Continuing medical education in Serbia with particular reference to the Faculty of Medicine, Belgrade
Abstract
Background/Aim. Continuing Medical Education (CME), conceptualised as lifelong learning (LLL) aims at improving human resources and continuing professional development. Various documents of European institutions underline its key importance. This paper therefore tries to analyse the current status of CME and the main deficits in the delivery of LLL courses at medical faculties in Serbia with special consideration of the Faculty of Medicine in Belgrade with detailed financial data available. Methods. Data of 2,265 medical courses submitted in 2011 and 2012 for accreditation were made available, thereof 403 courses submitted by 4 medical faculties in Serbia (Belgrade, Kragujevac, Niš, Novi Sad). A subset of more detailed information on 88 delivered courses with 5,600 participants has been provided by the Faculty of Medicine, Belgrade. All data were transferred into an Excel file and analysed with XLSTAT 2009. To reduce the complexity and possible redundancy we performed a principal component analysis (PCA). Correlated component regression (CCR) models were used to identify determinants of course participation. Results. During the 2-year period 12.9% of all courses were submitted on pre-clinical and 62.4% on clinical topics, 12.2% on public health, while 61.5% of all took place in Belgrade. The subset of the Faculty of Medicine, Belgrade comprised 3,471 participants registered with 51 courses accredited and delivered in 2011 and 2,129 participants with 37 courses accredited and delivered in 2012. The median number of participants per course for the entire period was 45; the median fee rates for participants were 5,000 dinars in 2011 and 8,000 in 2012, resulting together with donations in a total income for both years together of 16,126,495.00 dinar or almost 144,000.00 euro. This allowed for a median payment of approximately 90 eur per hour lectured in 2011 and 49 euro in 2012. The 2 factors, D1 (performance) and D2 (attractiveness), identified in the PCA for Medical Faculties in Serbia, explain 71.8% of the variance. Most relevant are the duration of the courses, credit points, and hours per credit point gained by lecturers and participants respectively. In the PCA for Belgrade D1 and D2 explain 40.7% of the total variance. The CCR on the number of participants reveals the highest positive impact from the number of lecturers per course and the expenditure on amenities, the highest negative impact from the total income collected per participant. Conclusion. The faculties of medicine in Serbia should reconsider the entire structure of their organisation of CME, especially to improve the quantity and quality of registration limit the course fee rates per hour and reduce administrative and other costs request lecturing in CME programmes as obligatory for academic promotion and organise a focussed marketing.
References
Aspin DN, Chapman JD. Lifelong learning concepts and con-ceptions. In: Aspin DN, editor. Philosophical perspectives on lifelong learning. Netherlands: Springer; 2007. p. 19.
Groot W, van den Brink MH. The health effects of education. Econom Educ Rev 2007 26: 186−200.
Bjegovic-Mikanovic V, Czabanowska K, Flahault A, Otok R, Shortell S, Wisbaum W, et al. Adressing needs in the public health workforce in Europe. In: European Observatory on Health Systems and Policies. Copenhagen: WHO-EURO; 2014.
European Parliament and the Council. Decision No 1720/2006/EC of the European Parliament and of the Coun-cil of 15 November 2006 establishing an action programme in the field of lifelong learning. 2014. [cited 2014 January 24]. Available from: http://eurlex.europa.eu/LexUriServ/site/en/oj/2006/l_327/l_32720061124en00450068.pdf
European University Association (EUA). European Universi-ties' Charter on Lifelong Learning. Brussels: European University Association. 2008. [cited 2014 Mar 3]. Available from: http://www.eua.be/publications/#c398
Conference of European Ministers Responsible for Higher Education: Communiqué on the Bologna Process 2020 – The European Higher Education Area in the New Decade. Leu-ven/Louvain-la-Neuve; 28-29 April 2009. Available at: http://www.ond.vlaanderen.be/hogeronderwijs/bologna/2010_conference [accessed 2014 January 24].
The European Union. Official Journal of the European Union 2009 C302/3. [cited 2014 January 24]. Available from: http://publications.europa.eu/official/index_en.htm
The European Union. Official Journal of the European Union 2009 C119/5. [cited 2014 January 24]. Available from: http://ec.europa.eu/education/lifelong-learning-policy/eqf_en.htm
Sursock A, Smidt H. Trends A decade of change in European Higher Education. European University Association. 2010. [cited 2014 January 24]. Available from: http://www.eua.be/typo3conf/ext/bzb_securelink/pushFile.php?cuid=399&file=fileadmin/user_upload/files/Publications/Trends_2010.pdf
Terzić Z, Vukasinović Z, Bjegović-Mikanović V, Jovanović V, Janicić R. SWOT analysis: the analytical method in the process of planning and its application in the development of orthopaedic hospital department. Srp Arh Celok Lek 2010; 138(7−8): 473−9. (Serbian)
Supic ZT, Bjegovic V, Marinkovic J, Milicevic MS, Vasic V. Hospital management training and improvement in managerial skills: Serbian experience. Health Policy 2010; 96(1): 80−9.
Milicevic-Santric MM, Bjegovic-Mikanovic VM, Terzic-Supic ZJ, Vasic V. Competencies gap of management teams in primary health care. Eur J Public Health 2011; 21(2): 247−53.
Radak D, Dedović S, Nikolić R. Continuing medical education-a modern fad or a future system. Srp Arh Celok Lek 2004; 132(1−2): 59−63. (Serbian)
Republic of Serbia. Law on Higher Education. "Official Ga-zette of RS", No. 76/2005. (Serbian)
Republic of Serbia. National Strategy for Development of Adult Education. "Official Gazette of RS", No. 55/05, 71/05. (Serbian)
Republic of Serbia. Law on Chambers of Health Workforce; Law on Health Care. "Official Gazette of RS", No.107/2005, 99/2010. (Serbian)
Republic of Serbia. Bylaw on closer conditions for delivering of continuing education for health worforce and health cooperators. "Official Gazette of RS", No. 130/2007.
Centre for Continuing Medical Education of the Faculty of Medicine, University of Belgrade. 2014. [cited 2014 March 3]. Available from: www.mfub.bg.ac.rs
University of Belgrade. Strategy for Development of LLL. 2014. [cited 2014 March 3]. Available from: http://www.bg.ac.rs/files/sr/studije/DozivotnoObrazovanje_strategija.pdf (Serbian)
Republic of Serbia. Law on Health Care. . "Official Gazette of RS", No. 107/05, 72/09, 88/10, 99/10, 57/11. (Serbian)
The health Council of Serbia. [cited 2014 February 20]. Available from: http://www.zdravstvenisavetsrbije.gov.rs/ (Serbian)
Military Medical Academy. [cited 2014 Feb 20]. Available from: http://www.vma.mod.gov.rs/eng/ (Serbian)
National Bank of Serbia. [cited 2013 January 1]. Available from: http://www.nbs.rs/internet/cirilica/scripts/ondate.html (Serbian)
Rencher AC. Methods of multivariate analysis. New York, NY: Wiley; 2002.
Magidson J. Correlated Component Regression: Re-thinking Regression in the Presence of Near Collinearity. In: Abdi H, Chin WW, Esposito Vinzi V, Russolillo G, Ttrinchera L, editors. New Perspectives in Partial Least squares and Related Methods. Springer-Verlag; 2013.
Hair JF, Tatham RL, Anderson RE, Black W. Multivariate data analysis. 5th. London: Prentice-Hall; 1998.
Costa A, van Hemelryck F, Aparicio A, Gatzemeier W, Leer JW, Maillet B, et al. Continuing medical education in Europe: towards a harmonised system. Eur J Cancer 2010; 46(13): 2340−3.
Balmer JT. Transforming continuing education across the health professions. J Contin Educ Nurs 2012; 43(8): 340−1.
Price D. Continuing medical education, quality improvement, and organizational change: implications of recent theories for twenty-first-century CME. Med Teach 2005; 27(3): 259−68.
Campbell C, Silver I, Sherbino J, Cate OT, Holmboe ES. Competen-cy-based continuing professional development. Med Teach 2010; 32(8): 657−62.
Birt C, Foldspang A. European Core Competences for Public Health Professionals (ECCPHP). Brussels: ASPHER; 2011.
Faculty of Medicine, University of Belgrade. General Regula-tions. [cited 2014 February 20]. Available from: http://www.mfub.bg.ac.rs/sr/organizacija_fakulteta/opsta_akta_u_primeni/ (Serbian)
Faculty of Medicine, University of Belgrade. Pravilnik o organi-zovanju i sprovođenju kontinuirane medicinske edukacije na visokoškolskoj ustanovi Univerziteta u Beogradu. 2013. [cited 2014 January 24]. Available from: http://www.mfub.bg.ac.rs/dotAsset/58133.pdf (Serbian)
Bjegovic-Mikanovic V, Vukovic D, Otok R, Czabanowska K, Laaser U. Education and training of public health professionals in the European Region: variation and convergence. Int J Public Health 2013; 58(6): 801−10.
Vukovic D, Bjegovic-Mikanovic V, Otok R, Czabanowska K, Nikolic Z, Laaser U. Which level of competence and performance is expected?, A survey among European employers of public health professionals. Int J Public Health 2014; 59(1): 15−30.
