The Avicenna Directories
FAIMER
Databases – IMED, Avicenna and
DORA– as tools for medical
regulators
David Gordon (World Federation for Medical
Education, Copenhagen)
John Norcini (FAIMER, USA)
The Avicenna Directories
FAIMER
Overview
FAIMER (John Norcini)
• Needs of regulators
• Current databases
– Limitations, challenges,
strategies for the future
• FAIMER directories: IMED
and DORA
Avicenna (David Gordon)
• History of the directories
• Why Avicenna?
• Challenges
The Avicenna Directories
FAIMER
Regulator Needs
• Data supporting policy creation and
implementation
– Descriptive information
• Name, address, website, degree, language of instruction,
duration of the curriculum…
– Quality indicators
• Outcome measures
– Government recognition, accreditation, licensure, test scores…
• Process measures
– Qualifications of the faculty, admissions process, governance,
courses, clerkship experiences…
The Avicenna Directories
FAIMER
Regulator Needs: Ideal International
Databases
• Database of educational programs
– Descriptive information (name, contact info…)
– Process measures
• Mapped to international standards (WFME)
– Outcome measures: Local accreditation
• Database of accrediting bodies
– Standards used in the country or region and the
process of accreditation
The Avicenna Directories
FAIMER
Limitations of Current Resources
• International
– Few quality indicators
– Some data are unverified
• Regional and special
purpose
– Decisions, not the
underlying data, often
presented
– Regions are missing
– Limited comparability
across regions
“This foreign policy stuff is
a little frustrating.”
George W. Bush
The Avicenna Directories
FAIMER
Challenges
• Educational practices
are not universal
– Medical education varies
within-across countries
• Criteria
– Standards vary across
countries
• Language
– Barrier to data collection
and interpretation
• Potential for corruption
– Influences data quality
• Disclosure
– Public disclosure reduces
accuracy and compliance
• Compliance
– Voluntary participation
does not work
• Keeping up to date
The Avicenna Directories
FAIMER
Strategies for the Future
• Collaboration
– IMED, AVICENNA…
• Alternate sources of information
– Students
• Research
– What are the best indicators of quality?
• Technology
– Improves storage, retrieval, sharing
The Avicenna Directories
FAIMER
International Medical Education
Directory (IMED)
• Freely available with
2300+ medical schools
• Criteria for inclusion is
governmental recognition
in the country
• Data sources include
surveys, routine ECFMG
business, regional
experts, schools…
• Updated whenever there
is a change
• Contents
– Name, address,
telephone/fax numbers,
email address, website,
degree title, graduation
years, language of
instruction, duration of
curriculum, entrance
examination
requirement, foreign
student eligibility…
The Avicenna Directories
FAIMER
The Avicenna Directories
FAIMER
Directory of Organizations that
Recognize/Accredit (DORA)
• Contains a country list with name of authority (or
authorities) and website link (if available)
– Duration and levels of accreditation
– Standards (description and/or links to documents)
– Evaluation process (description and/or links to
documents)
– Outcomes / Consequences of accreditation
• Mandatory / Voluntary
• Additional information
– Description of accrediting organization
• Governmental authority / Independent entity
The Avicenna Directories
FAIMER
The Avicenna Directories
FAIMER
Future Plans
• Plans to update and expand DORA
– Enhance descriptions
– Link additional documents
– Systematically solicit new and updated
information
• Link accreditation information to the
individual school level in IMED
– Global data on accreditation of medical schools is
lacking
The Avicenna Directories
FAIMER
Purpose: Why build a database of
medical schools?
• Where is the medical school? - an address list
• What is the medical school like? - where to
apply? - where to work?
• How good is the medical school? – do you
trust the graduates of the school? – would you
recruit doctors from the school?
• (Think about anarchy – what is in the
Wikipedia list?)
The Avicenna Directories
FAIMER
History of directories of medical
schools
• The first modern example (WHO, 1953) was for
purpose 1 – an address list, of schools recognised
by their national government
• Later directories have been more for purposes 2
and 3 (what is the school like, and how good is
it?) –
– Recognition by the national government implies an
acceptable standard
– Additional information on accreditation and quality
assurance goes further
The Avicenna Directories
FAIMER
World Health Organisation
• The WHO directory has
gone through successive
editions.
• WHO is limited to using the
information submitted to
them by member states and because member
states have a tendency to
report poorly, this is
necessarily an incomplete
document
• These data are now with
Avicenna
The Avicenna Directories
FAIMER
Other issues with the WHO
directory
• A book, not readily accessible, getting out of
date quickly…
• A lack of will to keep the WHO directory going
(“Isn’t all this data available anyway?”)
• Incompleteness – only member states of WHO
The Avicenna Directories
FAIMER
Hence the transfer of responsibility for the
WHO directory to the Avicenna project
• A partnership of WHO and the University of
Copenhagen, with the assistance of the World
Federation for Medical Education, with other
partners
• “Where, how, and how well the world’s health
professionals are educated”
• A register of genuine educational institutions
including medical schools
• Not a recognition or accreditation instrument
• Broader functions…
The Avicenna Directories
FAIMER
Why Avicenna?




Avicenna – ibn-Sina - Persian philosopher,
poet, physicist, physician, psychologist,
pharmacologist and politician
980-1037 CE
Collated Eastern and Western knowledge
in health science, influenced by Greek,
Persian, Arabic, Jewish, Indian and Chinese
philosophy and medicine.
Major publications
•
Al-Shifa (On healing) - ‫الشفاء‬
•
Qanun fi-t-tibb (Canon of Medicine)
- ‫القانون في الطب‬
•
Symbolises worldwide partnership in
health sciences
The Avicenna Directories
FAIMER
Four aims • Comprehensive information on each school
• Broad coverage of institutions, countries and
professions (other professions in due
course...)
• Reliable and up-to-date
• Easily accessible
• A systematic, questionnaire-based, datagathering and presentation process
The Avicenna Directories
FAIMER
Comprehensive information on each
school
• identifying information
• structure and affiliations with academic organizations
and health care institutions
• resources and facilities to deliver the educational
programme and to support students
• quality assurance, including external accreditation
• student admission and student numbers
• duration and structure of the academic programme
• teaching and learning methods
The Avicenna Directories
FAIMER
How do we know data is accurate?
• Validation - a check of: consistency of answers
to related questions, consistency with other
publicly available information, and checks by
reliable external organisations
• Students, staff and others may advise us that
data on the website is not correct
The Avicenna Directories
FAIMER
What problems have we faced? (1)
• Funding
– Who should pay, and why?
– How much does it cost?
– How should the project be funded in the future?
The Avicenna Directories
FAIMER
What problems have we faced? (2)
• IT issues
– Related to funding...
– But: the project has not been driven by IT, rather,
using it as a means to the end
– (and IT problems we have not detected ourselves!)
• Patterns of response from schools
– Should we pro-actively seek responses: or allow
schools to respond when they want?
– How should responses be encouraged?
The Avicenna Directories
FAIMER
Problems to be faced must be turned into
problems resolved
• Meeting, 22 and 23 September, Copenhagen
• Representatives from WFME, FAIMER, WHO,
University of Copenhagen (and others, below)
• The possibility of the merger of the IMED and
Avicenna databases is under active and
serious consideration.
• Two partners (WFME, FAIMER), two collaborators
(WHO, UC), sponsors and affiliates
The Avicenna Directories
FAIMER
- resolution – to be continued • Resources would come from:
– The two partners (WFME and FAIMER)
– The two collaborators (WHO and UC)
– Major sponsors (with explicit roles and rights in the
management and advisory structure)
– Other sponsors (also with roles and rights)
• “Under active and serious consideration” by two
potential major sponsors present at the CPH meeting –
AMC and GMC
• One other potential sponsor present at the CPH meeting
(National Board of Health, Denmark) also supportive