Ruyssers, Natacha

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A new curriculum based on four pillars []

Ruyssers, N

German Medical Science

A new curriculum based on four pillars

Natacha Ruyssers

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96
Tijdschrift voor Medisch Onderwijs, maart 2010 | Vol. 29, nr. 1, p. 96-98
Introduction
A few months ago, I was asked by our fac-
ulty administration to write a paper about
medical education at the University of
Antwerp in Flanders, the Dutch speaking
part of Belgium. They thought I was the
right person for this assignment because
not only do I know the faculty of medicine
as a student, I also participated in the de-
velopment of the education programme.
In the following, I will highlight some top-
ics which I think are unique to medical
education in Flanders.
The new curriculum and the 
bachelor-master structure
Over the past three years, professors of
our faculty, together with a group of stu-
dents, have developed a renewed and im-
proved curriculum, aimed at educating
better basic doctors who have the compe-
tencies required to enter further training,
either in one of the clinical specialities, in
family medicine, social medicine or in re-
search. In 2006 the new curriculum was
first implemented in the first year of the
bachelor programme and over the follow-
ing years it was gradually extended until
today only the students in year 5 (master
2) are still following the old curriculum.
The new curriculum is built on four pil-
lars. The first one is the knowledge pillar,
consisting of basic science courses and
modules. The second pillar is the scientific
pillar, which introduces students to re-
search, laboratory work, writing scientific
English, data analysis, etc. Then there is
the doctor & society pillar, which focuses
on the role of the doctor in contemporary
society, and the fourth, clinical pillar deals
with clinical and communication skills.
The clinical pillar is the showpiece of
medical education at Antwerp. It is aimed
at equipping students with clinical skills
and preparing them for their future prac-
tice as medical professionals. Addition-
ally, the clinical pillar includes learning
how to communicate with patients in 
hospital and primary care settings. A spe-
cially trained communication team orga-
nizes these courses, comprising theoreti-
cal sessions and sessions with simulated
patients. In the latter sessions, students
practise the skills learned during the the-
ory sessions, such as breaking bad news
to patients. Afterwards students 
receive feedback from the teachers, the 
simulated patients and their peers. Clini-
cal skills, such as abdominal examination,
CPR, suturing, catheterization, paediatric
examination, etc. are taught by the ‘prac-
tice team.’
The implementation of the bachelor
master structure was used to create two
phases in the seven-year undergraduate
medical programme: the bachelor phase
and the master phase. The programme of
the three-year bachelor phase covers all
aspects of the healthy human being but
includes also some important clinical syn-
dromes. The second phase comprises the
four master years. In master years one
and two, the main subjects are clinical
syndromes, diagnosis and treatment
strategies. The sixth year (master 3) is a
period of clinical training during which
students are judged on their clinical skills.
The fourth and final master year consists
A new curriculum based on four pillars
N. Ruysserss
Students’ experiences
97
The Flemish experience | N. Ruyssers 
of four months of clinical training,
courses to refresh basic medical knowl-
edge and a research thesis, which stu-
dents have to present to a jury.
In this way students gradually learn
about human nature, organ systems, 
health versus disease, clinical syndromes
and how to deal with patients and their
diseases. They learn how to function as
medical practitioners, as colleagues, as
communicators, as managers and as 
healthcare providers.
During the medical programme, stu-
dents are offered regular experiences in
clinical settings and with patients, such as
the ten-day nursing internship in one of
the hospitals in Antwerp, which is manda-
tory for all first-year bachelor students.
Students are prepared for the internship
by training sessions in which they learn
the required nursing skills. Bachelor 
students also visit a rehabilitation centre
as part of the module ‘addictions’ and
master students visit a care home and a
nursing home as well as a relief centre for
people with dementia. In addition master
students attend so-called viewing days in
a hospital. During these days they observe
consultations and surgical procedures but
they are not allowed to actually partici-
pate. All these activities plus the clinical
training sessions enable students to find
out whether being a doctor really is their
chosen future profession.
A project worth mentioning
The practice team that was mentioned
earlier also organizes extracurricular
weekly ‘return days,’ on which students
can refresh and retrain clinical skills
learned in earlier phases of the pro-
gramme, such as CPR, paediatric exami-
nation, etc. The underlying idea of these
return days is: the more opportunities stu-
dents have to practise their skills, the bet-
ter they will become at performing them.
Another part of this special project is
that master students can volunteer for a
function as a ‘studoc’. After receiving indi-
vidual training from clinical faculty, ‘stu-
docs’ are able to work as semi-profession-
als in the practice team on return days.
They are called semi-professionals be-
cause, although they are students, they
know more than their peers about the
skills for which they have received special
training. 
Where education meets culture
A project that is currently receiving a lot
of attention is internationalization of
medical education. Last year English lan-
guage modules were first introduced for
master students. The purpose of these
modules is to attract students from all
over the world to our Flemish universi-
ties. Even though this project is still in its
infancy, there is considerable enthusiasm
among our professors and students to de-
velop it further in order to make Flemish
medical education attractive for all inter-
ested students. Another aim of the Eng-
lish language modules is to encourage
Belgian students to go abroad to under-
take international internships and to
study at other universities.
Medicine is more than just studying
Students at Antwerp are taught in an
open and friendly educational climate. Ef-
forts are made to promote good relation-
ships between students and teachers in
order to avoid the kind of situation where
students are afraid to approach their
teachers after class to ask questions or to
make an appointment to have certain top-
ics clarified which they did not under-
stand fully in class. In Antwerp the educa-
tional climate is characterized by
cooperation between students and teach-
ers rather than a hierarchical structure.
We already mentioned one factor that
Students’ experiences
98
contributes to this sense of cooperation,
namely the possibility for students to take
part in the development and organization
of the medical education programme.
Students can volunteer to join one of the
many faculty boards and participate in
meetings which are generally scheduled
after education sessions. These extracur-
ricular activities give students the oppor-
tunity to develop other than medical
skills, such as skills for decision making,
teamwork and reaching compromises.
And last but not least, our students are
offered recreation and relaxation facilities
as a ‘reward’ for their hard work. On
Wednesday afternoons no educational
sessions are scheduled to enable students
to engage in sports or just relax in any
way they like. Our student association,
‘Aesculapia,’ plays a prominent role in
this by organizing parties, sports activi-
ties, cantus, annual skiing holidays, etc.
They ensure wonderful and unforgettable
moments, thereby contributing to an en-
joyable and memorable university experi-
ence.
Conclusion
Speaking from my experience as a student
at Antwerp medical university, I can say
that medical education here offers a good
balance between studying hard and enjoy-
ing student life. The education and train-
ing programme offers medical students
excellent theoretical and practical prepa-
ration for their future professional lives as
doctors. In addition, students also learn
how to organize their schedules, work to-
gether with colleagues and take time to
relax. It is this combination that makes
studying medicine at Antwerp such a re-
warding and satisfying experience.
The author
Natacha Ruyssers, student in medicine, master year 6,
former president of SOGA (student board of the faculty
of medicine Antwerp), Belgium.
Correspondence 
Natacha.ruyssers@student.ua.ac.be
No potential conflict of interest relevant to this article was reported
The Flemish experience | N. Ruyssers 
Students’ experiences


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