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Educational Conference
Int. J. Oral Maxillofae. Surg. 1997; 26 (SuppL 1): 8-10 Printed in Denmark. All rights reserved
Educational Conference 1. The Role of the International Association in Fostering Education
Goss, A. N. Chairman Education Committee, Oral and Maxillofacial Surgery Unit, University of Adelaide, South Australia 5005 One of the key tasks of the Education Committee is to foster education of Oral and Maxitlofacial Surgery trainees. In recent years the Education Committee has developed International Guidelines for speciality training in OMFS (IJOMFS 1992: 21: 130) and also internationally surveyed the training and surgical scope of Oral and Maxillofacial Surgeons (IJOMFS 1996: 25: 74). The Education Committee has developed a series of initiatives to help foster international education. Firstly, Jris necessary to develop a strong database from which one can organise exchanges. Three databases have been developed: Training Institutions Worldwide, Teachers Willing To Provide Training On Site In Development Countries, National Guidelines For Education. The possibility of developing an international exam (OMSINT) based on the AAOMS Examination for American residents (OMSITE) has been explored on a trial basis in Australia and New Zealand. These broad overview issues relating to the Education Committee will be presented by the Chairman. Following this: The Specifics Of National Guidelines, Principles Of Educational Exchanges, Educational Exchanges In Asia And South America will be presented by members of the Education Committee. At the conclusion of the presentations time has been set aside for discussion.
2. National Education and Training Standards
Ellis, E. University of Texas Southwestern Medical Center, Dallas, Texas, USA Specialists must be recognized as such by the public in which their services are sought. The demand for specialty services
will vary considerably from one country t o the next, and even from one region of a country to another. However, inherent in the concept of "specialty" is the perception that this individual has certain abilities not possessed by the general practitioner. Standards for advanced education and training in oral and maxillofacial surgery are used in many countries around the world. Although the education and training proscribed in these standards varies from one country to the next, inherent in each is a description of a curriculum that embodies the values and visions of the discipline. There are reasons why structured educational processes (i.e. education and training standards) are in the best interest of all. The primary purpose of formulating and instituting education and training standards is to protect the public through assurance that an individual calling themself an oral and maxillofacial surgeon has attained a certain level of competence through their education. A secondary function of education and training standards is to protect the genuine specialist. Clearly, each country needs to have well-defined guidelines for what constitutes the specialist. These guidelines will include education and training standards, outlining the educational requirements constituting an accredited program in oral and maxillofacial surgery.
3. The Role of IAOMS in Fostering International Education Principles of International Exchanges: USA-Europe
Williams J. L. Dean, Royal College of Surgeons of England, London, England Three levels of Exchange 1) Trainees 2) Trained surgeons a) Fellowships b) Research workers 1) Trainees a) Fundamental Requirements Prospective agreement for the programme by appropriate training authority Only supervised experience can count as training Hands on experience is essential, not observation alone Experience must be documented, authenticated and fully accepted by parent authority as equivalent Must be fully integrated into visiting scheme at an appropriate level
Educational Conference b) Practical Problems Ideal is exchange of individuals between centres this enables original funding to continue Direct exchange of accommodation/vehicles is the easiest arrangement c) Outcomes Success/problems must be subject to audit Maximum one year 2) Trained Surgeons - The same criteria of access must apply a) Fellowships (i) Short-Term (3-6 months) To study/learn specific techniques Gain additional experience in a given area, e.g. oncology/aesthetic surgery Funding - either employed by host unit or require assistance (ii) Long-term (6-12 months) Particularly suited to future teachers Will almost always need financial help Need to ensure they are likely to return to teach b) Research Workers Theoretically the easiest group to assist Specificity of Research Programme only known to researchers Access to material, especially clinical material must be assured Funding usually incorporated in original research budget 3) For all Programmes Experience must enhance value for everyone Trainees must never be disadvantaged, either visitor or home based individual Training programmes must never be disadvantaged
4. Principles of International Exchange USA-South America
Lew, D. Iowa City, USA One of the underlying principles of international exchange is interdependence. Fortunately, the principle is very well illustrated when considering the Americas. North America has an academic structure, an overabundance of practitioners and an inadequate number of patients to train residents to competence in certain parts of the curriculum. South America has an abundance of patients in need of care, some internationally renowned practitioners an unmet need and demand due to an inadequate number of qualified practitioners and an embryonic academic structure. Each region functioning alone cannot in the long run, fulfill its mission to provide the best possible care to all who are in need of our services. By co-ordinating our efforts we can achieve that lofty goal. The basic requirement is to establish an academic infrastructure that will fulfill two primary goals.
9
1. Development of Residency Programs in Oral and Maxillofacial Surgery a. Adopt a gradually expanding curriculum for full-time study b. Utilize these centers of learning to provide post-graduate and continuing education to the region
2. Establish an Accreditation Agency for the Hemisphere a. Undergraduate and Graduate education b. Certifying Board
Means of Achieving these Goals 1. Identify a core of willing and able teachers from within and without the hemisphere to identify and carry the teaching load. 2. Quickly develop a capable local faculty and support it with: a. Continued external intellectual support b. Rotation to external centers for specific periods of time 3. Raise the necessary funds to underwrite full-time study in a broad oral and maxillofacial surgery curriculum: 1) Locally 2) Internationally (Foundation)
5. Educational Exchanges in Asia
lizuka, T. Faculty of Medicine, Kyoto University, Kyoto 606, Japan Relationship between Associations: In 1986, a sister relationship between the Japanese Society of Oral and Maxillofacial Surgeons (JSOMS) and the Korean Academy of Oral and Maxillofacial Surgery was established, and since then scientific papers have been presented at each other's annual meeting. In 1989, the Asian Association of Oral and Maxillofacial Surgeons was founded and it has thus far held three scientific meetings, the first in Manila, the second in Taipei and the third in Kuchin. The next meeting will be held in Seoul in 1999. The offical journal of the Association, the Asian Journal of Oral and Maxillofacial Surgery, has been published semi-annually. Volunteers: Since 1992, the Japanese Association for Cleft Lip and Palate (NGO) has sent a surgical team consisting of oral surgeons, pediatricians and anaesthesiologists from Japan, Korea, Canada and the USA to Vietnam, Myanmar, Bangladesh, Mongolia and Indonesia, to provide medical care to patients with facial clefts as well as to teach surgery to surgical colleagues. Trainees and researchers: University clinics and departments of OMS in Japan receive various trainees and researchers from all nations in Asia with scholarships from the Japanese Ministry of Education, Science and Culture, and from the Japanese Society for the Promotion of Science. These foreign trainees receive OMS training mainly at institutions which have JSOMS accredited
10
EducationalConference
advanced OMS education programs. The present number of these institutions in Japan is 152. So far educational exchange in Asia has not been very intense, mainly due to the economic situation in the southeast Asian countries. It is, however, most likely that the rapid economic development will facilitate international exchange programs in Asia.
6. Educational Exchanges in Latin America
Quevedo, L.
Chairman OMF Surgery Training Program, Sotero del Rio Hospital SWMHS, Faculty of Dentistry, Universityof Chile, Santiago, Chile The near future in IAOMS is Regionalization. The Region which I will be talking about is Latin America and is represented by ALACIBU. ALACIBU means Latin American Association OMS. 21 countries belong to our organization divided into southern and northern continents. Chile, Argentina, Brazil, Paraguay, Uruguay, Bolivia and Peru belong to the southern continent and Mexico, Venezuela. Colombia, Panama, Nicaragua, Guatemala, E1 Salvador, Haiti, Costa Rica, Cuba; Ecuador, Honduras, Antillas Holandesas and Dominican Republic are part of the northern continent. To understand education in Latin America, it is imperative to know what happens in OMS practice. Different situations can be visualized. In some cases oral surgery is not a real speciality. The scope is very restricted, privileges are
inadequate and financially lacking. The practice in on a part-time basis, combined with general dentistry or other specific treatments. In spite of similar conditions the existence of semi-formal training in Oral Surgery under the University Hospital status provides a different scenario from an economical point view. In this case there are two or more trained oral surgeons involved in the process, while the staff and the students need to work in other fields, and then we do still have part-time practice of OMS. Fortunately, there are also places where formal Advanced Educational OMS Training Programs exist with a full scope of clinical experience, most of these being 3-year programs, and now being 4 years following IAOMS Training Guidelines. This represents a real educational exchange inside Latin America, because this program receives residents from other countries scheduled for full training. According to this, OMS Education in Latin America can and must be fostered. Programs and projects should be directed toward A) The need to have a structural change trying to get hospitals, universities, the Health Ministry or whatever other authorities are involved to obtain decent salaries for full-time employees and specialists. B) Opportunites for educational experience meaning reciprocal staff/residents rotation. C) Easy access to educational information via journals, papers, books, video cassettes, computer discs, internet and O M F network, etc. D) In our opinion, to complete the educational process, the access to an appropriate research system is crucial. This can be realized by offering someone who will be interested in full training in research on a Ph.D. or similar level a position, while at the same time securing his/her return with a view to establishing the research system in OMS locally, with IAOMS or other International Institutional support. This presentation will give a more detailed explanation as to our intentions of obtaining better educational levels.
Educational Conference 1. The Role of the International Association in Fostering Education
Goss, A. N. Chairman Education Committee, Oral and Maxillofacial Surgery Unit, University of Adelaide, South Australia 5005 One of the key tasks of the Education Committee is to foster education of Oral and Maxitlofacial Surgery trainees. In recent years the Education Committee has developed International Guidelines for speciality training in OMFS (IJOMFS 1992: 21: 130) and also internationally surveyed the training and surgical scope of Oral and Maxillofacial Surgeons (IJOMFS 1996: 25: 74). The Education Committee has developed a series of initiatives to help foster international education. Firstly, Jris necessary to develop a strong database from which one can organise exchanges. Three databases have been developed: Training Institutions Worldwide, Teachers Willing To Provide Training On Site In Development Countries, National Guidelines For Education. The possibility of developing an international exam (OMSINT) based on the AAOMS Examination for American residents (OMSITE) has been explored on a trial basis in Australia and New Zealand. These broad overview issues relating to the Education Committee will be presented by the Chairman. Following this: The Specifics Of National Guidelines, Principles Of Educational Exchanges, Educational Exchanges In Asia And South America will be presented by members of the Education Committee. At the conclusion of the presentations time has been set aside for discussion.
2. National Education and Training Standards
Ellis, E. University of Texas Southwestern Medical Center, Dallas, Texas, USA Specialists must be recognized as such by the public in which their services are sought. The demand for specialty services
will vary considerably from one country t o the next, and even from one region of a country to another. However, inherent in the concept of "specialty" is the perception that this individual has certain abilities not possessed by the general practitioner. Standards for advanced education and training in oral and maxillofacial surgery are used in many countries around the world. Although the education and training proscribed in these standards varies from one country to the next, inherent in each is a description of a curriculum that embodies the values and visions of the discipline. There are reasons why structured educational processes (i.e. education and training standards) are in the best interest of all. The primary purpose of formulating and instituting education and training standards is to protect the public through assurance that an individual calling themself an oral and maxillofacial surgeon has attained a certain level of competence through their education. A secondary function of education and training standards is to protect the genuine specialist. Clearly, each country needs to have well-defined guidelines for what constitutes the specialist. These guidelines will include education and training standards, outlining the educational requirements constituting an accredited program in oral and maxillofacial surgery.
3. The Role of IAOMS in Fostering International Education Principles of International Exchanges: USA-Europe
Williams J. L. Dean, Royal College of Surgeons of England, London, England Three levels of Exchange 1) Trainees 2) Trained surgeons a) Fellowships b) Research workers 1) Trainees a) Fundamental Requirements Prospective agreement for the programme by appropriate training authority Only supervised experience can count as training Hands on experience is essential, not observation alone Experience must be documented, authenticated and fully accepted by parent authority as equivalent Must be fully integrated into visiting scheme at an appropriate level
Educational Conference b) Practical Problems Ideal is exchange of individuals between centres this enables original funding to continue Direct exchange of accommodation/vehicles is the easiest arrangement c) Outcomes Success/problems must be subject to audit Maximum one year 2) Trained Surgeons - The same criteria of access must apply a) Fellowships (i) Short-Term (3-6 months) To study/learn specific techniques Gain additional experience in a given area, e.g. oncology/aesthetic surgery Funding - either employed by host unit or require assistance (ii) Long-term (6-12 months) Particularly suited to future teachers Will almost always need financial help Need to ensure they are likely to return to teach b) Research Workers Theoretically the easiest group to assist Specificity of Research Programme only known to researchers Access to material, especially clinical material must be assured Funding usually incorporated in original research budget 3) For all Programmes Experience must enhance value for everyone Trainees must never be disadvantaged, either visitor or home based individual Training programmes must never be disadvantaged
4. Principles of International Exchange USA-South America
Lew, D. Iowa City, USA One of the underlying principles of international exchange is interdependence. Fortunately, the principle is very well illustrated when considering the Americas. North America has an academic structure, an overabundance of practitioners and an inadequate number of patients to train residents to competence in certain parts of the curriculum. South America has an abundance of patients in need of care, some internationally renowned practitioners an unmet need and demand due to an inadequate number of qualified practitioners and an embryonic academic structure. Each region functioning alone cannot in the long run, fulfill its mission to provide the best possible care to all who are in need of our services. By co-ordinating our efforts we can achieve that lofty goal. The basic requirement is to establish an academic infrastructure that will fulfill two primary goals.
9
1. Development of Residency Programs in Oral and Maxillofacial Surgery a. Adopt a gradually expanding curriculum for full-time study b. Utilize these centers of learning to provide post-graduate and continuing education to the region
2. Establish an Accreditation Agency for the Hemisphere a. Undergraduate and Graduate education b. Certifying Board
Means of Achieving these Goals 1. Identify a core of willing and able teachers from within and without the hemisphere to identify and carry the teaching load. 2. Quickly develop a capable local faculty and support it with: a. Continued external intellectual support b. Rotation to external centers for specific periods of time 3. Raise the necessary funds to underwrite full-time study in a broad oral and maxillofacial surgery curriculum: 1) Locally 2) Internationally (Foundation)
5. Educational Exchanges in Asia
lizuka, T. Faculty of Medicine, Kyoto University, Kyoto 606, Japan Relationship between Associations: In 1986, a sister relationship between the Japanese Society of Oral and Maxillofacial Surgeons (JSOMS) and the Korean Academy of Oral and Maxillofacial Surgery was established, and since then scientific papers have been presented at each other's annual meeting. In 1989, the Asian Association of Oral and Maxillofacial Surgeons was founded and it has thus far held three scientific meetings, the first in Manila, the second in Taipei and the third in Kuchin. The next meeting will be held in Seoul in 1999. The offical journal of the Association, the Asian Journal of Oral and Maxillofacial Surgery, has been published semi-annually. Volunteers: Since 1992, the Japanese Association for Cleft Lip and Palate (NGO) has sent a surgical team consisting of oral surgeons, pediatricians and anaesthesiologists from Japan, Korea, Canada and the USA to Vietnam, Myanmar, Bangladesh, Mongolia and Indonesia, to provide medical care to patients with facial clefts as well as to teach surgery to surgical colleagues. Trainees and researchers: University clinics and departments of OMS in Japan receive various trainees and researchers from all nations in Asia with scholarships from the Japanese Ministry of Education, Science and Culture, and from the Japanese Society for the Promotion of Science. These foreign trainees receive OMS training mainly at institutions which have JSOMS accredited
10
EducationalConference
advanced OMS education programs. The present number of these institutions in Japan is 152. So far educational exchange in Asia has not been very intense, mainly due to the economic situation in the southeast Asian countries. It is, however, most likely that the rapid economic development will facilitate international exchange programs in Asia.
6. Educational Exchanges in Latin America
Quevedo, L.
Chairman OMF Surgery Training Program, Sotero del Rio Hospital SWMHS, Faculty of Dentistry, Universityof Chile, Santiago, Chile The near future in IAOMS is Regionalization. The Region which I will be talking about is Latin America and is represented by ALACIBU. ALACIBU means Latin American Association OMS. 21 countries belong to our organization divided into southern and northern continents. Chile, Argentina, Brazil, Paraguay, Uruguay, Bolivia and Peru belong to the southern continent and Mexico, Venezuela. Colombia, Panama, Nicaragua, Guatemala, E1 Salvador, Haiti, Costa Rica, Cuba; Ecuador, Honduras, Antillas Holandesas and Dominican Republic are part of the northern continent. To understand education in Latin America, it is imperative to know what happens in OMS practice. Different situations can be visualized. In some cases oral surgery is not a real speciality. The scope is very restricted, privileges are
inadequate and financially lacking. The practice in on a part-time basis, combined with general dentistry or other specific treatments. In spite of similar conditions the existence of semi-formal training in Oral Surgery under the University Hospital status provides a different scenario from an economical point view. In this case there are two or more trained oral surgeons involved in the process, while the staff and the students need to work in other fields, and then we do still have part-time practice of OMS. Fortunately, there are also places where formal Advanced Educational OMS Training Programs exist with a full scope of clinical experience, most of these being 3-year programs, and now being 4 years following IAOMS Training Guidelines. This represents a real educational exchange inside Latin America, because this program receives residents from other countries scheduled for full training. According to this, OMS Education in Latin America can and must be fostered. Programs and projects should be directed toward A) The need to have a structural change trying to get hospitals, universities, the Health Ministry or whatever other authorities are involved to obtain decent salaries for full-time employees and specialists. B) Opportunites for educational experience meaning reciprocal staff/residents rotation. C) Easy access to educational information via journals, papers, books, video cassettes, computer discs, internet and O M F network, etc. D) In our opinion, to complete the educational process, the access to an appropriate research system is crucial. This can be realized by offering someone who will be interested in full training in research on a Ph.D. or similar level a position, while at the same time securing his/her return with a view to establishing the research system in OMS locally, with IAOMS or other International Institutional support. This presentation will give a more detailed explanation as to our intentions of obtaining better educational levels.