Meeting Report

STRENGTHENING HEALTH PROFESSIONALEDUCATION REFORMS IN CAMBODIA, CHINA,
THE LAO PEOPLE’S DEMOCRATIC REPUBLIC
AND VIET NAM

27–28 February 2017
Hanoi, Viet Nam

Strengthening Health Professional Education Reforms In Cambodia, China, The Lao People’s Democratic Republic and Viet Nam
27–28 February 2017
Hanoi, Viet Nam

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WORLD HEALTH ORGANIZATIONREGIONAL OFFICE FOR THE WESTERN PACIFIC
RS/2017/GE/11(VNM)

English only

MEETING REPORTSTRENGTHENING HEALTH PROFESSIONAL EDUCATION REFORMS IN CAMBODIA, CHINA,
THE LAO PEOPLE’S DEMOCRATIC REPUBLIC AND VIET NAM

Convened by:WORLD HEALTH ORGANIZATIONREGIONAL OFFICE FOR THE WESTERN PACIFIC

Hanoi, Viet Nam
27–28 February 2017

Not for sale
Printed and distributed by:World Health Organization
Regional Office for the Western Pacific
Manila, Philippines
May 2017

-2NOTEThe views expressed in this report are those of the participants of the Meeting on Strengthening HealthProfessional Education Reforms in Cambodia, China, the Lao People’s Democratic Republic and Viet
Nam and do not necessarily reflect the policies of the conveners.

This report has been prepared by the World Health Organization Regional Office for the Western Pacificfor Member States in the Region and for those who participated in the Meeting on Strengthening HealthProfessional Education Reforms in Cambodia, China, the Lao People’s Democratic Republic and Viet
Nam in Hanoi, Viet Nam from 27 to 28 February 2017.

-3CONTENTS

SUMMARY .................................................................................................................................................. 1

1. INTRODUCTION .................................................................................................................................... 3
1.1 Meeting organization .......................................................................................................................... 3
1.2 Meeting objectives .............................................................................................................................. 4
2. PROCEEDINGS ....................................................................................................................................... 4
2.1 Opening session .................................................................................................................................. 4
2.2 Setting the scene ................................................................................................................................. 5
2.3 Country overviews .............................................................................................................................. 5
2.4 Technical sessions ............................................................................................................................... 7
Session I: Addressing the health professional education reform challenges – curriculum reforms...... 7
Session II: Addressing the health professional education reform challenges – faculty development... 9
Session III: Addressing the health professional education reform challenges – student assessment .. 10
Session IV: Addressing the health professional education reform challenges – quality assurance .... 12
2.5 Country-specific action plans............................................................................................................ 13
2.6 Country-specific sessions.................................................................................................................. 15
3. CONCLUSIONS AND RECOMMENDATIONS ................................................................................. 15
3.1 Conclusions ....................................................................................................................................... 15
3.2 Recommendations for Member States .............................................................................................. 16
3.3 Recommendations for WHO............................................................................................................. 17

ANNEXES .................................................................................................................................................. 18
Annex 1. Programme of activties............................................................................................................ 18
Annex 2. List of participants ................................................................................................................... 19
Annex 3. Speech of Dr Shin Young-soo ................................................................................................. 25
Annex 4. Health professional education – entry points for action .......................................................... 27

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SUMMARY
Universal health coverage has created an urgent need to improve the quality and safety of health services
at global, regional and country levels. In this context, health professional education plays an importantrole in preparing a health workforce that is both “fit for practice” and “fit for purpose” to meet theevolving health needs of the populations. Although governments have undertaken initiatives to reform
health professional education, these efforts have often been piecemeal, suggesting the need for a strategic
focus to support systematic improvements to build a workforce that is competent and responsive to healthservice needs.
The objectives of the Meeting on Health Professional Education Reforms in Cambodia, China, the Lao
People’s Democratic Republic and Viet Nam were:
1) to take stock of progress on policy developments and critical issues in health professional
education since the previous workshop;
2) to share experiences on health professional education reforms with a focus on enabling factors
and barriers;
3) to build linkages between education, regulation and the health system needs to prepare competentand responsive health workforces; and4) to identify areas of technical cooperation and follow-up actions for advancing health professional
education reforms.
The meeting provided 41 representatives from eight countries, including experts and staff from theministries of health and education, educational institutions and health professional bodies, with anopportunity to share experiences, discuss supportive policy options and explore possible areas fortechnical cooperation at country and regional levels, to enhance the quality and relevance of healthprofessional education. Several challenges are common across countries: weak institutional capacities;
mismatch of competencies to health service needs; narrow technical focus without broader contextual
understanding, especially public health competencies; predominant hospital orientation at the expense of
primary care; and limited coordination between health and education sectors.
Four main dimensions for the strengthening of health professional education were discussed:(1) curriculum reforms, (2) faculty development, (3) student assessment, and (4) quality assurance.
Several key themes emerged. These included the recognition that health professional education reforms
were necessary and timely in view of the changing health systems and health service needs. The need to
produce health professionals with the requisite competencies to meet the chronic long-term care needs
was highlighted. This will require changes in both the curriculum content and pedagogical approaches.
The role of faculty members as critical resources in the reform process was emphasized. Student
assessments were considered an important component of overall educational activities to provide areliable and generalizable measure of students’ progress in acquiring core knowledge and competencies.
It was agreed that quality assurance mechanisms should not be limited to the setting of processes andstandards, but should include an assessment of the educational outcomes.

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It was concluded that efforts to strengthen health professional education reforms will need broader
engagement of key stakeholders, at all levels, to ensure advocacy and commitment to increase
investments in professional education systems.

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1. INTRODUCTION
1.1 Meeting organization
Comprehensive approaches to improving and scaling up health professional education are essential in
supporting and advancing health system performance. To achieve universal coverage of quality healthservices, the focus should shift from producing more health workers towards reforming the quality andrelevance of health professional education, to prepare a workforce that is competent and committed torespond to population health needs.
Health professional education has not kept pace with the evolving demographic, epidemiological,
socioeconomic and information technology trends. In the World Health Organization (WHO) Western
Pacific Region, Member States continue to face a number of recurring educational issues and challenges.
In Cambodia, China, the Lao People’s Democratic Republic and Viet Nam, the problems are systemic:
mismatch of competencies with health service needs; poor teamwork and professional coordination;
narrow technical focus without broader contextual understanding, especially public health competencies;
and predominant hospital orientation at the expense of primary care. Furthermore, in these countries, theeducation ministry manages educational activities, often with limited coordination with the healthministry and driven by different sets of imperatives.
Mindful of the need to develop comprehensive policies and plans to strengthen health professional
education, WHO has been providing support to the Member States. In 2013, the Workshop on HealthProfessional Education in the Western Pacific Region was convened in Manila, Philippines. In line withthe recommendations from the workshop, support has been extended to the Education Development
Centres (EDC) established in Cambodia and the Lao People’s Democratic Republic, to strengthen faculty
and institutional capacity. Technical assistance has also been provided for the development of appropriate
policies and frameworks to strengthen regulation and accreditation mechanisms. Furthermore, linkages
have been created between the Member States and WHO collaborating centres to support healthprofessional education reforms.
In consideration of these developments, a meeting was held in Hanoi, Viet Nam from 27 to 28 February
2017 to discuss critical dimensions of health professional education reforms. The meeting was attended
by 41 participants that included representatives from the ministries of health and education, educational
institutions and health professional bodies as well as experts. It provided an opportunity to shareexperiences, discuss supportive policy options and explore possible areas for technical cooperation atcountry and regional levels to enhance the quality and relevance of health professional education. The
programme of activities is available in Annex 1.
Representatives from the following countries attended the meeting: Australia, Cambodia, China, Japan,
the Lao People’s Democratic Republic, the Philippines, the Republic of Korea, and Viet Nam. The
secretariat for the meeting included six WHO staff. The list of participants is available in Annex 2.

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1.2 Meeting objectives
The objectives of the meeting were:
1) to take stock of progress on policy developments and critical issues in health professional
education since the previous workshop;
2) to share experiences on health professional education reforms with a focus on enabling factors
and barriers;
3) to build linkages between education, regulation and the health system needs to prepare competentand responsive health workforces; and4) to identify areas of technical cooperation and follow-up actions for advancing health professional
education reforms.

2. PROCEEDINGS
2.1 Opening session
In his welcome remarks, Dr Lokky Wai, WHO Representative to Viet Nam, emphasized that healthprofessional education has not kept pace with the emerging health system challenges and continues to be
fragmented, outdated and static. He highlighted the shortage of health workers and its impact on access toquality health services. He further underlined that health professional education should not solely focus
on addressing quantity, but should pay particular attention to improving the quality and relevance of
training.
Dr Vivian Lin, Director, Division of Health Systems, WHO Regional Office for the Western Pacific,
delivered the opening address on behalf of Dr Shin Young-soo, WHO Regional Director for the Western
Pacific. Dr Shin’s opening address is available in Annex 3.
Dr Lin emphasized that achieving universal health coverage and the Sustainable Development Goals will
require scaling up and reforming the educational and health systems. She highlighted that these global
commitments provide an opportunity to foster innovation in the education systems, engaging healthprofessionals in critical reasoning and ethical conduct so that they are competent to participate as
members of multidisciplinary teams in people-centred health systems. She underlined the need to produce
competent professionals capable of responding to the changing needs of population groups impacted byemerging disease outbreaks, rapid rises in injuries and noncommunicable diseases. She acknowledged thereforms in health professional education that have already been initiated in Cambodia, China, the Lao
People’s Democratic Republic and Viet Nam. She reiterated that the challenges associated with healthprofessional education extend beyond the narrowly defined health sector and beyond a single level ofpolicy purview, which highlighted the need to work effectively across governments and stakeholders.
In his address, Professor Le Quang Cuong, Vice-Minister, Ministry of Health, Government of Viet Nam,welcomed the participants to the meeting. He recognized the challenges that the health workforce in Viet
Nam has been facing, such as shortages of health professionals, including qualified educators. Skill-mix
imbalances, combined with concentration of health workers in urban areas, were affecting access toquality health services. He emphasized that the Government of Viet Nam remains committed to5addressing these challenges and that health professional education reforms have been identified as a
strategic priority.
2.2 Setting the scene
Dr Indrajit Hazarika, Technical Officer, Health Workforce Policy, WHO Regional Office for the Western
Pacific, highlighted the demographic and epidemiological trends, socioeconomic development, and rapid
advances in science and information technology that are driving transformations in health services andhealth professional education. The current education systems suffer from outdated curricula and teaching
methods, and shortages of resources required to make desired changes. The lack of faculty and faculty
development, unsupportive culture and norms in health professional education, insufficient channels forsharing information and best practices, and limited oversight processes were identified as important
challenges. He emphasized that realization of the reforms in health professional education will require aseries of instructional and institutional changes. He presented a framework (Annex 4) that identified theinterlinkages between the different institutional and instructional elements, as well as potential points ofentry to initiate these changes.
2.3 Country overviews
Individual countries provided an overview of their health professional education system, outlining their
key issues and challenges, and also identified priorities for action.
Cambodia
The Ministry of Health and the Ministry of Education Youth and Sports have been working together toimprove the education of health professionals in Cambodia. Within the Ministry of Health, the Human
Resources Development Department is the responsible authority.
The country has six public and 11 private health training institutions, of which seven are located in thecapital city and 10 in the provinces. While the Accreditation Committee of Cambodia is responsible for
institutional and programme accreditation, these institutions have not been accredited. Although there is arequirement for institutions to conduct internal quality assessments, this is not done regularly. For mostinstitutions, shortages in clinical placement sites and clinical preceptors are an important challenge.
The National Exit Examination (NEE) was introduced to standardize the quality of health professional
education but resource shortages have impacted the continuation of the Objective Structured ClinicalExamination component of the NEE.
The identified priorities include the revision to Sub decree 21, the finalization of the joint prakas onminimum standards and criteria for training institutions for health, the review the NEE process, review
national curricula to match the agreed competency frameworks, and advocacy to increase civil service
recruitments to meet health system needs.

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China
Considerable progress has been made in increasing the size of the health workforce in China. The
workforce increased by 2 078 000 individuals (24%) during the period 2011–2015 compared to 2006–
2010. Health workforce planning has been guided by the Healthy China 2030 plan and the National
Health Workforce Development Plan (2016–2020).
In 2015, there were 1600 health-related specialties in secondary vocational schools nationwide, with
700 000 enrolled students. In 2016, there were 2600 health-related specialties in higher professional
schools, with 470 000 enrolled students.
Despite these achievements, several challenges persist. For the bachelor’s degree programmes, theseinclude the low calibre of enrolled students, lack of internship postings and variability in the quality of the
training across the different regions. For postgraduate degree programmes, the challenges include
variations in the quality of education among the different training institutions, unsatisfactory salary andbenefits packages for interns, weak internship programme for general practitioners, and outdated curriculaand pedagogical methods. In addition, although the continuing medical education programmes have wide
individual and institutional coverage, there are challenges related to the management and relevance of
these programmes, the instructional methods and their application, and a lack of clear understanding of
the target audience.
The identified priorities include efforts to strengthen synergy between the National Health and Family
Planning Commission and the Ministry of Education; efforts to strengthen postgraduate training by
introducing salary and benefits reforms, improving the quality of training and addressing the shortages ofqualified faculty; and efforts to improve the continuing medical education programmes by developing a
new policy, including the development of guidelines and protocols on their organization, management
and evaluation.
Lao People’s Democratic Republic
The Department of Training and Research of the Ministry of Health is responsible for training andsupervises all education, pre-service and in-service training in the Lao People’s Democratic Republic.
The University of Health Sciences is the main public training institution and offers seven programmes.
There is currently no system for accreditation of health professional education in place. A system for
quality assurance has recently been established, including the establishment of a quality assurance
committee in each of the training institutions to monitor and evaluate programmes internally.
The main issues and challenges identified relate to the curriculum design, the capacity of the existing
faculty, the lack of supply of equipment and materials, the shortages of clinical practice sites, limited
management and leadership capacity of training institutions, and infrastructure limitations.
The identified priorities include designing and introducing a national examination to certify thecompetence of graduates; introducing a system for accreditation of institutions; securing support forfaculty development; improving the learning environment in hospitals, including supervised clinical7
practice; further strengthening the Education Development Center at the University of Health Sciences asa national resource; and leveraging resources including skills labs and simulation models.
Viet Nam
There are 185 health profession training institutions (90 public and 95 private) in Viet Nam. Of these, 41
offer university-level degrees, 53 offer college degrees and 91 offer vocational courses. The number of
medical schools has increased from eight in 2000 to 23 in 2016.
The key challenges identified include the lack of strategic planning in terms of skill mix and thegeographical distribution of health workers. Shortages of health professionals (both quantity and quality),
limited resources to support institutional and educational reforms, overcrowded institutions and curricula,and lack of quality assurance (accreditation) were listed as additional challenges.
The identified priorities include setting a vision for the health system, outlining the strategy for healthprofessional education based on national demand (health system) and supply (education system),
continuing the support for curriculum reform, improving continuing professional development
opportunities, introducing a national licensing exam, and establishing systems for programme andinstitution accreditation.
2.4 Technical sessions
The technical sessions were structured as follows:
1) a country case study relevant to the session topic and presented by a country participant;2) a topical overview delivered by a temporary adviser that included information on current
practices from different countries in the region and globally; and3) country-specific group work to identify the key issues related to the session topic, including a
discussion and identification of priorities to address them.
Session I: Addressing the health professional education reform challenges – curriculum reforms
Professor Tran Diep Tuan presented the current initiatives undertaken in Viet Nam to introduce acompetency-based curriculum. He highlighted the challenges associated with the existing medical school
curriculum and its implementation, including their content-based nature, traditional pedagogy, strong
hospital focus, large student batch size, lack of comprehensive assessments, and limited mechanisms andstructures to support continuing quality improvement.
To address these challenges, efforts are under way in Viet Nam to develop integrated, practice- andcompetency-based curricula; reinforce students’ abilities in knowledge application, problem-solving,clinical and social competence; introduce comprehensive assessments; support faculty development
programmes; and institute mechanisms for continuing quality improvement. There are also ongoing
discussions to introduce a national licensing exam.
For these efforts to be effective, he emphasized that it will be important to secure financial and politicalsupport, establish a “change” environment, develop international strategic and technical partnerships,
support faculty development programmes and set mechanisms to oversee the curriculum reform process.

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Professor Michael Kidd presented key policy questions related to the design and implementation of acompetency-based curriculum: What are some of the lessons learnt? What have been the challenges in
implementation and how can they be tackled?
He emphasized that curriculum development should be determined by detailed learning objectives,
expected competencies, and based on community needs. This should guide the core curriculum
development goals designed to facilitate the achievement of these competencies. The best teaching
methods and educational experiences can then be selected to accomplish the objectives and plan alongitudinal curriculum. It is important to establish a system for evaluation and feedback of learners.
Additionally, it is important to establish or meet criteria for programme evaluation, recognition andcertification.
Among others, Professor Kidd presented the Institute of Medicine’s five core competencies needed for
health-care professionals: (1) provide patient-centred care; (2) work in interdisciplinary teams; (3) employ
evidence-based practice; (4) apply quality improvement; and (5) utilize informatics.
Following the presentations, participants worked in groups to further deliberate the current status of
curriculum reforms in their countries, identify the key issues and develop strategies to address them.
Key discussion points for this session
 The curriculum reform process should be preceded by a clear articulation of a vision for thehealth system, addressing the current and future individual and population needs. The curriculum
should then be designed to produce health professionals with requisite competencies to provide
these services.
 Review and revision of the curricula should be accompanied by commitment to invest resourceson its implementation. This should include resources to support faculty development to facilitate
the introduction of contemporary pedagogical methods and techniques.
 The curriculum reform process should encourage dialogue, open exchange and discussion among
different stakeholders including educators, health service providers and regulators.
 The implementation of the curriculum reforms should be closely monitored via the establishmentof agreed criteria for reform evaluation.
 Clinical placements, with their complex environments and working relationships, carry powerful
messages about what activities are considered important or not. These implicit understandings
and professional values influence learners in unexpected ways. Learners gain clinical knowledge
and skills within a particular context, but also learn much about professional ethics anddisciplinary cultures. These experiences, often referred to as the “hidden” curricula, can provide
insights into what it is to be a health professional and also have a subtle influence on a learner’s
professional identity.
• The curriculum should be considered a “live” document and should be regularly updated to keep
up with advances in medical scientific knowledge and technology.
• Curricula should focus on competencies that extend beyond clinical knowledge and skills, such as
management, education and training, information technology, communication and team building.
• The curriculum reform process should aim to inculcate a culture of lifelong learning.

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Session II: Addressing the health professional education reform challenges – faculty development
Professor Ketsomsouk Bouphavanh discussed the experiences of the Education Development Center(EDC) in the Lao People’s Democratic Republic. He mentioned that the health workforce in the country
faces challenges related to shortages and imbalances in skill mix and distribution of qualified healthworkers. The urgent need to scale up and improve the quality of health professional education has been
identified but is limited by inadequate educational capacity. To respond to the need for a resource centre
for educational development for health professions, the EDC was established in 2011 at the University of
Health Sciences with the purpose to act as a focal point for educational reform, coordination and capacitybuilding.
To perform this role, the EDC mobilizes experts and support from the university faculty and affiliatedhospitals. The Center has also evolved as a focal point for collaboration with development partners who
contribute to educational development in the country. It continues to work closely with the Department ofTraining and Research and other departments of the Ministry of Health.
Since its establishment, the EDC has contributed to the development of quality standards for monitoring
educational development of universities, helped develop a five-year strategic plan for the University of
Health Sciences, conducted workshops on educational leadership and institutional governance, andoffered continuing professional development and training for senior faculty, including training ofprovincial training management teams.
The EDC continues to work towards strengthening training units in clinical settings, improving clinicalteaching skills, developing educational assessment books and revising logbooks. It is currently assistingwith the preparation of quality standards for accreditation as well as formulation of national competencies
for the design of the licensing examination. The EDC plans to develop a teacher training curriculum, aguideline for teacher practice, a teacher assessment manual and a teacher assessment system and to
implement short- and long-term training in medical education.
In his presentation, Professor Jwa-Seop Shin addressed key policy questions related to faculty
development that included a discussion on the critical roles of faculty development in producing
competent profession-oriented graduates; the role of institutional policies in promoting faculty
development; and the importance of international collaboration to address challenges related to faculty
development.
The presentation highlighted the core roles of faculty in teaching, research and services (clinical,
administrative, network building). The faculty can be an important driving force to change theinstitutional culture, system and policy, with implications for the institution’s reputation. Although in the
narrow sense, faculties help improve instructional skills, curriculum design and the organizational milieu,
in the broader sense, they are critical for programme design and institutional development.

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The ADDIE framework provides a useful tool to guide faculty development: Analyse – analyse needs, relevant learner characteristics and tasks to be learned;
 Design – define objectives and outcomes, and select an instructional approach; Develop – create the instructional materials;
 Implement – deliver the instructional materials; and Evaluate – ensure that the instruction achieved the desired goals.
Sometimes, a non-instructional solution is more effective than the instructional approach in addressing
faculty needs. These include feedback, job performance aids, reward systems and employee selection.
Designing a career pathway for the faculty is equally important. This may involve an organizational
redesign depending on the career stage of the faculty. For example, in teaching, entry-level faculty
members may be involved in lecturing, facilitating and developing materials; mid-level faculty in courseorganization and evaluation; and senior-level faculty more in quality control and accreditation. Similarly,
for administrative tasks, entry-level faculty may be involved in the development of operating procedures
and reporting; mid-level faculty in coaching, mentoring, directing and conflict management; and seniorlevel faculty in organizational development, change management, funding and brokering.
Following the presentations, participants worked in groups to further deliberate the current opportunities
for faculty development in their countries, identify the key issues and develop strategies to address them.
Key discussion points for this session
 Faculty are not only agents of knowledge transmission but important role models for students.
They play a critical role in ensuring that health graduates are competent not only in the individual
provision of health care but also as members of a multidisciplinary team.
 The policy environment, institutional arrangements, organizational culture and resource
availability can have important implications for faculty development opportunities.
 Effective modalities of faculty development can have a positive influence on their performance,
motivation, satisfaction and productivity. In some instances, appraisals and other noninstructional methods can be more effective than opportunities for continuing skills development.
 Taking advantage of information technology for distance learning, collaborative connectivity, andknowledge management can increase avenues for faculty development.
 Timely adaptation of global teaching and learning resources, such as translation into local
languages, can harness the potential for transferring global knowledge and experiences.
 Opportunities for faculty development should be explored through linkages via networks,
alliances and consortia between educational institutions worldwide and across allied sectors.
Session III: Addressing the health professional education reform challenges – student assessment
Professor Han Chanvohreak presented the design and implementation of the National Exit
Examination (NEE) in Cambodia, which was introduced following a prime ministerial sub-decree (21) on
the establishment of a National Examination Committee in 2011. Subsequently, a road map for the
implementation of the NEE was developed that outlined the formation of technical working group foreach discipline, consisting of representatives from private and public institutions. These working groups
were responsible for developing valid and reliable tools to test the core competencies.

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The purpose of the NEE is to test the competencies of health professional graduates to ensure that they
have adequate knowledge and skills for practice. The examination assesses both knowledge and skills
through written multiple choice questions (MCQs) and an objective structured clinical examination.
The introduction of the NEE has led to standardized assessments of health graduates and the introductionof a transparent process for student assessment with indirect impact on improving the quality of training
programmes in health.
The NEE is currently organized with technical support from the National Examination Committee andadministered by the Human Resources Development Department of the Ministry of Health.
Given that the NEE is a labour- and resource-intensive process (more than 500 medical students sat theexam in 2015), concerns have been raised regarding its long-term feasibility, especially under the current
administrative arrangements. The opinion that the responsibility of organizing the NEE should gradually
be transferred to a dedicated unit or institution is growing.
Professor Erlyn Sana discussed key policy questions related to student assessment, including a discussionof the type of assessments that is effective at the various stages of health professional education; the useof student assessments as a measure of the quality of education and training; and current initiatives
undertaken by countries to standardize and strengthen student assessment.
Assessments in general involve the collection and organization of data to measure how learners haveachieved the expected levels of competencies as a result of instruction. The assessments should bedesigned to measure learning outcomes, competencies and objectives.
Depending on the level of comprehension, the assessment can be designed to test:
 knowledge – through written assessments (essay, short answer questions, completion questions,
MCQ, extended matching type, modified essay, patient management problems, progress test,
dissertation, report, etc.);
 practical knowledge – through written assessments (essay, short answer questions, completion
questions, MCQ, extended matching type, modified essay, patient management problems,
progress test, dissertation, report, etc.);
 demonstration of knowledge – through clinical/practical assessment (long case, practicalexamination, spot examination, objective structured clinical examination, objective structured
practical examination, objective structured long examination record, group objective structured
clinical examination, tutor’s report, checklist, rating scale, patient report, etc.)
 performance – through portfolios, other records of performance, logs, procedure logs, peer
assessment and self-assessment.
Several countries have introduced licensing examinations with the objective of conducting performancebased assessments. These examinations may include a combination of written and practical examinations.
Success in the examination may be a requirement for registration with the professional regulatory
authority.

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Following the presentations, participants worked in groups to further deliberate on the role of assessmentin monitoring and evaluating the performance of students and faculty. The group discussions allowed
participants to share country-level experiences in the design and implementation of assessments andidentify priorities for improvement.
Key discussion points for this session
 Student assessment should serve two main functions: evaluation of current knowledge and thetranslation of the knowledge into practice.
 Among learners, assessment should be designed to foster learning, inspire confidence andenhance the ability to self-monitor individual progress.
 The findings and observations from assessments should be used to inform curriculum changes
and to certify achievement of curriculum goals.
 Student assessment should also be used as an indirect measure of faculty performance, besides
offering comparative data on the quality of educational programmes.
 The validity and reliability of the assessments are important to ensure that the students possess
the knowledge, skills, and professional/personal values required for the next level of training or toserve as an independently functioning entry-level practitioner.
 Advances in technology such as the use of techniques to test clinical skills also hold the potential
to revolutionize health professional education, offering students the opportunity to customize
their learning and to progress at their own pace and at geographic locations that meet theireducational needs. Such an approach would need to be closely monitored by faculty and validated
through testing.
Session IV: Addressing the health professional education reform challenges – quality assurance
Mr Wang Songling presented the process of introducing quality assurance mechanisms in China. Thesemechanisms have been introduced for courses in clinical medicine, dentistry, traditional Chinese
medicine, nursing and Chinese pharmacy. All these disciplines have developed their professional
standards, set up verification agencies, and have verified colleges and universities with relevant
specialties. The guiding ideology has been the promotion of evaluation and excellence, adopting a
student-centred and continuing improvement approach.
To advance this approach, work began in 2002 with the development of the project of undergraduate
medical education standards by the Ministry of Education. In 2005, these standards were approved theMinistry of Education and the Ministry of Health. In 2006, they were piloted to verify their validity andreliability. In 2008, the two Ministries jointly issued the Chinese Undergraduate Medical Education
Standards, including the establishment of a so-called expert committee and working committee under the
Ministry of Education. In 2009, verification of medical schools was undertaken using the national
standards of medical education. In 2011, a secretariat working group was established. The standards wererevised/updated in 2015. These are considered to be equivalent to international standards and include 22
standards and 44 sub-standards. By the end of 2016, 58 medical colleges had been certified
through a spot investigation evaluation and monitoring.

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The evaluation process includes three tracks: student evaluation, peer teacher evaluation, and supervisor
evaluation. It involves all basic and clinical faculty. After conducting classroom visits, feedback isprovided to the school leadership, administrators, inspection experts and peer faculty based on thefindings. The teachers themselves are also given this feedback, together with other forms of feedback.
The quality assurance system and its processes are still evolving and maturing. The current challenges
include unbalanced regional capacities to conduct these evaluations, development and construction ofquality indicators, and incomplete institutionalization of routine assessments.
Professor Ducksun Ahn discussed the different component structures that are needed in the accreditation
system, that is, for institutional versus programme accreditation. He also highlighted the influence ofquality assurance mechanisms in improving the quality of health professional education and training. The
purpose of accreditation is to build a competent health workforce by ensuring the quality of training
taking place within institutions. Within this context, quality assurance mechanisms play an important rolein setting the educational and professional standards. The need for innovative and effective approaches toquality assurance of health professional education was recognized. Accreditation and other processes
should not be perceived as a means to an end, but as a path to encourage and instil a culture of continual
quality improvement.
Key discussion points for this session










Accreditation plays an important role in establishing and ensuring the quality of healthprofessional education. It is important to ensure that accreditation standards emphasize
professionalism and ethics.
Modalities and systems for quality assurance should be determined by the professional needs anddictated by the country context and availability of resources, but should remain comparable tointernational standards.
Quality assurance mechanisms should operate within a legal framework that ensures autonomy of
the system as well as independence of the quality assessment from government, the training
institutions and the profession. The legal framework must authorize the accrediting body to set
standards, conduct periodic evaluations, and confer, deny and withdraw accreditation of training
schools and their programmes.
The standards or criteria must be predetermined, agreed upon and made public. These should be
used as the basis for the process (self-evaluation, external evaluation, recommendations and final
decision on the quality of education).
Beyond standard setting, quality assurance mechanisms should be able to promote learningorganizations in the health system with a focus on improving quality and patient safety.

2.5 Country-specific action plans
The country presentations identified the following priorities for health professional education reforms.

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Cambodia
The need to reform the curriculum to align with the core competency framework was identified as an
immediate priority. In addition, investments and efforts to develop the faculty development programme
were recognized. This would require exploring support from international partners, student and staff
exchange programmes, and access to online teaching and learning resources.
To sustain the NEE and to enhance its quality, the importance of establishing a National Education
Development Center was recognized. However, this would require support from development partners. In
the interim, continued support will be extended to the standardization of ongoing student assessment,
including the establishment of an objective structured clinical examination as a summative clinicalassessment tool in all training institutions.
The finalization of the joint prakas (proclamations) on “minimum standards and criteria for training
institutions for health” and “criteria for establishing specialist courses” was seen as key to theestablishment of a quality assurance system for health training institutions.
China
The focus will be on strengthening the integration of the basic and clinical sciences curricula using anorgan and body system approach. In addition, efforts will also be made to strengthen the standardized
residency training programme that was introduced in 2014.
To increase opportunities for faculty development, the option of establishing a national centre for faculty
training will be considered. This will require fiscal commitment from the central government but will be
important to address the regional variations in the quality of education and training.
Further efforts will be undertaken to strengthen student assessments, ensure its comprehensiveness anduse it as a means to follow up on the acquisition and maintenance of competencies in the long term. In
addition, efforts will be undertaken to improve the quality assurance system to ensure that it matches
recognized internationally standards.
Lao People’s Democratic Republic
Addressing the discord between universities and hospitals with regard to clinical placements and training
was seen as an immediate priority. In most clinical placement sites, the preceptors used traditional
teaching methods that are ineffective in developing clinical skills. It was also pointed out that the clinicalskills and competency of the training units in hospitals need to be improved and increased.
To strengthen student assessment, there are plans to develop an assessment book for clinical skills, askills logbook for students and a student assessment policy. In addition, planning is ongoing to introduce
a national examination in 2019, initially for medicine and dentistry, followed by other health professions.
In addition, professional registration of nurses and midwives will be introduced in 2018.

15
Viet Nam
The development of the template for a standardized undergraduate medical curriculum that supports
delivery of outcome- and competency-based medical education was pointed out as an urgent priority. In
addition, the establishment of a formal internship programme (12 or 18 months) and, in the longer term,
postgraduate specialty training programmes were also recognized as priorities. This would require thedeveloping an implementation plan to support hospitals and health facilities so they can offer internships
and start implementing such programmes initially in selected university-affiliated provincial hospitals.
Other priorities would include the development of university faculty and clinical preceptors (at universityaffiliated hospitals) to equip them with the knowledge, skills and tools that support profession-oriented
medical education, including through the establishment of education steering committees at each
university and a mechanism to ensure university faculty are engaged in clinical practice and vice versa.
National standards for medical school programmes should be set and programmes accredited against
those standards.
Another priority area that was identified was the establishment of a professional regulation system thatwill cover licensing and specialist certification and the ongoing regulation of practice by licensed doctors.

2.6 Country-specific sessions
Recognizing that each country is at a different stage in the health professional education reform process, aone-size-fits-all approach appears impractical. The WHO Regional Office for the Western Pacific andWHO country offices will work with Member States on the challenges and issues highlighted during thecountry-specific discussions.

3. CONCLUSIONS AND RECOMMENDATIONS
3.1 Conclusions
In view of the changing health systems and health service needs, health professional education reforms
are necessary and timely. These reforms should promote contemporary competencies, critical reasoning
and ethical conduct to produce practitioners that are responsible and responsive members of peoplecentred health systems.
Broad engagement at all levels – local, national and regional – will be important. It should include
collaboration between key stakeholders, especially ministries of education and health, professional
associations and the academic community, for policy- and priority-setting. This should be accompaniedby strong advocacy to increase investments to reinforce the professional education system.
Growing demand for chronic long-term care mandates a paradigm shift in approaches to service delivery,
especially the need for multidisciplinary practice. Core to a redesigned health system will be a healthworkforce equipped with competencies to deliver integrated people-centred care. The reforms in theprofessional education system should support the production of health professionals with requisitecompetencies.

16
The current curriculum and pedagogical approaches indicate the need for a change to promotetransformative learning. The use of active learning or student-centred pedagogical methods should be
encouraged to enhance learning outcomes and allow development of capabilities to extract and synthesize
knowledge that is necessary for clinical and population-based decision-making.
Traditionally, the majority of clinical education occurs in hospitals. Within the curriculum reforms, asustained shift towards community and primary care teaching is necessary at both undergraduate andgraduate levels.
Faculty members are the ultimate resource of all educational institutions. In most countries, faculty
challenges consist of heavy teaching loads, low access to professional resources, limited careerdevelopment opportunities, competing demands for research and unattractive remuneration. Focus on all
facets of faculty development, including academic and career development, teaching improvement andleadership development, will be critical.
Assessment and evaluation are integral components of overall educational activities. They should bedesigned prospectively along with learning outcomes and should match the competencies and pedagogicalformats. They should provide a reliable and generalizable measure of students’ progress in acquiring coreknowledge and competencies.
Ensuring continuing competence of health practitioners necessitates strong linkages and collaboration
among education institutions and regulatory authorities in line with the health service needs. This includes
the creation of valid measures to evaluate the quality of education and continuing professional
competencies, with an emphasis on ethical practice, professionalism and social competencies.
The aim of quality assurance mechanisms, such as accreditation, is to ensure that health professionals areproperly educated and competent to practice. The evaluation of programmes and institutions should not
be limited to the processes and standards, but also include an assessment of the educational outcomes.
The engagement of government, professional bodies, and the academic community is essential in theprocess.

3.2 Recommendations for Member States
The meeting recommended the following to Member States:
1) working on the strategies identified to address the country-specific challenges to strengthen healthprofessional education reforms;
2) initiating or continuing policy dialogues at the national level to garner support for the
implementation of the identified strategies to strengthen health professional education reforms,
leveraging on the expertise available in the Region;3) strengthening linkages between education and health sectors, regulators and other quality
assurance mechanisms with the objective of advancing the quality of health professional
education;4) introducing curriculum reforms and creating opportunities for faculty development with the intent
of improving educational outcomes and producing ethical practitioners;

175) designing and introducing comprehensive assessment methods that reliably measures theeducational outcomes and provide important data to determine programme effectiveness; and6) instituting appropriate quality assurance mechanisms to ensure that health professionals areproperly educated and competent to practice.
3.3 Recommendations for WHO
The meeting recommended the following to the WHO Secretariat:
1) supporting countries in the implementation of the health professional education reforms andworkforce regulation with the objective of preparing a health workforce competent to deliver
quality, safe and people-centred health services;2) continuing to work closely with the WHO country offices, academic institutions, collaborating
centres and other stakeholders to support and strengthen ongoing health professional education
reforms;3) encouraging and facilitating regional collaboration to strengthen the capacity of governments,
professional bodies and the academic community at the country level; and4) providing country-specific support:i.

Cambodiatechnical support for the finalization of the draft joint prakas on the accreditation of training
institution for health, technical support for the expansion of the NEE to additional healthprofessional cadres and technical assistance for the implementation of competency-based
curricula

ii.

China
technical support to improve the implementation of the continuing professional development
initiatives and technical assistance to introduce salary and benefits reforms in public hospitalsiii.

Lao People’s Democratic Republictechnical support for the introduction of the registration and licensing requirements,
especially in building the capacity of the Health Professional Board, and for the
implementation of the accreditation standards and processes, and continued support to the
Education Development Center on faculty development

iv.

Viet Namtechnical support to carry forward the medical education reform agenda, including theestablishment of an accreditation mechanism, technical support for the introduction of alicensing examination for health professionals, and support for the finalization anddissemination of the medical competency-based curriculum framework.

18
ANNEX 1PROGRAMME OF ACTIVITIESTime

Day 1 (27 February 2017)Time

Day 2 (28 February 2017)08:00–08:15

Registration

08:00–08:15

Welcome and Review of the Day’s Agenda and Objectives
Summary of Day 1

08:15–08:45

Welcome, Opening Remarks and Introductions

08:15–09:45

Session V: Addressing the Health Professional Education Reform
Challenges – Student Assessment

09:45–10:00

Mobility Break

10:00–11:30
11:30–12:30
12:30–13:30

Session VI: Addressing the Health Professional Education Reform
Challenges – Quality Assurance
Session VII: Open Space
Lunch

13:30–15:30
15:30–15:45

Session VIII: Country Template Presentations
Mobility Break

15:45–16:00
16:00–17:30

Session IX: Summary & Conclusion
Country-Specific Discussions[WHO Secretariat with Country Participants]
Cambodia
Lao People’s Democratic Republic
Viet Nam

Welcome / Administrative announcements

08:45–09:30

09:30–09:40
09:40 -10:00
10:00–12:00
12:00–13:00
13:00–14:30
14:30–14:45
14:45–16:15
16:15–17:00
17:00–18:00

Opening Remarks and Objectives of the meeting
Introductions
Open Space [Introduction to the process]Session I: Setting the Scene – Driving Health System
Transformation through Health Professional
Education Reforms
Group photo
Mobility BreakSession II: Status of Health Professional Education
Reforms - Country Overview
Lunch
Session III: Addressing the Health Professional
Education Reform Challenges – Curriculum Reforms
Mobility BreakSession IV: Addressing the Health Professional
Education Reform Challenges – Faculty Development
Country-Specific Discussions
Welcome Reception(Light dinner)

19
ANNEX 2
LIST OF PARTICIPANTS, TEMPORARY ADVISERS, OBSERVERS AND SECRETARIAT
1. PARTICIPANTS
CAMBODIADr Youttiroung Bounchan, Dean of Faculty of Medicine, University of
Health Sciences, 73 Monivong Blvd., Phnom Penh,
Telephone: 011 768 593, Email: youttiroung@uhs.edu.kh
Associate Professor Chanvohreak Hang, Vice-Rector, University of Health
Science, 73 Monivong Boulevard, Sras Chork, Daun Penh, Phnom Penh,
Telephone: 012 484 817, Email: chanvohreakhang@uhs.edu.kh
Mr Kimseat Hean, Vice Chief of Accountant, Pharmacy Council of
Cambodia, 47B Street 351 Sangkat Nerot, Khan Chbar Ampov, Phnom
Penh, Telephone: 012 983 334, Email: hkimseat@yahoo.com
Mr Chansophea Ros, Chief of Policy and Curriculum Office, Department ofHigher Education, Ministry of Education Youth and Sports (MoEYS)
No 169 Norrodom Blvd, Phnom Penh, Telephone: 017 345 758
Email: sopheadhe@yahoo.com
Dr Phom Samsong, Deputy Director of Human Resources Development
Department, Ministry of Health, 80 Pennut Avenue, Phnom Penh
Telephone: 012 822 035, Email: psamsong@yahoo.com
HE Professor Kruy Thir, Secretary of State, Ministry of Health
80 Pennut Avenue, Phnom Penh, Telephone: 12 812 145
Email: kruythir@gmail.com

PEOPLE'S
REPUBLIC
OF CHINA

Mr Dang Yong, Consultant, National Health and Family Planning
Commission of China, 1 Xizhimenwai Nanlu, Xicheng District, Beijing
Telephone: 86-10 68792258, Email: dangyong@163.com
Mr Liu Jun, Deputy Director, Division of Curriculums and Teaching
Materials
Department of Vocation & Adult Education, Ministry of Education
No. 37 Damucang Hutong, Beijing, Telephone: 86-10-66096722
Email: liujun0327@moe.edu.cn
Mr Song Xianbao, Director of Continuing Education Division
Ministry of Education, Friendship Hotel, No 1 Zhongguancun South Street

20
Haidian District, Beijing, Telephone: 86-10-68945371
Email: 15755193@qq.com
Mr Wang Bo, Program Officer, Department of Health Science, Technology
and Education, NHFPC, Friendship Hotel, No 1 Zhongguancun South Street
Haidian District, Beijing, Telephone: 86-13 911796496
Email: wangbo@nhfpc.gov.cn
Mr Wang Songling, Vice-President, Capital Medical University
10 Xitou Tiao, You Anmen, Fengtai District, Beijing
Telephone: 86-83911708, Email: slwang@ccmu.edu.cn

LAO
PEOPLE'S
DEMOCRATIC
REPUBLIC

Mr Ketsomsouk Bouphavanh, Director of Education Development
Center, University of Health Sciences, Vientiane
Telephone: (856) 21 254820, Email: ketvanh@yahoo.com
Mrs Phengdy Inthaphanith, Head Office of Healthcare Professional
Regulatory, Department of Healthcare, Ministry of Health
Vientiane, Telephone: (856) 020 22483666, Email: phengdys@yahoo.com
Mr Vongsinh Phothisanesak, Faculty of Medicine, University of Health
Sciences, Vientiane, Telephone: (856) 205 5405207
Email: vongphothi@gmail.com
Dr Phisith Phoutsavath, Deputy Director General, Health Care Department,
Ministry of Health, Sisathanak District, Vientiane
Telephone: (856) 20 99966198, Email: psavath@gmail.com
Mr Mithong Souvanvixay, Director General of Pre-school andPrimary Education Department, Ministry of Education and Sports
P.O. Box 67, Vientiane, Telephone: (856) 21 911 484
Email: souvanvixay@gmail.com
Mr Khampasong Theppanya, Deputy Director General, Health Personnel
Department, Ministry of Health, Sisathanak District, Vientiane,
Telephone: (856) 20 22414 001, Email: pasong05@yahoo.com

VIET NAM

Mr Bui Ha, Rector, Hanoi University of Public Health
1A Due Thang Street, Duc Thang Ward, Bac Tu Liem District, Hanoi
Telephone: (84.4) 0913363603, Email: bth@hupb.edu.vn

21
Ms Bui My Hanh, Senior Lecturer, Department of Tuberculosis & Lung
Disease, Hanoi Medical University, Hanoi, Telephone: (84.4) 983 070973
Email: buimyhanh@hmu.edu.vn
Mr Do Van Nhuong, Senior Expert, Higher Education Department
Ministry of Education and Training, 36 Dai Co Viet, Hanoi
Telephone: (84.4) 38680407, Email: dvnhuong@moet.edu.vn
Dr Luong Ngoc Khue, General Director, Department of Medical Service
Administration, Ministry of Health, 138A, Giang vo, Ba dinh, Hanoi
Telephone: (84 4) 919121818, Email: khuebyt@yahoo.com
Mr Nguyen Huy Quang, Director, Legal Affairs Department
Ministry of Health, Hanoi, Telephone: (84.4) 627 4979
Email: quangnh10@yahoo.com
Mr Nguyen Minh Loi, Vice Director, Administration of Science
Technology and Training, Ministry of Health, 138B Giang Vo Ba Dinh
Hanoi, Telephone: (84.4) 38435666
Email: ngminhloi@gmail.com
Dr Ta Thanh Van, Professor and Vice-President of Hanoi Medical
University, No 1 Ton That Tung St., Dong Da, Hanoi
Telephone: 0912272922, Email: tanthanhvan@hmu.edu.vn
Dr Tran Tuan Diep, President, University of Medicine and Pharmacy
217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh
Telephone: (84) 985 598 528, Email: dieptuan@ump.edu.vn
Mr Tran Viet Hung, Vice Director of Manpower and Organization
Department, Ministry of Health, 138A, Giang vo, Ba dinh, Hanoi
Telephone: 0903411266, Email: hungtv62@gmail.com

2. TEMPORARY ADVISERS

Dr Ahn Ducksun, President, Korean Institute of Medical Education and Evaluation,
Seongbuk-Gu, Seoul, Republic of Korea, Telephone: (82) 10-9187-1417,
Email: dsahn@korea.ac.kr
Professor Michael Richard Kidd, Professor of Global Primary Care Southgate Institute of
Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia
Telephone: (61) 414578065, Email: Michael.kidd@flinders.edu.au22

Professor Erlyn Sana, National Teacher Training Center for the Health Profession,
University of the Philippines Manila, Central Block Building, Philippine General Hospital,
Taft Avenue, Manila, Philippines, Telephone: (632) 454 2576, Email: easana@up.edu.phProfessor Jwa-Seop Shin, Professor, Seoul National University, College of Medicine, 103
Daehak-ro, Jongno-gu, Seoul, Republic of Korea, Telephone: (82-2) 140-8175,
Email: hismed1@snu.ac.kr

3. OBSERVERSASIAN
DEVELOPMENT
BANK

Professor Sophal Oum, Consultant, Asian Development Bank
Lao People’s Democratic Republic: Strengthening Capacity for
Health Sector Governance Reforms, 6 ADB Avenue, Ortigas,
Mandaluyong, Philippines, Telephone: (63 2) 632 4444,
Email: sophal_oum@yahoo.com

GUNMA
UNIVERSITY

Dr Akinori Kama, Professor, Gunma University
WHO Collaborating Centre for Research and Training on
Interprofessional Education, 3-39-22 Showa, Maebashi, Gunma
371-8514, Japan, Telephone: (81) 27-220-8945 ,Email: kamaa@gunma-u.ac.jp
Dr Hideomi Watanabe, MD, PhD, Vice Dean, Graduate Schoolof Health Sciences, Professor, Department of Rehabilitation
Sciences, Gunma University, WHO Collaborating Centre for
Research and Training on Interprofessional Education
3-39-22 Showa, Maebashi, Gunma 371-8514, Japan
Telephone: (81) 27-220-8945, Email: watanabeh@gunma-u.ac.jp

HEALTH HUMANRESOURCESDEVELOPMENTCENTRE (HHRDC)

Dr Junhuan Zhang, Vice Director, China National Health
Development Center, WHO Collaborating Centre for Human
Resources for Health, Beijing, People's Republic of China
Telephone: (86) 10-82801232, Email: junhuazhang@hotmail.com

JAMES COOK
UNIVERSITY

Associate Professor Caryn West, Director
WHO Collaborating Centre for Nursing and Midwifery, Education andResearch Capacity Building, P.O. Box 6811, Cairns 4870, Queensland,
Telephone: ( 61) 7 423 21825, Email: caryn.west@jcu.edu.au

JAPAN
INTERNATIONALDr Hirotsugu Aiga, MPH, Ph, Senior Advisor on Health & Nutrition
Japan International Cooperation Agency (JICA)

23
COOPERATIONAGENCY

5th floor, Nibancho Center Bldg, 5-25 Niban-cho, Chiyoda-ku,
Tokyo, Japan, Telephone: (81) 3-5226-9329,
Email: Aiga.hirotsugu@jica.go.jp

NATIONAL CENTERFOR GLOBALHEALTH AND
MEDICINE

Dr Norito Fujita, Director, Division of Global Health Programs
Department of Planning and Management, Bureau of International Health
Cooperation, National Center for Global Health and Medicine
Tokyo, Japan, Telephone: (81)-3-3202-7181, Email: norikof@it.ncgm.go.jp
Ms Chiyoko Hashimoto, Director, Division of Human Capacity Building
Department of Planning and Management, Bureau of International Health
Cooperation, National Center for Global Health and Medicine
Tokyo, Japan, Telephone: (81)-3-3202-7181,
Email: c-hashimoto@it.ncgm.go.jp
Ms Megumi Ikarashi, Expert on Project for Strengthening Clinical Training
System for New-Graduate Nurses, JICA Viet Nam Office, Hanoi, Viet Nam,
Telephone: (84)-0-97-600-6803, Email: m-ikarashi@it.ncgm.go.jp

PARTNERSHIPFOR HEALTHADVANCEMENT IN
VIET NAM (HAIVN)Dr Todd Pollack, Country Director, Health Advancement in Viet Nam
6th Floor, 27 Hang Bai Street, Hoan Kiem District, Hanoi, Viet Nam
Telephone: (84 4) 3664 7979, Email: todd@haivn.org

WORLD BANKDr Nareth Ly, Health Specialist, World Bank Country OfficeHanoi, 8th Floor, 63 Ly Thai To, Hanoi, Viet Nam
Telephone: +855-23 217 304, Email: nly1@worldbank.org

4. SECRETARIATDr Vivian Lin, Director, Division of Health Systems, WHO Regional Office for the Western Pacific1000 Manila, Philippines, Telephone: (632) 528 9951, Email: linv@who.int
Dr Indrajit Hazarika (Responsible Officer), Technical Officer, Health Workforce Policy, Division of
Health Systems, WHO Regional Office for Western Pacific, 1000 Manila, Philippines,
Telephone: (632) 528 9845, Email: hazarikai@who.int
Dr Momoe Takeuchi, Team Leader, No. 61-64, Preah Norodom Blvd. (corner Street 306)
Sangkat Boeung Keng Kang I, Khan Chamkamorn, Phnom Penh Cambodia, Telephone: 855 23 216610,
Email: takeuchim@who.int
Dr Tuohong Zhang, National Programme Officer, World Health Organization, 401, Dongwai
Diplomatic Office Building, 23, Dongzhimenwai Dajie, Chaoyang District, 100600 Beijing,

24
People's Republic of China, Telephone: (8610) 6532-7189, Email: tuohongz@who.int
Dr Monica Fong, Team Leader, World Health Organization, 125 Saphanthong Road, Unit 5, Ban
Saphangthongtai, Sisattanak District, Vientiane Capital, Lao People's Democratic Republic,
Telephone: (856) 21 353-902 81831, Email: fongm@who.int
Dr Socorro Eescalante, Team Leader (Health Systems), World Health Organization, 304 Kim Ma Street,
Hanoi, Viet Nam, Telephone: (84 4) 38500308, Email: escalantes@who.int

25

ANNEX 3
SPEECH OF DR SHIN YOUNG-SOO, WHO REGIONAL DIRECTOR FOR THE WESTERNPACIFIC, AT THE MEETING
Distinguished participants, honoured guests, ladies and gentlemen:
Dr Shin Young‐soo, WHO Regional Director for the Western Pacific, regrets not being able to join us due
to previous commitments. He has asked me to send his regards and deliver these words.
In a changing world, health systems continue to face many complex and converging global, national andlocal challenges.
Being the human faces of the health system, health workers are at the forefront of the response to thesechallenges. Their role is being constantly redefined by the demographic, epidemiologic, socioeconomic
and scientific trends.
Unfortunately, countries in the Region continue to experience shortages of health workers.
Overspecialization in the workforce combined with skill-mix imbalances and distribution issues have leftmany people without access to quality services, especially at the primary health care level. To strengthen
the provision of frontline health services, countries such as China and Viet Nam, have worked to increase
the number of primary care physicians. But challenges persist.
To begin with, health professional education has not kept pace with emerging knowledge andtechnological advances. Countries in the Region face recurring educational issues that include shortagesof qualified educators; inadequate budgets and resources of educational institutions; traditional teaching
and learning methods; and poor linkages between health service demands and education systems.
Simply producing more will not be enough. Reforms in health professional education are required to
produce competent professionals capable of responding to the changing needs of population groups
impacted by emerging disease outbreaks, rapid rises in injuries and noncommunicable diseases.
Achieving Universal Health Coverage and the Sustainable Development Goals will require scaling up andreforming our educational and health systems. We must address not only the quantity, but also the quality
and relevance of education in health professions.
These global commitments provide an opportunity to foster innovation in the education systems,
engaging health professionals in critical reasoning and ethical conduct so that they are competent toparticipate in people-centred health systems as members of multidisciplinary teams.
The good news is that many countries have already started reforming health professional education. In
Viet Nam efforts are underway to design and implement a competency-based curriculum and to introduce
a national examination system. In Lao People’s Democratic Republic, the Education Development Centerhas been actively supporting faculty development. In China, reform of instructional content and purpose
has ushered modernization of medical education, including post-graduate and continuing education. In

26
Cambodia, standardization of student assessment has been targeted through the introduction of a national
exit exam.
In many cases, challenges associated with health professional education extend beyond the narrowly
defined health sector, beyond a single level of policy purview, which highlights the need to work
effectively across governments and stakeholders.
It is commendable that health workforce leaders, educators, representatives of regulatory bodies and theeducation sector have gathered in this meeting today to collectively review and share experiences andinnovations in health professional education.
This meeting provides a wonderful opportunity to highlight critical areas for strategic intervention tofoster innovation in health professional education, to ensure its responsiveness and relevance to healthsystem and population needs, to ensure that all individuals have access to quality health services.
On behalf of WHO, thank you all for being a part of this process.

27
ANNEX 4HEALTH PROFESSIONAL EDUCATION – ENTRY POINTS FOR ACTION

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