HANOI MEDICAL UNIVERSITY OVERVIEW OF GRADUATE TRAINING AND ORIENTED DEVELOPMENT

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HANOI MEDICAL UNIVERSITY OVERVIEW OF GRADUATE TRAINING AND ORIENTED DEVELOPMENT DOAN QUOC HUNG. MD, PhD AMDS, Hanoi 23/8/2018

Outline Introduction to Graduate training of Medicine in Vietnam Introduction to the Hanoi Medical University (HMU) Introduction to Graduate training at HMU 2

CAREER OVERVIEW Name: DOAN Quoc Hung, MD, PhD DOB: 20/04/1968 Ha Noi, VN Email: hung.doanquoc@hmu.edu.vn, hung.doanquoc@gmail.com Profession: Surgeon, Senior lecturer, Ass/Professor in Surgery Speciality: Cardio Vascular and Thoracic Surgery Actual Institution: Director of Graduate Training Department- HMU (from 2011- today) Deputy of Department of CardioVascular and Thoracic Surgery, Viet Duc University Hospital Formations 1986-1991: Undergraduate Study, Hanoi Medical University. 1992-1995: Graduate study in surgery, HMU, Viet Duc University hospital. 1995: Master Thesis: Result of closed commissurotomy- thrombus in the left atrial appendage through the left thoracotomy 2006: PhD Thesis : Clinical and paraclinical Reseach and Longterme Result of surgical treatment in patients with lower limbs chronic atherosclerose ischemia Publications 210 papers and 16 books on Adult cardiac surgery, Pediatric cardiac surgery, Vascular-Thoracic surgery, Management in Education and Training. 3

Medical Graduate training in Vietnam

Distribution of Univ Medicine-Pharmacy VN

Ministry of Education Model of State Management Specialized orientation CME Ministry of Health Philosophy of Doctor (3-4 years) 2st degree of specialization (2 years) Master (1-2 years) Medical degree (6 years) Residency ( 3 years) 1st degree of specialization (2 years) 1. MOET: management academic training, provide norms (quota) for undergraduate training and academic graduate training (master, PhD), management regulations, accreditation and control after graduation. 2. MOH: management practice training, provide norms (quota) for practical graduate training (residency, 1 st, 2 st degree of specialization), management practice regulations and issued certificate of practice

Medical staff and Medical doctor after 10 years-vn quantity uncontrolable, quality? 25000 20000 15000 10000 5000 0 2007 2017 Medical staff Medical doctor

Student s number of Univ Med-Pharm VN Medical docteur Phamacology Nursing Hanoi Medical University 500 0 540 HN college of Phamacy 0 750 0 Hue Medecine University 725 180 245 HCM city UMP 400 560 290 Can tho Univ Med-Phar 640 140 80 Vo Truong Toan U 575 635 0

Introduction to the Hanoi Medical University

HMU: Founded in 1902 1 st Dean: Dr Alexandre Yersin 15/11/2018: Ceremony of 116 years old

HMU 2018

The Organizational Chart of HMU Ministry of Health MOH Ministry of Education and Training MOET Rector Board Educational and Scientific Council 02 schools 03 Faculties Thanh Hóa Branch (2016) 37 line departments 31 line departments 18 administrative departments 15 centers and projects 01 Hospital (250 beds) # 4,500 Undergraduates # 3,500 Graduates 12

Staff Numbers & Academic member 8-2018: 1700 staff, 819 lecturers (+546 affilliated teachers) 869 312 297 222 Prof. & Ass. Prof. PhD degree Master degree Other degrees 13

Aspects of graduate training

Brief history of graduate training at HMU (1) HMU had program graduate training earliest in VN. 2nd degree of specialization: 1972. It laid the foundation for the expansion of other graduate program. Next: Resident physician and 1st degree of specialization in 1974, PhD student in 1979 and Master in 1992 Training on demand: 1982 (1st degree of specialization, 2008 (2nd degree of specialization). Now: all provinces in VN

Brief history of graduate training at HMU (2) MASTER (1992) 1 st Spec (1974) Residence (1974) 2 nd Spec (1972) PhD (1979) MOH MOET

Department of graduate training at HMU Staffs: 13 1 Professor; 2 Ass professor, 01 Doctor, 01 2 nd Specialist, 8 Master (02 are PhD students). 1981 QĐ 292-BYT/QĐ (31/3) Faculty of postgraduate training 1972-1981 Center of Research and graduate of training 1994 QĐ 952/YHN-QĐ (29/3) Administrative departments of graduate training 2004 Department of graduate training

Academic Actual Model of graduate training at HMU (>45 years): quite different Professional Philosophy of Doctor Selection Exam (3-4 years) Master (1-2 years) Selection Exam Exam Exam 2st degree of specialization Residency (3 years) (2016: 10%; 2018: 50%) Medical degree (6 years) High school (2 years) Exam Exam 1st degree of specialization (2 years) Exam Practice at Hospital (18 months)

Actual Model of graduate training at HMU (>45 years): characteristics 1. Training interrupted intermittently 2. Mixed between practice training (Resident, Specialist I-II) and academic training (PhD, masters) 3. Quota: decided by MOH and MOET 4. Outcomes and Competency Standards: - ; national exam for licensing - 5. Cirriculum: ancient and unsuitable

GRADUATE SPECIALIZED TRAINING at HMU (38) TT SPECIALIZED TT SPECIALIZED 1 Radiology 19 Histology and Embryology Surgery (Thoracic Surgery; Gastro-intestinal Surgery; 2 Dermatology 20 Urology; Neuro Surgery; Burn Surgery; Orthopaedics and Plastic Reconstructive Surgery 3 Epidemiology 21 Ophthalmology 4 Nutrition 22 Histology and Embryology 23 Pediatrics 5 Allergy and Immunology 24 Internal Medicine (Cardiology; Rheumatology; Gastroenterology; Pneumology; Endocrinology; Nephrology) 6 Pharmacology and Toxicology 25 Plastic Reconstructive Surgery 7 Anesthesia and Reanimation 26 Odonto-stomatology 8 Human Anatomy 27 Obstetrics and Gynecology 9 Pathology 28 Pathophysiology 10 Medical Biochemistry 29 Physiology 11 Emergency and Clinical Toxicology 30 Otorhinolaryngology 12 Blood Transfusion and Hematology 31 Psychiatry 13 Medical Parasitology 32 Neurology 14 Tuberculosis 33 Infectious and Tropical diseases 15 Immunity 34 Oncology 16 Medical Microbiology 35 Family medicine 17 Traditional medicine 36 Forensic Medicine 18 Preventive Medicine 37 Biomedical and Genetic 38 Public Health

Achievement of graduate training at HMU The number of students trained and being trained (2018) Subjects Total Being trained PhD 1945 673 Master 5716 883 Resident physician 2172 522 1st DS 13369 1334 2st DS 3214 283 Total 26.416 3695 Prof. Đặng Văn Chung Prof. Nguyễn Lân Việt

Trend Graduate training during 3 last years at HMU 1000 800 600 400 200 0 Resident physician Master 1st DS 2st DS PhD 2016 2017 2018 Lớp BSNT Khóa IX tại Bệnh viện Việt- Đức

Other forms of training at HMU Master of public health-international program Training on demand: Hanoi Health Department, Hospitals Joint training programs (Traditional Medicine Institute Army, South Central...) International Training under Treaty: Laos, Cambodia, Mongolia

International cooperation at HMU Trained Treaty for students of Laos, Cambodia, Mongolia, Ukraine Master or PhD training: in Public Health with Netherlands Denmark, Sweden, Australia (Ophthalmology) Memorandum of cooperation and exchange students with: Japan, France, Italy, Germany, Brazil, Netherlands. Irland, UK

Oriented development graduate training

Why we have to change (1)? Quite difference in comparision with other systems in medical education in the world. Too old and inadequate model of graduate training (temporary applied solutions in war s period, from 1945) Interuppted formation. Out comes: 10% competent doctors, working at several national hospitals 1 st important raison of hospital s overload because of lacking of good doctors at provincial hospital.

Why we have to change (2)? No outcome/compertency standard outcome for graduate training Practical certificate: issue once and valid everlasting, not tested Training many types of students: General Doctor, Traditional doctors, Odonto-Stomatology (#Dentistry) and preventive medicine doctor (Belong Institute of preventive medicine and public health) Unreasonable salary: Doctor (6 years) starting salary about 110 USD/month; equal the bachelor's salary (4 years) and less than military's salary (5 years) about 250 USD/month Requiement to intergrate regionnally and internationally

Oriented development: Training model in the future in VN 18 y 22 y 24 y 27 y 30-32 y Practical Training System/ MOH MD: 6 years Master (1-2 ys) Residency (3ys) PhD (3-4 ys) Specialization (2+ 5 ys) 1. Training model Academic Training System/ MOET Separation between practice training (Resident, Specialist I-II) and academic training (PhD, masters) Model (expected): 6 ys + 3ys + 2-5 ys of specialist training. 100% have to pass residency pathway if they want to practice. ROLES: Gouvernement, MOH, MOET, Ministry of Home affair, Ministry of Finance

Oriented development of graduate training 2. Improve management of graduate training Enhanced International cooperation: +++ Completing the process management of graduate training Reform of all training s curriculums; Expand practical facilities: important +++, public and private hospital (affiliate hospital) Continue to improve the recruitment, training and graduation; Improvement teaching by staff (Young staff, Resident physicians). Development HMU becomes a Health Science University Graduate School: approved by Rector Board in 12/2016

Thanks for your attention!