Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education

Fedde Scheelea*j, Scheltus Van Luijkbjk, Hanneke Muldercjl, Coby Baanedjm, Corry Den Rooyenejn, Matthijs De Hoogfjo, Joanne Fokkemagjp, Erik Heinemanhjq & Henk Sluiterijra VU University Medical Centre, The Netherlandsb Maastricht University Medical Centre, The Netherlandsc University Medical Centre Utrecht, The Netherlandsd Academic Medical Centre, The Netherlandse Royal Dutch Medical Association (KNMG), The Netherlandsf Erasmus MC-Sophia Children's Hospital, The Netherlandsg St. Lucas Andreas Hospital, The Netherlandsh UMC Groningen, The Netherlandsi Deventer Ziekenhuis, The Netherlandsj All contributors are members of the special interest group for postgraduate medical education of the Dutch Society for Medical Education.FEDDE SCHEELE, MD, PhD, is a Full Professor of Health Systems Innovation and Education at the VU University Medical Center and at the Athena Institute for Transdisciplinary Research at the VU University in Amsterdam, The Netherlands.k SCHELTUS VAN LUIJK, MD, PhD, is a physician and working as an Educationist at the Maastricht University Medical Center and at the Royal Dutch Medical Association with a focus on postgraduate medical education.l HANNEKE MULDER, MSc, PhD, is an Associate Professor of Quality and Innovation at the University Medical Center Utrecht School of Medical Sciences in Utrecht, The Netherlands.m COBY BAANE, MSc, is an Educationist and Director of the Teach the Teacher program and the education-program for residents of all specialities at the Academic Medical Centre Amsterdam, The Netherlands.n CORRY DEN ROOYEN, MSc, is an Educationist and working at Royal Dutch Medical Association. Project leader in a national program on implementing CanMEDS.o MATTHIJS DE HOOG, MD, PhD, is an Associate Professor of Pediatrics at the Erasmus Medical Centre, Rotterdam, the Netherlands, and Chairman of the Dutch Pediatric Program Directors.p JOANNE FOKKEMA, MD, is a Medical Doctor and PhD student in Medical Education, St. Lucas Andreas Hospital, Amsterdam, the Netherlands.q ERIK HEINEMAN, MD, PhD, is a Professor of Surgery and Chief of the Department of Surgery of the University Medical Center Groningen, the Netherlands.r HENK SLUITER, MD, PhD, is a Specialist in Internal Medicine and Manager of postgraduate medical education at the Deventer Ziekenhuis, Deventer, the Netherlands.* Correspondence: F. Scheele, Department of Obstetrics and Gynaecology, St Lucas Andreas Hospital, Jan Tooropstraat 164, Amsterdam 1061AE, The Netherlands. Tel:+31615640929; email: [email protected]: Worldwide, the modernisation of medical education is leading to the design and implementation of new postgraduate curricula. In this article, the Special Interest Group for postgraduate medical education of the Netherlands Association for Medical Education (NVMO) reports on the experiences in the Netherlands.Aim: To provide insight into the shift in the aims of postgraduate training, as well as into the diffusion of distinct curricular activities, introduced during the process of modernisation.Methods: Based on three levels of training described by Frenk et al., the process of modernisation in the Netherlands is reviewed in a narrative way, using the expert views of the NVMO-SIG on PGME as a source of information.Results: Educational science has effectively been incorporated and has until now mainly been applied on the level of informative learning to create ‘medical expertise’. Implementing change on the level of formative learning for ‘professional performance’ has until now been a slow and arduous process, but the concept of reflection on practice has been firmly embraced. The training on the level of transformative learning is still in its early stages.Conclusion and recommendations: The discussion about the aims of modern medical education could benefit from a more structured and transdisciplinary approach. Research is warranted on the interface between health care provision and those sciences that specialise in generic professional skills and in the societal context. Training professionals and educating ‘enlightened change agents’ for transformation in health care requires more governance and support from academic leaders with a broader perspective on the future of health care.

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