External Representation & Academic Recognition in Exchanges

Manual

External representation & Academic recognition in Exchanges Edition 1.0 - 2016 www.ifmsa.org

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IFMSA The International Federation of Medical Students’ Associations (IFMSA) is a non-profit, non-governmental and non-partisan organization representing associations of medical students internationally. IFMSA was founded in 1951 and currently maintains 124 National Member Organizations from more than 100 countries across six continents with over 1,3 million students represented worldwide. IFMSA is recognized as a non-governmental organization within the United Nations’ system and the World Health Organization and as well, it is a student chapter of the World Medical Association. For more than 60 years, IFMSA has existed to bring together the global medical students community at the local, national and international level on social and health issues.

Imprint SCORE International Team Tara D’Ignazio - SCORE DA on AQ Koen Demaegd - SCORE Director SCOPE - International Team Maud Harding - SCOPE RA Europe Omar Cherkaoui - SCOPE Director SCOME - International Team Lukas Rodrigues de Souza - SCOME RA Americas Stijntje Dijk - Liaison Officer for Medical Education issues

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International Federation of Medical Students’ Associations General Secretariat: IFMSA c/o Academic Medical Center Meibergdreef 15 1105AZ Amsterdam, The Netherlands Email: gs@ifmsa.org Homepage: www.ifmsa.org

www.ifmsa.org Introduction

Dear reader, Welcome to the manual on external representation and academic recognition in exchanges. This manual aims to guide Exchange Officers and Officers on Medical Education through the process of achieving external representation or academic recognition through their faculty or an external organization and can be used as a supplement to any training in this field. For any additional support, please consult one of the additionally existing manuals, or contact the SCOPE, SCORE or SCOME International teams.

Best wishes, The International Teams of 2015-2016

Introduction to External Representation Definition of Academic Recognition and External Representation Academic Recognition: It means that the exchange is recognised as a formal part of the curriculum. The exchange can take place either during the elective period of the student or not, but it would mean that students receive the credit hours that they have spent on their exchange and they would not need to obtain those hours through their own curriculum anymore.

Ex; an elective rotation being replaced by a professional exchange (SCOPE), a research exchange (SCORE) being credited as an optional course in research, research from a research exchange (SCORE) being presented at a faculty congress, etc.

External representation: The contact an organization has with other organizations/institutions/companies.

It is done in order to achieve goals that we cannot reach only by ourselves, defend our point of view to others and establish partnerships. Ex: endorsement letters from external organizations that recognize the quality of the exchanges, promotion of exchanges through external networks, recruitment of tutors/preceptors through external networks, guidelines for projects revised by professionals, quality control checklist for exchanges made by professionals, or negotiations with faculties on the inclusion of exchanges within the formal curriculum.

Why is it relevant and beneficial for both your organisation and for the students?

If professional exchanges are credited as being at par with rotations offered by the home university, more institutional support could be put in place to ensure

the academic conformity of the students concerned.

The university might choose to provide more structural support in the form of financial aid or academic flexibility to students going on exchange, or they might even give the students credit hours for the work they have achieved during their exchange. They might also choose to be involved in the promotion of the exchanges.

If research exchanges are credited or acknowledged as legitimate research that can eventually be presented at faculty conferences and have a significant contribution to medical science, then this provides a new and interesting way to introduce students to research.

This may provide research opportunities to students that would not otherwise exist due to the research program of the original university, as not all universities have internship programs organized. In this sense, the exchanges can serve as an initiation to research and all of the competencies it develops in a future medical practitioner. Research exposure in medical school has been shown to improve the overall medical education system. Some references of this have been added at the end.

Endorsement letters, which legitimize the exchanges, can be used to convince deans and people from the education department that our exchanges are of quality and acknowledged by those major organisations.

You can find some examples of these endorsement letters here. Another good resource is the Profile Book which outlines the scope and the growth of the exchanges through images such as the one below.

Manual on External Representation & Academic Recognition in Exchanges - version 1, 2016

How to start: setting goals petencies. The ultimate goal of the exchanges is to make better doctors by increasing exposure to other cultures, other health care systems, and to research.

1) What would you like to achieve for your NMO in terms of recognition of your exchanges or changes in your medical curriculum?

Before beginning to approach your faculty, you should have a solid idea of what you would like to achieve for your NMO in terms of recognition of your exchanges and/or changes in your medical curriculum. For this, you should have a firm understanding of your current medical curriculum and the competencies that it seeks to develop in its students. You must also take into account what is logistically feasible for your medical curriculum.

Examples of what you might like to achieve in terms of recognition include, but are not limited to: - SCOPE exchange as an accredited (alternative) external rotation - SCORE exchange as an accredited (optional) course in research 2) Why are the SCOPE and SCORE exchanges relevant to your particular medical education system?

How do the exchanges provide an added value to the current medical curriculum?

These questions will help you to gather elements that can convince the decision-making party to recognize your exchanges.

Following suit with the previous point, it is important to understand which competencies your medical curriculum seeks to develop in its medical students. In light of this, you can reexamine the entire medical education system and find ways in which the exchanges program provides an added value to the curriculum and solutions to the underdevelopment of certain com-

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For example, your medical curriculum might seek to develop an interest in continuing education and academia in its future practitioners, which is often achieved through some level of research involvement. However, there might be a lack of exposure to research in the current medical curriculum or a lack of access to research internship opportunities. In light of this, you could propose the implementation of optional SCORE exchanges to the medical curriculum as a solution to this discrepancy.

Another recurrent pitfall in many medical education systems is the lack of an internationalization component. Students may never be affronted with medical systems or different cultures other than their own, and may be limited to learning only the scope of medical conditions and practices of their home country. The implementation of professional exchanges through SCOPE would allow for students to explore the advantages and disadvantages of another medical system, learn about the medical conditions specific to another population, and bring this expertise back to their home country. These experiences of cultural exchange is of course also an argument for SCORE. Lastly, we should not forget the non-formal education aspect of exchanges. Above what the exchanges bring to a medical curriculum, it is important to also consider the learning opportunity they present to medical students as individuals. Exposure to a new medical system is a non-negligible form of non-formal education which may foster language development, interpersonal development and encourage adaptability and resourcefulness.

Exchanges provide: - An internationalization component - Exposure to research through hands-on experience - Enhanced communication skills - Exposure to a different health care system - Exposure to diseases that might not be common in the sending country

Creating a strategy Before you present any proposal to your faculty or to an external organization, you should already have a certain academic quality threshold achieved in your NMO. You cannot ask for external recognition if your program is not already of high academic quality, meaning that the students have a proper learning process and receive training for scientific skills and research techniques during the exchange that you promise to deliver.

1) Determine who you should present to in light of your goals - Stakeholder mapping First, you must determine who you would like to be involved in your exchanges program and their possible motivations to grant you recognition. For each of these stakeholders, you should try and appeal to their corporate or personal interests. You should have an idea of why they might be motivated to help your program.

Examples can be found in the textbox on the right.

2) Determine what has already been done by other organisations/other faculties - Include pre-existing letters of endorsement (available on IFMSA website) as a form of quality assurance for the exchanges as attested to by external organizations - Have knowledge of the recognition that other universities provide, how they achieved this, possibly their legal conventions. Be prepared to acquiesce their demands!

3) Personalize the message to your intended audience. Think of the specific advantages for your dean/ faculty/external party. These can include: - Visibility of your university (to visiting students, internationally, taking national lead in this field, etc.)

- Internationalization - Teaching experience for tutors - Language experience for staff and students - Curriculum development, added value to the curriculum - Appreciation by the university’s own students for the offered opportunities - Means to recruit new students - Lowered burden of not having to establish a similar program from scratch by themselves

Faculty staff (dean of medicine/medical education center/internationalization office): Their goals likely concern the enhancement of medical education outcomes as discussed earlier.

NGO (Non-Governmental Organization): Shared joint goals with your organization are most probably at the top of their interests, therefore, you might want to highlight this when approaching them (ex; internationalization of health care, improving the knowledge of medical students in a specific area, such as a particular neglected disease, or communication skills with underrepresented groups within your own country) Foundation: They give attention to the activities that are in line with their mission and vision, therefore your goals need to reflect that (ex; improving access to healthcare, internationalization of healthcare, etc.). Foundations often have extended lists of criteria established on their websites that specify the kind of partners and initiatives they are looking to support Individual - student: The students might see the exchanges as a way to achieve personal growth and as a learning opportunity. There might be secondary reasons for them that make an IFMSA exchange additionally compelling, such as the unique aspects of the program being run by students on the local level, or a lower financial burden.

Individual - tutor: Why might a tutor like to take on an intern? Many have intern quotas, some may feel personal satisfaction, and some appreciate the pedagogical component.

Manual on External Representation & Academic Recognition in Exchanges - version 1, 2016

Approaching the target audience If the target audience does not have a firm understanding of IFMSA and its goals, then you should begin with an introduction to IFMSA and its vision, which we intend to achieve through exchanges. Each organization, including your faculty, has its own vision and strategies. If you can formulate your vision and initiative to fit theirs, you would have a compelling argument to request their support.

For example, if a faculty’s strategic plan includes increased communication skills and development of cultural competencies, a way to approach them using the Why, How, What method, starting with the most important of the story, the why. An example might look like this: WHY = The Purpose What is your cause? What do you believe?

HOW = The Process Specific actions taken to realize the Why. WHAT = The Result What do you do? Result of the Why.

WHY HOW WHAT WHY = We believe medical students should be equipped with the skills and values needed to provide the best possible care for the communities they will serve.

HOW = We intend to do this is by providing community-based opportunities to medical students to develop skills through hands on experience in other cultural settings.

WHAT = We make this happen by organising SCOPE and SCORE exchanges on a global scale, and we would like to work together with you to achieve this.

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The main goal is to pitch the idea of exchanges to your intended audience while highlighting its strengths and anticipating the audience’s concerns. Solutions for these concerns should be elaborated before presenting to your target audience. You should also make a case for the authenticity of the exchange program you are promoting. This model of approach is called the Pain, Gain, Unique Claim Theory and is further elaborated upon here: 1) Address Pain: Anticipate concerns of your audience and provide solutions for them before the pitch. Concerns might include: “Implementing this proposal will only cost me time and money”; the exchange program is run on a voluntary basis and helps to achieve faculty goals. The program requires no investment, as the model already exists and is successful.

“Exchanges will bring a lot of liabilities to my faculty and could do harm to its reputation”; have a firm understanding of insurance requirements for exchanges and the logistical issues they may cause for the faculty.

A collaboration between faculty and students could ensure that the right preparations and legal actions be taken in advance “The exchanges might be an expensive all-in-vacation paid and supported by my faculty, while this time is taken away from their formal education.” Advance the steps already put in place to ensure academic quality, and reiterate the additional value of exchanges in the medical curriculum: - Rigorous student selection for the exchange program - Pre Exchange Training and Upon Arrival Training - Quality control of research projects through Supervising Board - Student handbook to ensure student participation/to assess competencies acquired by student on exchange - Impact assessment through Evaluation Forms - Certificates awarded and signed by the tutors only after completing the exchange

Approaching the target audience 2) Prove Gain to Medical Education System:

Follow Up

- Demonstrate the success of previous exchanges: this can include reports and quotes from the university’s students who have been on an exchange that describe the added value to their curriculum, the number of students that have gone on exchange, interest polls/surveys from students that want to go on an exchange to prove the existing demand, the number of years exchanges have already been run. If your NMO is starting up SCOPE and/or SCORE, you can use statistics from the international level or perhaps neighbouring NMOs as well. Please refer to the Profile Book for more information regarding IFMSA statistics.

- References from literature: to prove added value of exchanges in terms of increased learning outcomes/ competencies among students having gone on exchange. Some examples can be found at the end of this document.

- Quality of work during the exchange season: collect data on the exchanges and present it to your faculty as a form of outcome analysis. Have statistics regarding your own NMO; for example, how many incomings, outgoings, and researchers were involved in the previous exchange season? Were the tutors/students satisfied? Find a way to evaluate the success of the program and present it.

In order to ensure continued good standing with your faculty, they should be as involved as possible in the exchanges procedures. As their trust in the professional structure of your exchanges grows, their willingness to increase the recognition for exchanges will likely increase.

3) Unique Claim: Why is IFMSA in particular THE best partner to work with, and THE best organization to achieve these goal or to provide exchanges? Some examples:

Congratulations, you have succeeded in (ex)changing your faculty!

- We are the THE oldest medical student exchange run program, the most experienced federation with the largest number of countries participating in exchanges - Depending on the NMO: We are THE official representative student body within this faculty, making us the most suited organization to speak on behalf of medical students and their needs.

- We are the only student run exchange program within the country that works directly with students on the local level. Our work with bilateral contracts ensures the ethical responsibility of the faculty. Our students have the unique opportunity to be supported and guided by local students in the host country

Ways to do this include: - Involving the stakeholders in the development and implementation of academic quality: The faculty might like to see what is included in the Pre Exchange Training and the Upon Arrival Training, and might suggest some topics be covered.

- Involving the stakeholders in the process of outgoing selection, exchange attribution, and conditions for outgoings. For example, they might want their outgoings to write a scientific report or to sign up for a particular class in order to go on exchange so that the exchange may be recognized. They might like to have a legal convention signed with your NMO in order to ensure that the incomings meet the exchange conditions of your NMO and to provide insurance to these incomings.

- Provide an annual report that summarizes the exchanges and send it to all tutors and to the faculty.

Suggested References for the impact of exchanges in medical education: 1. Mutchnick E, Moyer C, Stern D. Expanding the Boundaries of Medical Education: Evidence for Cross-Cultural Exchanges: Academic Medicine [Internet]. LWW. 2016 [cited 5 January 2016]. Available from: http://journals.lww.com/academicmedicine/Fulltext/2003/10001/Expanding_the_Boundaries_of_Medical_Education_.2.aspx 2. Drain P, Primack A, Hunt D, Fawzi W, Holmes K, Gardner P. Global Health in Medical Education: A Call for More Training and Opportunities: Academic Medicine [Internet].

LWW. 2016 [cited 5 January 2016]. Available from: http://journals.lww.com/academicmedicine/Abstract/2007/03000/Global_Health_in_Medical_Education__A_Call_for.4.aspx 3. The Erasmus Impact Article. EU Publications [Internet]. 2016 [cited 5 January 2016];.

Available from: http://ec.europa.eu/education/library/study/2014/erasmus-impact_en.pdf

Manual on External Representation & Academic Recognition in Exchanges - version 1, 2016

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IFMSA International Federation of Medical Students Associations

Algeria (Le Souk)

Georgia (GMSA)

Oman (SQU-MSG)

Argentina (IFMSA-Argentina)

Germany (BVMD)

Pakistan (IFMSA-Pakistan)

Armenia (AMSP)

Ghana (FGMSA)

Palestine (IFMSA-Palestine)

Australia (AMSA)

Greece (HelMSIC)

Panama (IFMSA-Panama)

Austria (AMSA)

Grenada (IFMSA-Grenada)

Paraguay (IFMSA-Paraguay)

Azerbaijan (AzerMDS)

Guatemala (ASOCEM)

Peru (APEMH)

Bangladesh (BMSS)

Guinea (AEM)

Peru (IFMSA-Peru)

Belgium (BeMSA)

Guyana (GuMSA)

Philippines (AMSA-Philippines)

Benin (AEMB)

Haiti (AHEM)

Poland (IFMSA-Poland)

Bolivia (IFMSA-Bolivia)

Honduras (ASEM)

Portugal (PorMSIC)

Bosnia and Herzegovina (BoHeMSA)

Hungary (HuMSIRC)

Romania (FASMR)

Bosnia and Herzegovina - Rep.

Iceland (IMSIC)

Russian Federation (HCCM)

of Srpska (SaMSIC)

India (MSAI)

Rwanda (MEDSAR)

Brazil (DENEM)

Indonesia (CIMSA-ISMKI)

Serbia (IFMSA-Serbia)

Brazil (IFMSA-Brazil)

Iran (IMSA)

Sierra Leone (SLEMSA)

Bulgaria (AMSB)

Iraq (IFMSA-Iraq)

Singapore (AMSA-Singapore)

Burkina Faso (AEM)

Ireland (AMSI)

Slovakia (SloMSA)

Burundi (ABEM)

Israel (FIMS)

Slovenia (SloMSIC)

Canada (CFMS)

Italy (SISM)

South Africa (SAMSA)

Canada-Quebec (IFMSA-Quebec)

Jamaica (JAMSA)

Spain (IFMSA-Spain)

Catalonia - Spain (AECS)

Japan (IFMSA-Japan)

Sudan (MedSIN-Sudan)

Chile (IFMSA-Chile)

Jordan (IFMSA-Jo)

Sweden (IFMSA-Sweden)

China (IFMSA-China)

Kazakhstan (KazMSA)

Switzerland (SwiMSA)

China-Hong Kong (AMSAHK)

Kenya (MSAKE)

Taiwan (FMS-Taiwan)

Colombia (ASCEMCOL)

Korea (KMSA)

Tatarstan-Russia (TaMSA-Tatarstan)

Congo, Democratic Republic

Kuwait (KuMSA)

Tanzania (TAMSA)

of (MSA-DRC)

Kurdistan - Iraq (IFMSA-Kurdistan/Iraq)

Thailand (IFMSA-Thailand)

Costa Rica (ACEM)

Latvia (LaMSA-Latvia)

The Former Yoguslav Republic

Croatia (CroMSIC)

Lebanon (LeMSIC)

of Macedonia (MMSA-Macedonia)

Cyprus (CyMSA)

Libya (LMSA)

The Netherlands (IFMSA-NL)

Czech Republica (IFMSA-CZ)

Lithuania (LiMSA)

Tunisia (ASSOCIA-MED)

Denmark (IMCC)

Luxembourg (ALEM)

Turkey (TurkMSIC)

Dominican Republic (ODEM)

Mali (APS)

Uganda (FUMSA)

Ecuador (AEMPPI)

Malta (MMSA)

Ukraine (UMSA)

Egypt (IFMSA-Egypt)

Mexico (IFMSA-Mexico)

United Arab Emirates (EMSS)

El Salvador (IFMSA-El Salvador)

Moldova (ASRM)

United Kingdom of Great Britain

Estonia (EstMSA)

Mongolia (MMLA)

& Northern Ireland (Medsin-UK)

Ethiopia (EMSA)

Montenegro (MoMSIC-Montenegro)

United States of America (AMSA-USA)

Fiji (FJMSA)

Morocco (IFMSA-Morocco)

Uruguay (IFMSA-Uruguay)

Finland (FiMSIC)

Namibia (MESANA)

Venezuela (FEVESOCEM)

France (ANEMF)

Nepal (NMSS)

Zambia (ZAMSA)

Gambia (UniGaMSA)

New Zealand (NZMSA)

Zimbabwe (ZIMSA)

Nigeria (NiMSA) Norway (NMSA)

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