Quantity ahead of quality in medical education

Turkey quietly broke a world record over the last 20 years. This record was achieved in such topics as the number of new medical schools opened and the ratio of these schools to the population.

According to Turkish Medical Association (TTB) data, the ratio of medical schools for a population of one million is 0.62 for North America and the world average is 0.30.

Turkey has left the most developed Western countries behind in this field. The ratio in question for Turkey has exceeded 1 and has reached 1.02 in the year 2010. However, the government still does not find this ratio adequate and encourages new medical schools to be opened.

The TTB’s Undergraduate Medical Education Report 2010 demonstrates that in Turkey a major boost was experienced in the opening of new medical schools, especially in the 1990’s and 2000’s. According to this, the number of medical schools, which was 25 in 1990, increased to 47 by 2000 (an increase rate of 88 percent).
 
A similar increase trend is also applicable to the next 10 years. The number of medical schools, which was 47 at the beginning of 2000, reached 74 in 2010 with a 57 percent increase. In 2010, 66 of these schools were recruiting students; eight of them had been established and were preparing to accept students. In 2012, the number of schools accepting students was 74. However, this number is close to 85 including the ones that have been established but have not started accepting students.

In the case that this trend continues, it would not be wrong to say that before 2020, the total number of medical schools will exceed 100.

On the other hand, in Germany, the number of universities offering medical education is 41, in France 52 and in Italy 42.

Yes, in Turkey, there is an impressive rise when viewed quantitatively. Well, can we talk about the same impressiveness from the point of the quality of the education?

All the objective data before us suggests that the qualitative development, in other words “quality,” is seriously behind the quantitative increase.

Actually, there does not seem to a problem from the point of the qualifications of students registering for medical schools. Generally, we see that the acceptance scores of even the newest medical schools are high; however, it is not possible for us to make a similar observation about the academic environment waiting for the new recruits in these medical schools.

According to the TTB’s report, we are faced with a very thought-provoking picture. For example there are medical schools which do not have an anatomy laboratory, where students complete their anatomy courses without seeing a cadaver.

In the 66 medical faculties the TTB evaluated in 2010, only in 44 of them there are basic science laboratories. The number of medical faculties that do not have a professional skill laboratory is 12.

Also, the number of departments and number of faculty in the departments are also sources of concern. In this total, the number of schools that have medical history and ethics departments is only 33. There are also many medical schools that do not have professors or associate professors in their departments. This list is long.

Another concern is that the increase rate of the number of faculty (8 percent in the period between 2008 and 2010) has been left behind the increase in the number of students (14 percent). This indicates that the student/faculty ratio will increase in coming years.

However, in 2010, with the Full Time Law, it can be estimated that these calculations further regressed back when the faculty who quit are also included in the figures as well as those who are banned from conducting applied training because they have private practices.

The TTB report said, “Even though there have been quite a number of medical schools opened in the past 10 years, some of these lack a mission, adequate resources and adequate clinical training and research means… Students, in their clinical internships, face an educational environment quite far from their basic knowledge and skill levels, in extremely specialized clinical fields, most of the time in training environments that have not been structured for them.”

It can be seen that opening new medical schools does not mean that medical education is advancing.

Sedat Ergin is a columnist for daily Hürriyet in which this piece was published on March 5. It was translated into English by the Daily News staff.