Medical education and the pursuit of excellence : the quest for the Holy Grail?

Medical education in Europe is currently facing enormous challenges brought about by the number and the diversity of medical schools that are now within the fold. This diversity is amplified by different educational systems, cultural and socioeconomic issues, health care delivery systems and the ever increasing burden of communicable and non-communicable disease. There is also a movement away from traditional taught curricula to curricula that emphasise self-directed learning and thererby promote lifelong learning. The ultimate goal of undergraduate medical curricula should be to produce a medical doctor with certain core competances and the right basis for further specialisation and adaptability to different roles in health care. Furthermore, increasing professional mobility has highlighted the need for the establishment and maintenance of standards for quality assurance common to all EU countries.peer-reviewe

The Bologna Process and the reform of medical education

In 1988, the Magna Charta Universitatum was signed at a meeting of European University rectors on the occasion of the 900th Anniversary of the University of Bologna to mark their commitment to harmonising the European Higher Education sector. Subsequently in 1999, Ministers of Education from 29 countries were co-signatories to the Bologna declaration. Since that time, the Bologna process has developed from a declaration of commitment to improving education to a process dedicated to standardising education, ensuring quality whilst maintaining the appropriate level of flexibility.peer-reviewe

Research in medical education

The year 2009 saw a number of developments in Medical Education in Malta that were initiated as a result of a commitment to revising the medical curriculum in order to meet the challenges in medical education. A record number of students were admitted to the medical course in 2009. There is concern that eventually this exponential increase in admissions is not sustainable due to infrastructural, financial and human resource restraints. Meanwhile there has been a simultaneous attempt to re-vamp the first and second year curriculum and to continue to fine tune the curriculum in years three, four and five. Students are now introduced to clinical scenarios as early as during the first year of the medical course and case based learning is being implemented into a modular system of teaching that integrates anatomy, physiology, biochemistry and genetics to ensure a holistic approach to understanding the human body in health and subsequently in disease. It is hoped that such changes will bring the University of Malta Medical School more in line with the ethos of the Bologna process and the European Credit Transfer System.peer-reviewe

The role of the discount rate in tendering highway concessions under the LPVR approach.

Flexible-term highway concessions are becoming quite popular around the world as a means of mitigating the traffic risk ultimately allocated to the concessionaire. The most sophisticated mechanism within flexible-term concession approaches is the least present value of the revenues (LPVR). This mechanism consists of awarding the concession to the bidder who offers the least present value of the revenues discounted at a discount rate fixed by the government in the contract. Consequently, the concession will come to an end when the present value of the revenues initially requested has been eventually reached. The aim of this paper is to evaluate the effect that the discount rate established by the government in the bidding terms has on the traffic-risk profile ultimately allocated to the concessionaire. To analyze this effect, a mathematical model is developed in order to obtain the results. I found that the lower the discount rate the larger will be the traffic risk allocated to the concessionaire. Moreover, I found that, if a maximum term is established in the contract, the lower the discount rate, the less skewed towards the downside will be the traffic-risk profile allocated to the concessionair

Rheumatoid arthritis and spondyloarthropathy

Part 2 of the article can be found through this link: https://www.um.edu.mt/library/oar//handle/123456789/13280Rheumatoid arthritis (RA) and spondyloarthropathy are two groups of inflammatory joint disease. Detection of early inflammatory joint disease is not possible with clinical examination or plain radiography, which have been the main diagnostic methods in the past. Changes detected on plain radiography are those of chronic damage caused by these conditions rather that acute inflammation, which results in delay in diagnosis and often suboptimal outcomes in these patients.peer-reviewe

What is Doppler ultrasound?

The term Doppler should be capitalized because it refers to Christian Johann Doppler, an Austrian physicist (1803–1853). He described a phenomenon whereby the frequency of sound changes when it is reflected off a moving object. If the object is moving towards the observer, reflected sound frequency is increased (blue shift), while if the reflecting object is moving away from the observer, the sound frequency decreases (red shift). This is analogous to a moving ambulance with its siren on; the siren pitch increases as ambulance approaches and decreases as it receeds. The Doppler Effect may be used also in ultrasound. With normal grey scale ultrasound we rely on amplitude of reflected sound waves and the reflectivity of anatomic structures is proportional to the intensity (or amplitude) of the reflected sound and hence brightness on the scanner display. If frequency (rather than amplitude) is analysed, one can detect motion on the basis of Doppler shifts. These frequency shifts can be quantified reasonably accurately according to direction, velocity and also acceleration, all of which provide specific signatures that help identify both normal and diseased blood vessels.peer-reviewe

Medical education and healthcare needs

Educators in the sphere of medicine face a number of complex challenges in the provision of a learning environment suited to ensuring students acquire essential core competencies as well as additional skills and expertise targeted to their area of practice This needs to be done against a series of standards in medical curricula for quality assurance purposes. Furthermore, in medicine, the concept of life long learning is essential to the further honing of available skills and the acquisition of new expertise relevant to the ever-changing and increasing demands on medical practitioners. Mobility of graduates and doctors has highlighted this, as moving to a different geographical area invariably causes a change in the working environment, the medical problems encountered and the resources available to deal with these issues.peer-reviewe