its activities. Chapter three: Covers information on the evaluation of the teaching and learning processes, methods to assess student knowledge, skills and attitude. Reflects and summarizes how this evaluation and assessment promotes student learning process and how it links to the training methodologies employed in the program. Chapter four: Informs about regulations for student admission, legal environment for educational services for students, tuition fees, student movement, direct and indirect costs per student, activities to support the development of students into members of the society, ethical and other norms of health institutions and the information on the employment status of the graduates. Chapter five: Reflects information on “Basic medical science” program’s human resource policy, planning, structure, situation in academic grades, its development; appraisal of the teacher’s educational, research and specialty activities; salaries and other sources of income. Chapter six: Describes the general requirements and standards for classrooms, strengthening of material basis, activities to improve the training environment, establishment of new laboratories, listing of financial sources, sponsorships and support and development perspectives. The chapter is based on evidence of the establishment of connections with related departments of foreign universities to learn from their experience in planning and implementing similar programs; implementation of student and teacher exchange program and its future directions. Chapter seven: Describes and concludes about the program evaluation and its development mechanism, evaluation methods used, evaluation status, graduates competency evaluation as its main product and graduates’ employment status. 11
  • 12. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Chapter eight: Informs about the SOM structure, governance and management. Chapter nine: Summarizes the training program development to meet international standards, the development processes, and innovations. 12
  • 13. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 INTRODUCTION Health Sciences University of Mongolia (HSUM) is the state university. It was founded in 1942 as the Faculty of the Mongolian State University and then established as the independent Medical Institute in 1961. It was next extended as the Medical University in 1995; and in 2002 it was designated as the University of Health Sciences and currently includes ten constituent schools. As the oldest and largest university, HSUM has been the main source to produce medical professionals for the nation and has so far produced 10,000 medical graduates and other health care providers. The School of Medicine (SOM) was reorganized as a constituent institution of HSUM in 2003 and has, since then produced over 1900 graduate alumni with a Bachelor degree in medical sciences. 1. MISSION AND OBJECTIVES 1.1. Statement of Mission and Objectives Basic Standard The medical school must define its mission and objectives and make them known to its constituency. The mission statements and objectives must describe the educational process resulting in a medical doctor competent at a basic level, with an appropriate foundation for further training in any branch of medicine and in keeping with the roles of doctors in the health care system. Quality development The mission and objectives should encompass social responsibility, research attainment, community involvement, and address readiness for postgraduate medical training. The Vision of the School of Medicine is to be recognized internationally as the leading Mongolian medical school to deliver academically excellence medical education, high quality research and health services. Mission and Objectives HSUM mission is to be recognized as the leading national university which produces future graduate health care professionals capable of meeting the national, regional and global, healthcare demands; to integrate research, education and health care delivery; and to compete in competency based society. SOM mission is to be recognized as the leading national medical school which is distinguished by its innovative educational approach and methods; introducing international standard higher medical education, world-class level of medical research, and promote the proper use of modern medical technology in health care services. Core value 13
  • 14. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • Democracy and Liberty • Integrated curriculum • Historical Experience • Professional Human Resource • Academic Autonomy • Highly Valued Graduates Strategies We are confident in the advancement of our strategies to achieve the establishment of our mission and objectives of School of Medicine Strategy 1. Development of a quality medical education program • To develop a quality medical education program including academic autonomy, curriculum content and outcome, innovative teaching methods, modern evaluation and student assessment techniques • To produce high quality graduate professionals with the required competencies to meet health care challenges and needs of society • To develop teacher – student friendly environment Strategy 2. To improve the quality of medical education and to aim for a world-class level of education. • To encourage and support attendance of young lecturers in educational and research exchange programs in developed countries and prepare younger lecturer’s generation and enhance the human resource capacity • To establish research laboratories which meets international standards with high technological tools and implement national and international research activities in diagnosis, treatment and in screening. • To establish effective international collaborations in science and technology • To provide and support international student exchange programs. 14
  • 15. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Strategy 3. Contribution of modern medical technology in health care service • To develop the capacity of the Erkhes outpatient clinic through building high technology research – teaching – service • “To obtain the national medical accreditation certification for the SOM outpatient Clinic” • To expand the number of university teaching hospitals The mission statement and strategies are derived from following government policy documents, national programs and HSUM strategies: • Health Law • Higher Education Law • Science and Technology Master Plan, MECS 2007-2020 • Health Sector Master Plan, MOH 2006-2015 • Primary Health Care Development Project, World Health Organization • Third Health Sector Development Program, Asian Development Bank • Health Project, Millennium Challenge Account • Strategic Plan, HSUM 2007-2016 • HSUM Development Program 2010-2012 School of Medicine through a 6 year Integrated Curriculum of Basic Medical Education is producing medical doctors, who meets the main job description requirements of soum health centres and FGPs. SOM is cooperating with Postgraduate Training Institute and Masters’ and Doctorate Department of HSUM on the postgraduate, residency training and continuing medical education. The whole system challenges the doctors and provides an opportunity for graduates as medical doctors to continue specialist and continuing training. 1.2 Participation in Formulation of Mission and Objectives Basic standard 15
  • 16. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 The mission statement and objectives of a medical school must be defined by its principal stakeholders. Quality development Formulation of mission statements and objectives should be based on input from a wider range of stakeholder. The mission and objectives are defined by the participation of principal and a wide range of stakeholders such as members of HSUM board, academic staff and students. School of Medicine also worked closely with following partners in the development of its Mission Statement and Objectives: • Patients and Community • Primary Health Care Facilities • Curriculum Committee • Faculty and Student Development Committee • SOM Administrative Committee • HSUM Administrative Council • HSUM Steering committee • Academic counsel The main principles are to implement and achieve the mission and objectives of the curriculum through the involvement and representation of students, employers or health managers and graduates in the curriculum management process along with harmonizing our mission and objectives to address the health needs of the public and also reflecting comments and opinions of graduates, employers when updating the mission and objectives by undertaking the following activities: • Joint meeting of graduates and employers, inter universities and professional organizations joint workshops and meetings, conferences. • Joint Meeting with Ministry of Health, and its clinical hospitals and district and aimag health departments and hospitals, affiliated hospitals managers. • Organizing “Professors and graduates meeting” with rural doctors and specialists. • "Altan Gagnuur" annual meeting of professors and graduates from generation to generation • (each year all graduates with same last number of graduation year with 10 years gap are celebrating they graduation, such as all graduates 1951, 1961, 1971, 1981, 1991, 2001. 2011). 16
  • 17. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1.3 Academic Autonomy Basic standard There must be policy for which the administration and faculty / academic staff of the medical school are responsible, within which they have freedom to design the curriculum and allocate the resource necessary for its implementation. Quality development The contributions of all academic staff should address the actual curriculum and the educational resources should be distributed in relation to the educational needs. According to Higher Education Law the HSUM has the authority to define its educational policies and strategies. The main body responsible for ensuring curricular autonomy is Division of Medical Educational Policy and Management (DMEPM), HSUM which is responsible for establishment, direction and oversight of the general educational policy at HSUM, monitoring the broad scope of the curriculum and the overall coordination and implementation of the program schedule. In accordance with HSUM policy, SOM has the overall responsibility for the implementation and further development of the basic medical education program. Academic freedom and institutional autonomy is enshrined in the SOM policy and operationalised through the activities of its Curriculum Committee. The Curriculum Committee of SOM determines its own policies and procedures for teaching, institutional management and accountability within the framework of the HSUM Master Plan, Educational rules and regulations in close coordination with DMEPM, HSUM. The Curriculum Committee, SOM has the responsibility for developing, governing, maintaining and monitoring the BME curriculum through the cooperative work of all faculty staff and students operating through its three subcommittees. The Curriculum Committee has three subcommittees each with its specific role and participating in the process of curriculum development. The Curriculum Strategy Subcommittee has the responsibility to define the goals, objectives and outcome of the BME curriculum in accordance with HSUM strategy and social accountability. The Curriculum Standards Subcommittee has responsibility for defining the goals, objectives and standards of the curriculum for individual block, line and clerkship and for the courses. The Curriculum Evaluation Subcommittee is responsible for the creation of a curriculum quality system to ensure continuous curricular improvement and refinement. Each department plays an important role in formulation of curriculum content, course objectives and course standards. Academic staffs in the each department of SOM engage in the curriculum designing, planning, implementing and monitoring processes through determining specific needs of the program, identifying and introducing innovative methods of teaching. Also, there are 73 faculty staffs from Biomedical School and 21 Public Health School of HSUM that participate in the development and implementation of the integrated curriculum of basic medical education program at SOM (See Chapter 5). To develop continuing training of our graduates, SOM also has the responsibility to provide graduate; residency; postgraduate; and specialized medical programs, along with Master and Doctoral Degree programs. These activities are facilitated with strong collaboration of Postgraduate Institute, HSUM and City Health Department as well as Family Health Centers, Central Hospitals and Health Centers. 17
  • 18. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1.4 Educational Outcome Basic standard The medical school must define the competencies that students should exhibit on graduation in relation to their subsequent training and future roles in the health care system. Quality development The linkage of competencies to be acquired by graduation with that to be acquired in postgraduate training should be specified. Measures of, and information about, competencies of the graduates should be used as feedback to program development. The goal of the basic medical education program is to prepare a competent medical doctor who is broadly educated and capable to work ethically and effectively at primary health care service to provide personal, primary and continuing health care in Mongolia. The outcome of basic medical education program at SOM is to produce a medical graduate (general physician) who possesses scientific knowledge, adequate clinical and communication skills to meet the health care delivery requirements in Mongolia and be capable of pursuing continuous professional development. The departments of School of Medicine have the primary purpose to prepare specialists with superior characteristics by implementing the Integrated Curriculum which consists of basic sciences 12 subjects, 21 basic professional blocks (1 block curriculum with 4-8 departments participating), and professional training or clerkship with 16 rotations and 18 elective courses. The educational outcome of Basic Medical Education Curriculum is graduates, medical doctors with a Bachelor Degree in Medicine. The graduates of SOM meets the Mongolian health sector needs with obtained basic health science knowledge and clinical skills and attitude and is capable to further develop through continuing postgraduate training. The specialty focus of the graduates of Integrated Curriculum study has been defined as follows: “The Bachelor degree in medicine is directed to be obtain knowledge and skills to provide public health care, to solve socio-psychological problems, to diagnose and treat common diseases, prevention from diseases and provide palliative and rehabilitation care within the population” Knowledge, skills and attitude of medical doctors by Basic Medical Education program are defined as follows: 18
  • 19. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Graduate must be knowledgeable and understand the scientific basis of medicine: 1. Basic knowledge of the modern biology, physiology and behavioral and social sciences 2. Knowledge of the normal structure and function of the human body and mind with an understanding of stages of human life 3. Knowledge of the mechanisms by which pathology modifies normal structure and function to generate symptoms, signs and abnormal laboratory findings 4. Knowledge of the various causes and mechanisms underlying diseases among children, adolescents and adults. 5. Diagnostic tools, efficacy and adverse effects of therapeutic interventions 6. Knowledge of clinical pharmacology, nutrition, behavior and rehabilitation therapies 7. Knowledge of management of the primary health care 8. Reproductive health, family planning, pregnancy planning and counseling, primary health care in reproductive diseases and pathology, urgent and emergency obstetrics 9. Health education, preventive medicine 10. Understanding of individual, family, socio-economic, cultural, religious and environmental determinants of causes of health problems 11. Knowledge of the organization and delivery of healthcare service, financing, health insurance, health related legal documentation 12. Concept of demographic classification of health status 13. Knowledge of ethical behavior and professionalism 14. Understanding of the epidemiology of common communicable and non-communicable diseases in various population groups 15. Understanding and identification of important determinants of health and the economic, psychosocial, and cultural factors that contribute to disease. 16. Understanding of approaches useful in reducing the incidence and prevalence of disease Graduate must be highly skilled in providing care to patients: 1. Ability to obtain an appropriate and accurate medical history 2. Ability to perform both a general and an organ system specific physical examination 3. Ability to perform common clinical procedures in relevant situations 4. Ability to appropriately investigate the patient’s problem 5. Ability to choose appropriate and available diagnostic tools for patients 19
  • 20. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 6. Ability to understand and interpret the results of commonly used investigations and laboratory manifestations of both common and important diseases 7. Ability to apply clinical reasoning in solving diagnostic and treatment problems 8. Ability to communicate and to inform with patients, their family, and medical staffs 9. Ability to advise patients and to obtain informed consent before providing any kind of clinical procedures 10. Ability to conclude what is a life-threatening condition and to provide emergency medical care for unconscious patient 11. Ability to manage the medical tools and equipments at the primary care under antiseptic and aseptic rules. 12. Understanding of approaches useful in reducing the incidence and prevalence of disease, and intervention during infectious disease outbreaks, and provide epidemiological supervision. 13. To organize primary and secondary diseases prevention interventions, promote behavior change and conduct health education activities among population 14. Ability to collaborate with a wide range of stakeholders to manage family medicine practice 15. Ability to use information technology 16. The ability to retrieve, manage, and utilize relevant information for solving medical problems Graduates must be able to demonstrate ethical behavior and professional attitude: 1. Honesty and integrity in all professional interactions 2. Maintenance of confidentiality 3. Respect for patients’ right to self-determination, privacy and dignity 4. Compassionate management of patients 5. Commitment to advocate the interests of patients 6. Understanding and respect for cultural, religious and racial differences 7. Understanding of the special needs of minority groups and those with disabilities 8. Understanding of the ethical basis of medical practice and major ethical issues in medicine 9. Ability to recognize and analyze the ethical content of clinical situations 10. Tolerance of clinical and ethical uncertainty 11. Understanding of, and respect for, the roles of all health care professionals 12. Acknowledge personal strengths and weakness, recognizing when to seek counsel and assistance 20
  • 21. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 13. Commitment to critically assess and continuously improve personal knowledge and skills Currently, SOM has had its sixth graduation and will have graduated a total of 1921 graduates with a Bachelor’s degree in medical sciences. The employment rate for SOM graduates has constantly been over 94.8% for the past 5 years. This shows the high demand for these graduates in the health care industry. Data on continuing training of our graduates in recent 5 years shows that 54.8% (1044graduates) have successfully completed their residency programs and 43.6% (837 graduates) have passed the specialized medical programs in 21 disciplines. From these, 370 graduates (19.3%) pursued a M.A. degree and 36 (0.2%) pursued a PhD degree while they were in the health care service working closely with their academic supervisors. In addition, the number of graduates pursuing the graduate programs abroad has been growing year by year. Reference chapter 1 Statement of mission and objectives of School of Medicine 1. Health Law , Mongolia 2. Education Law, Mongolia 3. Higher Education Law, Mongolia 4. Science and Technology Development Master Plan, MECS 2007-2020 5. Health Sector Strategic Master Plan, 2006-2015 6. Third Health Sector Development Program, Ministry of Health of Mongolia, 7. Asian Development Bank 8. Health Project of the Millennium Challenge Corporation, 9. HSUM Strategic Master Plan, 2007-2016 10. “HSUM Development” Midterm Program 2010-2012 Statement of lecturer, student, supporter, employee, interest and donor participating in formulating mission and objectives 1. The book “Health Science University of Mongolia”, Ulaanbaatar city, “Erkhes” printing, 2010, 29p. 2. Annual Reports of School of Medicine, 2006-2010 3. Discussions and meeting protocols of Departments presented to the administration committee of School of Medicine, 2006-2010 4. Reports and e-database of Departments of School of Medicine, 2006-2010 5. Training reports of “Education integrated environment – integrated curriculum standard ” 6. The alumni annual conventional booklet of “Roseroot” lecturers and graduate students of HSUM Academic autonomy 21
  • 22. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1. Formulary of rules and regulations for Education Policy and management. Ulaanbaatar city, Erkhes printing, 2010, 84p 2. “Establish Education Department” School of Medicine, Dean order 3. “Establish Division for Education Policy and Management” HSUM, president order 4. The to “Establish Faculty and Student development committee” School of Medicine, Dean order №A/3, 2011.09.20 5. “Establish Curriculum Committee” School of Medicine, Dean order №A/4, 2011.09.22 6. Questionnaires of lecturers’ opinion and suggestion about curriculum plan, administration, implementation and evaluation. Statement of the accrediting curriculum is compatible with requirements for specialist, model of specialist and job descriptions. 1. “Special license for medical training” provided to HSUM, №960003, 15 September,2010 2. The development document for Medical specialists, 2008 3. “The job description standard model of medical professionals”, Minister of Health order # 442, 2009, www.moh.mn 4. “Regulation of assistant doctor employment” Minister of Health order # 90, 2008, www.moh.mn 22
  • 23. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 2. EDUCATIONAL PROGRAM 2.1. Curriculum Models and Instructional Methods Basic standard: The medical school must define the curriculum models and instructional methods employed. Quality development: The curriculum and instructional methods should ensure the students have responsibility for their learning process and should prepare them for lifelong, self-directing learning. Implementation of the project TACIS/Tempus European union “Developing Medical Educational Framework” since 1995, Canada, Netherlands, Australia, Great Britain, Japan, Taiwan, Thailand, Malaysia, Korea have introduced integrated curriculum for providing basic medical education. During 1997-1999, the Medical University initiated the implementation of a model curriculum from the University of the Groningen (Netherlands) and the University of Leeds (England). The integrated curriculum was developed and implemented since 2000-2001 with a purpose to train basic doctors who are humane and compassionate, and have an ethical code, flexible and capable to meet the needs and expectations of the Mongolian society and the international standards. Gaining the membership of Asia Pacific Countries’ Medical Education Association (APC MEA) in 2006, Asia Pacific Countries’ Qualification Network (APQN) in 2008, and Asian Medical Education Association (AMEA) in 2009 was a step forward to become closer to sustainably implementing the changes recommended in international education and innovation, science and technology, medical development orientation and in terms of meeting the demands of today’s health care sector. Basic medical education program concept Health care strategies of medical science in XXI century are to prevent diseases instead of treating them after their onset, to implement guidelines for preventing and managing chronic diseases, to improve capacity of diagnostic laboratory, to conduct research work, to implement evidence based diagnosis and treatment approaches, to change unhealthy behavior for individuals, to avoid abusing drugs (Table 2.1). Table 2.1. Comparison between medical education program concepts № Indicators Traditional education program Integrated education program To focus on curative medicine To focus on public health and prevention 1 Concepts and treatment of diseases of diseases Acute and communicable To reduce risk factors for non- 2 Disease diseases communicable diseases Diagnosis and treatment based Diagnosis based on symptoms and 3 Diagnosis on causes of disease individual To focus on treatment for Not only treatment of diseases in 4 Treatment diseases individual 23
  • 24. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Chemical drugs Healthy lifestyle 5 Prevention Antibiotics Unhealthy habits Vaccine Rehabilitation 6 Profession Specialization General practitioner Basic medical education technology Education technology is one of the main instruments to improve the quality of basic medical education e and during the implementation of an integrated curriculum, we are using the following education technologies: Global strategy on medical education Our university’s traditional approach for medical education has been completely renewed by the implemented international strategy for medical education. The concepts of the traditional approach for medical education is mainly focused on scientific knowledge, and does not refer much to the socio-physical aspects and learning; is lecturer centered, content oriented, lectures dominated, all students participating and participation of students for planning and assessing of learning is inadequate. Learning is also separately obtained in the various branches of medical science. We conducted SPICES-T approach for implementing integrated curriculum (Table 2.2). Our strategy SPICES – T approach Lecturer centered Student centered • Student centered Lecture based Problem based • Problem based • Integrated Separated knowledge Integrated knowledge • Community oriented Hospital oriented Community oriented • Elected Standard learning Elective learning • Systematic • Team work Tutored Systematic Figure 2.1. Global strategy for integrated curriculum on medical education Coil shaped integrated curriculum We defined the integration between lessons in accordance with the recommendation of Association for Medical Education in the Western Pacific Region (AMEWPR) “Curriculum TIPS-Trends, Innovation, Priority and Strategy” as follows (Figure 2.1): • Horizontal integration • Vertical integration 24
  • 25. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • Integrated interdisciplinary medical science By this coil shaped medical curriculum students combine 2 basic purposes, theoretical and medical science, medical and communication skill, and until they become doctors, students study continually the 3 level programs I. Healthy constitution, activity and characteristics II. Path anatomy, activities and characteristics III. Medical practices) (Figure 2.2). Course goal 3rd stage Implementing into Branch sciences the clinics2nd stage Morphology Pathology, path physiology, Physiology Genetics behavior Surgery Pediatrics 1st stage Normal morphology, physiology, behavior Organ Clinical study (line) system Figure 2.2. Coil shaped curriculum (R.H.Harden “Practical guide for medical teachers”, 1997.) The integrated curriculum model is organized to accommodate the integration of basic science and medical science and tutor these to all years. In the earlier years basic knowledge is predominated, in the middle years this ratio is equal, and in final years subjects of medical science dominate. But until graduation students will acquire knowledge of the basic sciences The integrated curriculum is a: • Move from problem informing to problem solving • Training is brought closer to clinical practice • From didactic method of teaching to self learning and student centered training • Multidisciplinary • Students able to undertake lifelong and continuous training • Able to work as a team and with effective interpersonal communication skills The advantage of integrated medical curriculum is providing the opportunity to medical students to study clinical skills early and we try to build their capacities in both theoretical and clinical skills.The integrated medical curriculum includes studying the basic sciences in first 2 years of study and clinical courses within the framework of interdisciplinary approach through the active communication by lectures and students learning in small group discussions. Main principles The curriculum policy is to implement the training in evidence-based medicine using modern information technology (Figure 2.3). 25
  • 26. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Evidence Quality Info Integrated tech curriculum Figure 2.3. Basic medical education policy (R.H.Harden “Practical guide for medical teachers”,1997.) Also, the integrated medical curriculum has been using new trends in medical education technology such as information technology, lifelong learning methods, evidence-based medical science, research methodology, information management of medical science, communication skills consistent with the curriculum standards (Figure 2.4). Figure 2.4. Integrated curriculum (R.H.Harden “Practical guide for medical teachers”,1997.) Integrated curriculum model Even though the traditional system was teaching general sciences until 4th year and giving clinical lessons from 4th year onward.(curriculum H model). H model is based on the medical theory and clinical skill development (Figure 2.5). Curriculum content is mainly focused on the basic information of the sciences and health and psychosocial issues. The course is teacher oriented and information flow is from teacher to student, mainly using the lecture and mini-lecture as teaching methods. One model course covering all students, and students’ participation was not enough in the course planning and evaluation. The main disadvantage of this model is that the course teaches medical sciences in very high level and teaches basic medical education separately. 26
  • 27. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Z type H type Clinics Theor Clinics Theory Figure 2.5. Curriculum model Student assessment technology Based on Miller’s methodology, SOM has implemented a wide range of new assessment methods of student’s achievement including knowledge, skill and attitude such as multiple choice tests based on different types of clinical cases, objective structured procedural examinations OSCE, OSCE checklist, objective structured procedural examinations OSPE, and DOPS, Mini-CEX (Figure 2.6). Job place Skill lab Figure 2.6. Miller’s model of student achievement (Miller G.E., 1990) The “Basic medical education program” integrated curriculum The “Basic medical education” integrated curriculum is a complex document which corresponds to the articles and amendments of the Mongolian Education Law such as “General requirements needed for higher education institutions”, to the orders and decisions on implementation of higher education by the Minister of Education and Science, and to the Medical University Regulations developed by the Academic Committee in line with the above mentioned law and regulations to meet the peculiarities of the HSUM and also be in line with the orders and regulations of the president of the Medical University. The integrated curriculum is based on integration of biomedical and medical training, as well as the integration of practice and theory, improvement of the ability for critical thinking and decision making, facilitation of self-directed learning processes, enabling learning from advances and achievements in medical science and technology; enabling the students to choose an interesting field of study; directed towards reducing the reiterations in a program context; based on an integrated organ level medical skills training; ensuring the widening of the training context with advanced grades; ultimately based on a problem solving and student-centered approach. “Basic medical education” curriculum model is showed in Figure 2.7. 27
  • 28. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Figure 2.7. Integrated curriculum model The “Basic medical education” curriculum that has been implemented since 2000 is based on the principles of an integrated training program, which improves students learning abilities, focuses on integrating knowledge, practice and attitude training, and corresponds, with the current trends in medical training. The aim of the curriculum is to train medical doctors who following their graduation are able to improving the sanitation and hygiene for the population, take actions on preventing illnesses, through organizing public health interventions, diagnose and manage common diseases, be competent in using various methods of treatment, possess the capabilities for providing emergency medical care, demonstrate high level of medical ethics, abide by the laws and legal requirements and be capable of working at the primary care level. Basic science courses for freshmen are intended to give the students basic knowledge on general science needed for undertaking higher education, for person development to be humane and to lay the foundation for further study of professional courses. From second to fifth year, students study in various forms of integrated training programs which consist of 21 blocks of basic professional and skill development lessons (Table 2.2). Professional courses are generally studied during years I, II and these give them the capacity to undertake basic medical education. The content, the selection and the sequence of the courses are decided by the stipulations of the educational policy of the Medical University, the aim of the department that is responsible for teaching that specific course, the needs and requirements of employers and the reinforcement of the links between the professional groups. Clinical courses are focused on giving the students the capacity to meet social needs and employer’s requirements. The graduating specialist is the purpose of implementing of our program. We apply the curriculum model to improve the content, and the listing of the courses is to comply with the requirements regarding today’s needs. We always do research for continuing development. Based on the new program, over 4 years, besides the basic clinical courses, students are assisted to possess the knowledge, capacity and inclination towards studying the medical science. 28
  • 29. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Table 2.2. General structure of curriculum I grade II grade III grade IV V VI grade grade grade Genaral Must 1-6 block 7-11 12-16 17-21 General Basic Study block block block Basic Lesson Assimilate Assimilate abilities of clinical training basic abilities of program clinical training program Selectiv Basic professional, selective learning, e practicing lessons OSPEI, II lessons United OSCEI OSCEII OSCEIII examination Clerkship is a clinical self directed program that plays an important role in improving the application of their theoretical knowledge, gained from the block lessons, gaining practical experience, developing their clinical skills and capabilities, and formulates the structure of their medical ethics and motivations required to become a competent doctor. General rules for organization of training activities: In accordance to training curriculum in basic science and basic professional courses students acquiring knowledge and skills in following 3 stages: • Preclinical training to acquire basic clinical knowledge and skills (1-6 blocks) • Clinical training to acquire main clinical (7-21 blocks) • Clinical training (Line training and clerkship) The Medical University’s educational approach is changing from a teacher-centered learning to student- centered learning. The curriculum achieves this using the following types of teaching lessons: • According to confirmed standards, lectures are being taught as traditional, clinical and interactive forms. • Seminars are being held as solving problems, discussing case reports and presentations. • Small group practice trains students solving case study, training in the clinical skill laboratory, taking history from patient with lecturers, assessing test results, submitting diagnostic and treatment plan and counseling about treatment and prevention. • Self-practice time is included in time table because to train self-study and improve education quality. The students train under lecturer as self-study. • III, IV and V year students select and study up to 2 credit subjects via the training program as own interest. 2.2 Scientific methods Basic standard 29
  • 30. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Must reflect the basic principles of scientific methods and evidence-based medicine, teach the ability to analyze and cogitate in the curriculum development. Quality development Curriculum should include lessons for training students in scientific thinking and research methods. To convey the professional educational content to students, avoiding explaining the meaning by the use of books, but presenting basic knowledge through creative, rational methods and promote new ideas and different scientific opinions by linking specific scientific development and future trends. Tutors also try to reach the students by explaining, contradictory perspectives of evidence-based medical science and survey results. To meet this requirement, every tutor must also be a researcher, thus help develop critical and creative thinking. The integrated medical curriculum is focused on the student’s skills to do independent work, developing student-centered curriculum, integrate training, research, health care, clinical communication and management skills and students ability to learn independently. With this purpose in mind, we are providing training by using following methods: • Case based training • Integrated seminars • Use internet information’s and distance learning • Problem based learning and bedside training. The PBL training method has become one of the most successful methods using in training. Also by using case based and role play methods in professional training of the students, their involvement in these activities is improving the clinical and evidence based decision making skills. Self directed learning study Purpose of self learning at the Medical school is to promote a student centered approach, develop communication and practical skills in students. Self-directed learning (SDL) has been identified as an important skill for medical graduates. To meet the challenges in today's healthcare environment, self-directed learning is most essential. The Medical School has made SDLs a central part of the curriculum. In self- directed learning, students take the initiative in making use of resources rather than simply react to transmissions from resources, thus helping students to learn more and learn better. The main purpose of education is to develop the skills of inquiry, and more importantly to go on acquiring new knowledge easily and skillfully the rest of his or her life. Specializing lessons, using leaning methods such as take medical decisive initiative, role play, motivates student’s learning force, medical ability, capacity to solve evidence-based problem, are improving. Considering student’s assignment, selective learning in 3d, 4th and 5th year students are provided with possibility to choose from interested professional or specialized lessons and take 2 credit training. The encouraged curriculum processes are mentioned in the following: • Widen specific lesson’s theoretical subject or chapter, read materials from other books, write thesis and summaries and evaluate • As a trainee learn handling methods of specific operation from the tutors of departments, masters and residents • Resolve clinical issues given by the tutor and observe the results • Organize training program focusing on single person or collective people in order to educate them about taking preventive actions on diseases or medical educational program 30
  • 31. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 • In order to widen the framework of the surveyed subject, verify the essence of theories by practice, work on given clinical issue and evaluate • Participate in national and international Olympiads • Debate in conferences, organized at school, nationwide or internationally • Conducted by a teacher, learn the methodology of research works and master the abilities in handling in laboratories • Students should work as trainees in the province hospitals and score Research methodology The integrated medical curriculum conducts disciplines of research methodology from early years of study. During all academic year, students acquire the knowledge, concepts, methods, skills and attitudes necessary for provide medical research in the field of socio-economic, demographic and cultural determinants of causes, distribution and consequences of health problems. The introductory session on scientific methodology starts with Block 5, Society and the Physician. Scientific Method and Methods of Health Education. The aim of this course is to teach medical and other research skills and to encourage an interest in medical research in their future careers. Also students should know how to organize and conduct health education courses for population and target groups. Students will achieve above mentioned goal through the clinical problem-solving tasks, problem-based tutorials and exercises in evidence- based practice, as well as student research projects and assignments. The main block to teach basic medical research methodology is Block 20, Research Methodology, which is worth 5 credits. The Department of Epidemiology and Biostatistics is responsible for this course. Students learn theoretical and practical knowledge, and the basic skills to conduct medical research work, to develop decision making abilities using data from evidence based medicine, and to demonstrate research and survey skill. Students are required to write research papers and projects. Research activities Research activities become an important factor affecting the content and the quality of the training. There is an independent association for students and tutors teach research methodology and conduct their research works. The results of research activities of students and tutors are regularly presented and published in the following ways: • Organizing conferences and seminars, presentations at the joint seminars, and abstract publications • Report of results of studies in medical magazines and newspapers • Publishing a summary of students work • Reporting research work and results on the school website The Medical University organizes activities such as establishing professional clubs among students, tutoring students on selected topic, debating about selected essays from the clubs, organizing Olympiads and form groups of chosen students and preparing them using specialized program to participate in National Olympiads. Annually, the Medical University also organizes a conference “Students’ scientific convention”, from where students can be chosen and given awards, and also provided with the needed laboratories and research equipment. The students of the Medical University can be selected from 15 students’ clubs and associations according to their field of interest and also provided with the opportunity to participate in various conferences. The Medical University students annually organize “Specialty promotion days” to promote interest in the medical profession and also they participate successfully in many events such as World Health Days. 31
  • 32. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Students’ clubs, which are focused on supporting students in their learning process to help improve foreign language skills and research methodology, are functioning efficiently. Clubs were originally established to give their members and students of the Medical University the opportunity to enhance their knowledge and skills, and enable them to acquire knowledge on modern science and technology outside the formal curricular training. Clubs and associations of the Medical University are coordinated by researchers and teachers of SOM departments. Club and associations, have as their main purpose, the organization activities that give students opportunity to work independently or in teams, in activities focusing on humanitarian, and public deeds that enable students to spend their leisure time efficiently. Association and clubs that have received ratification from the Student’s Office are shown in Annex 1. 2.3 Basic Biomedical science Basic standards: The School of Medicine must identify and incorporate in the curriculum the contributions of the basic biomedical sciences to create understanding of the scientific knowledge, concepts and methods fundamental to acquiring and applying clinical science. Quality development: The contributions in the curriculum of the biomedical science should be adapted to the scientific, technological and clinical developments as well as to the health of the society. Integrated curriculum is a process to accommodate the integration of basic medical and clinical science and to teach basic biomedical science to all students. Integrated curriculum is implemented in form of branch science and covers various medical science subjects, particularly, in the first year of curriculum during which basic theoretical courses are covered. In the subsequent years, clinical science courses will be taught, which would contain integrated subject areas and the, training methods focuses on interaction between student and teacher, small group training, cooperative teacher in theoretical and clinical science and share experiences. Medical science has been developing rapidly since the 2nd half of the XX century and students study the human body at molecular and genetic levels, about diagnosing disease at early stages (being aided by molecular and cellular sciences) and about new treatment methodologies focusing on molecules. 1st and 2nd level preventive actions, social-psychological health, healthy environment are also considered to be important. We prepare professionals, who will be working as XXI century doctors, thus it becomes indispensible to include new directions into the curriculum, and so continuous changes are being constantly made. For example, “Human, health and clinical science” block teaches general understanding of human, human health, clinical appearance and state, social, biological, psychological factors that affect humans, and preventive medical science. In the block “Molecule to cell” lessons such as structures of organism, organization of cells and molecules as basic units for functioning, micro level circulation of biochemical reactions, lifecycle of a cell, distinguish between circulating or non circulating destruction of a cell, give basic knowledge of medicine and introduce new methodologies of bio analyzes, and also allow students to combine these with other lessons. After having studied these two blocks, the process of basic unit cell becoming a tissue of a human body functioning, functions of early stage reproduction system with other science such as physiology, biochemistry, immunology, branches of pathology are taught in blocks “Cell to tissue” and “Systems of organs”. The purpose of “Society and environment”, “Society and doctor” blocks are to provide bachelor degree level education on preventive medical science, by relating the processes of society with the doctor to establish the role, responsibilities, professional habits and qualities expected from professional actions, such as interactions between doctor and patient, jurisprudence, health care systems and development of required attitudes. Basic biomedical science is the basis of clinical science lessons and consists of the following. : 32
  • 33. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 1. Anatomy of human body (8 credits) Student will possess knowledge about the normal human body anatomy of skeleton, ligaments, muscles, respiratory, digestive, urinary, male and female reproductive, nervous, sensory, cardiovascular, endocrine systems. Also gain knowledge about its composition, organ size, shape, function, development, embryogenic norms, age related characteristics, commonly occurring anomalies, normal organ location, innervation and vascular supply. 2. Physiology of human body (6 credits) Students gain knowledge about normal human tissue, organ and system, central nervous, endocrine, blood, cardiovascular, respiration, metabolism, excretion, acid base balance, reproduction, sensory organ’s physiology, human body physiological mechanism, their regulation, principle of adaptation, physiological basis of experiments, laboratory and instrumental analysis, understanding of bioethical issues. 3. Histology (4 credits) Gain knowledge about human embryo development stages, early manifestation of histological action, human eucaryot cell structure, determining ultra structure of cells by using electron microscope. Tissue classification, structure, their relation, understanding structure and functional units on a micro scale, distinguishing human tissue, cell structure in micro preparations. 4. Pathologic anatomy (4 credits) To study understanding of general pathology, cell tissue reaction against any disease, adaptation, regeneration and cancer changes. To determine macro and micro changes in systemic disease, disease etiology, pathophysiology, complication, death and differential diagnosis based on general histological concept and clinical thinking. 5. Pathologic physiology (4 credits) Basic theoretic concepts of disease, etiology of disease, development of conditions, pathophysiological progression of a disease, general principles, causes, and prognosis of the common diseases of population 6. Biochemistry and nutrition (3 credits) The structure, characteristics and mechanism of macromolecules that form the basic components of body and foods such as proteins, nucleic acids, carbohydrate, fat, vitamins, enzymes and their exchange, regulation and deficiency. 7. Microbiology (2 credits) The structure, forms, development and mutation of microbes and mechanism of pathology of tissues and detection and laboratory analysis of pathological microbes, basic methods of analysis and knowledge about prevention form infections 8. Immunology (2 credits) General understandings about immunology and immunology system, specific and non specific immunological reactions, antibodies, immune cells, organs, interactions of cells in immune reactions, immune mechanism 9. Molecular biology (2 credits) Principles of molecular biology, genetics mechanism in molecular pathology, diagnostic molecular and biological methods, causes of pathology and origins, pathophysiology, intracellular research, modern research methodologies in molecular biology, genetic engineering and basics of cellular biology 10. Genetics (2 credits) 33
  • 34. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Skills to use the genetics textbooks and journals, think about diseases in genetic terms, know about heredity of diseases, define the forms of heredity and develop skills in genetic prognosis, genetic counseling, referral of patients with right indication for genetic analysis, advocacy about genetics with the public 11. Pharmacology (4 credits) To know about essential medicines which are used for prevention, diagnosis and treatment, public and clinical package of services and their chemical structure, poisoning and coping mechanism in a human body and counseling skills and about rational drug use. 2.4. Behavioral and Social Sciences and Medical Ethics Basic standards: The School of Medicine must identify and incorporate in the curriculum the contributions of the behavioral sciences, social sciences, medical ethics and medical jurisprudence that enable effective communication, clinical decision making and ethical practices. Quality development: The contributions of the behavioral and social sciences should be adapted to scientific developments in medicine, to changing demographics and cultural contexts and to health needs of society. The main responsibility of organizations and institutions granting higher education is not only prepare professional experts but also set up people, who have sense of responsibility for their profession, who are active in the society, and are skilled in communication. In the section “General requirements for graduating students” of the Higher education model standards, it is stated: • Demonstrate the ability to observe the ethics, adhere to legislative rules in taking action to coordinate the interactions between environment, society and people • Demonstrate the ability to live healthy lifestyle and improve one’own physical conditions • Acquire the knowledge of ethics, of democracy, and the demonstrate the ability to comprehend the historical and cultural heritage and abide by the traditions of humanity • Possess the ability of working as a team, be participative and respectful towards other ‘s viewpoints and taking responsibilities for one’s own self and for others • Possess the ability to debate and summarize in Mongolian • Possess the ability to work independently in a constantly changing environment In accordance with Order #481 of the Minister of Education, Culture and Science of Mongolia signed on 29 December, 2006, modifications have been brought about in the content of bachelor degree training program. According to this new content, new lessons on social, humanitarian and natural sciences have been included into the curriculum. Besides the general requirements expected by employers in terms of professional skills, they place emphasis on improved communication skills, ability to work independently and in a team. Therefore, School of Medicine is striving to train skilled professional graduates, who are also excellent social individuals and civilians with high sense of civic responsibilities. The main aim of the School of Medicine is to train doctors, who are humane and caring, who possess the qualities of compassion high ethical standards, values, and are flexible as experts and doctors who conform with international standards. To accomplish these, lessons in communication, social sciences, medical ethics and law have been included in the curriculum. One. Subjects areas in the domain of Humanitarian Sciences 1.1. Fundamentals of Philosophy (3 credits) 34
  • 35. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 This subject focuses on main branches and theories of philosophy, ontology, theory of epistemology and main elements of philosophy, philosophy of morality, esthetics, humanitarianism and religion. It also discusses issues in social philosophy, etc. 1.2. Mongolian history (3 credits) This subject focuses on periods of Mongolian history, nomadic and modern civilization, society, state, culture, periods of development, features of regional zones of Mongolia etc. 1.3. Culture study (2 credits) This subject examines the issues in the cultural history of Mongolia, overview of culture, main duties of culture, main factors of influencing culture, communication and culture, and history of world culture, cultural monuments, and ideology of famous representatives. 1.4. Ecology and environmental protection (3 credits) Ecology is the scientific study of the relation of living organisms with each other and their environment are covered in this course During this course students will learn about relationship of ecology and other sciences, factors influencing ecology, fundamentals of ecology, ecological systems, human ecology, social ecology, community ecology, natural resources, classification and utilization of resources, environmental pollution, prevention from pollution, environment protection, and restoration of nature and legal issues of ecology. 1.5. Human development (2 credits) Topics include information on fundamental principles of human development, human development perspectives, equity, inequality, poverty, human safety, human development and globalization, human development and gender, human development and economics, policy, political organizations and human development. 1.6. Syntax of the Mongolian language. (2 credits) Focuses on basic concepts of syntax: principles and rules for constructing sentences, classification of syntax, specific features of syntax, vocabulary and choice, how to use words and expressions, vocabulary and expression limitation, specific characteristics of idioms, combination of words, word order in sentences, order of the parts of a sentence, difference in the scripts, genres and script types, literacy, structure of script and etc. Two. Subjects areas in the domain of Social Sciences 2.1 Basics and theory of Economics (3 credits) 35
  • 36. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 Focuses on basic theories of economy, methods of study, micro-economics, factors affecting the market, macroeconomics, development of economy, (foreign trade, payment balance, international money configuration, economy development) 2.2 Fundamentals of Political Studies (2 credits) Emphasizes the principles and objectives of political sciences, research methods, roles of political sciences, political life and governing communication, role of politics in a modern social life, history of political thought, main types of political doctrine/teaching/, civil society, essential characteristics of civil society, specific features of Mongolian civil society, political institutions, political system and political organization, composition of political organizations and their role, mechanism of their activities and interrelations, political governance, political regimes, party politics, election systems, historical types of state associations, political interactions and processes, political culture and its components, types of political culture, political values, political culture of society, class, group and individuals, political socialization and political contribution. 2.3 Fundamentals of Sociology (3 credits) Students will learn about objects of sociological sciences, research methods, society and its types, elements of a society, social institutions, social groups, social context of individuals, evaluation of social events, and sociology research methods. 2.4 Fundamentals of Psychology (3 credits) This course covers several areas of psychology including learning, motivation, emotion, developmental changes, personality, abnormal behavior, psychotherapy, and social behavior with special attention to the physiological and neurological basis of human behavior. Students will learn about psychology of behaviorism, neobehaviorism, and gestalt, branches of freudism and neofreudism, structures of the brain and mentality, how we sense and perceive the world around us, how we learn, and what motivates us, instincts, mental functioning, and assessment of mentality. The course will review the scientific basis of psychology and learn how scientific research is conducted in psychology. Learn about research principles and methods, major approaches to understanding human thought and behavior including biological, cognitive and behavioral models of human functioning, human temperament, human talent, motivation physiology, principles of society and psychology. 2.5 Fundamentals of management (3 credits) This course covers scientific basis of management and objectives of management, institution or organizational governance and manager’s activities, management thinking development, governance strategy and plan, institution’s social responsibilities, leadership, ethics, communication, decision making, human resources 36
  • 37. Self-Evaluation Report, SOM, HSUM BME program evaluation by WFME/AMEWPR Standards 26 September, 2011 management, structure of organization, institution change management, conflict management, management of an institution’s monitoring system. Three. Communication skills, ethics, medical jurisprudence and legal norms 3.1. Communication skills (2 credits) This subject is intended for first grade students of HSUM to give fundamental knowledge on communication skills, ethics and legal norms. During this course medical students will learn about fundamental principles of communication, communication culture and its types, communication and attitude intrinsic characters, value of profession of doctor, medical pedagogy, specific features of adult learning, teaching and learning process, duties and responsibilities of learners, paper or report presentation skills, ethics and its norms. Also students achieve knowledge about UNIFACE student program, student rules and HSUM rules. 3.2 Ethics for a Practitioner Emphasizes the doctor’s values, humanity, flexibility, fairness, ethics, special features of the medical profession, image of practitioner /doctor/ and its negative and positive factors, group work and group communication, cooperative activities, types of group, treatment and patient groups, group mentality, topics on communication between practitioners /doctors/, practitioner and patient communication, practitioner- practitioner communication, practitioner and society communication. Students frequenting these subjects through following blocks:” Society and practitioner”, “Nursing”, “Mental health”, “Society and environment” Also in each blocks, as a part of clinical skill education program, there are topics of communication skills with patients, pediatric patients, seniors, patients in the terminal stage of disease and their families. 3.3 Medical jurisprudence and legislation Discusses the following topics: practitioner’s error, its legal basis; mental preparedness to communicate with suspect, victim and criminals, lawyers and medical workers, and examining cadavers; comply with biomedical ethics, learn how to justify and show fairness in forensic decision making and drawing expert conclusions. Students also encounter these subjects through following blocks: “Society and practitioner”, “Mental health”, “Society and environment” 3.4 Scientific method and Methods of health education (2 credits) This 2 credit course is designed to teach second year students health education methods, communication and consultation skills. The course is based on the self-learning method to acquire knowledge and skills on how to conduct health education research, how to organize health education courses for general population and target groups. During the course students will improve their presentation skills. Students will achieve above mentioned goals through the clinical problem-solving tasks, problem-based tutorials and exercises in evidence-based practice, as well as student research projects and assignments. In 2009-2010 academic year 343 students (85.3% of all students) from School of Medicine had participated in a Health education program. 3.5 Training for assistant practitioners. During this course students learn about methods of team work, PBL, how to identify the problems, skills in decision making and critical thinking, complex problem solving, determine ways for solving problems, and other ways of individual development to enable the person to work harmoniously in society and community. Focuses on: • human actions intended to benefit the patient or others, ethical principles and appropriate attitudes and professional caring for patients, and in relating to patient’s families and to others involved in the care of patients • Learn skills of being just and fair, respect for institutional and patient privacy • Learn team working skills to work with medical staff and colleagues. Learn skills in ethical decision- making within the context of the complex issues and act effectively. 37