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Fourth World Conference on Medical Education

The Fourth World Conference on Medical Education, arranged by the World Medical Association in conjunction with the World Health Organization, took place in Copenhagen on 25-29 September 1972. Few conferences of its kind and size can have received such arduous preparation and as this included careful delineation of its objectives it should be possible to evaluate its success. To this end participants were liberally supplied with questionnaires and exhorted to. record their reactions. The outcome of this investigation will be interesting and should not be prejudiced, though it may be noted that the questions themselves came in for considerable criticism from those attempting to answer them. The objectives of the Conference were: ‘To develop in the participants an awareness of health needs and their influence on medical education, knowledge of how to determine health needs, desire to institute changes in medical education based on those needs, cognizance of ways and means by which the changes in medical education based on health needs can be accomplished, an appreciation of the need for sound evaluative approaches in medical education, and perception of evaluative techniques in medical education.’’ The 54 authors who wrote working papers for the conference were clearly conscious of its objectives and the resulting book2 published by the World Medical Association makes interesting and very informative reading on many issues. Many of the participants at the Conference were less clear about the objectives, not least perhaps because in many preliminary documents these were couched in a phraseology which, in the English language, was obscure to many people. A difference in aim between providers and recipients, in conferences as in all educational enterprises, is likely to have a profound impact on the results. Everyone ought, of course, to want to learn more about how best to relate medical education to medical care, on which subject the first day of the conference was spent. It is a fact, however, that it is at present extremely difficult to evaluate medical care and to estimate with any degree of precision the future health needs which medical education must help to meet. This fact is of serious import in countries where some form of national control is exerted over medical care and medical education, and the opportunity exists to relate one to the other. There are, however, countries where no single authority is responsible for medical education. This situation offers remarkable opportunities for experiment but no chance at all to relate either medical care or medical education to national needs or capacity. For representatives of such countries the relationship of medical education to medical care is an entirely theoretical, albeit agonising, problem. The many representatives of these countries tended to dominate and obscure the conference’s attempt to grapple with this subject. The chances ‘of several hundred participants from different countries coming away from a conference on this particular subject wiser than they were on arrival were probably also much reduced by the workshop system chosen as the method by which the conference would achieve its objectives. Each workshop was intended to focus the discussion of its members on to a specific aspect of the day’s subject, with the ultimate aim of enabling participants to make recommendations or agree guidelines. Discussion, however, was frequently diffuse, resulted in exchange of more opinion than of information, and seldom allowed for collaborative consideration of such data as were available. ‘Workshops’ on some issues, at least, are perhaps more likely to encourage talking than thinking and would be more accurately entitled ‘talkshops’. Their value to those not taking part, which was the position of the majority of participants at Copenhagen, is extremely limited, even if the system of rapportage is perfect.