Ms Caroline Spillane:

On behalf of the Medical Council I welcome the opportunity to address the committee on this important topic. I am joined by the vice president of the Medical Council, Dr. Audrey Dillon.

The role of the Medical Council is to protect the public by promoting and better ensuring high standards of professional conduct, professional education, training and competence among doctors. The Medical Council is responsible, under Part 10 of the Medical Practitioners Act 2007, for setting and monitoring standards in undergraduate, intern and postgraduate education and training in Ireland. We also ensure that doctors engage in lifelong learning and skills development activities by monitoring the ongoing maintenance of doctors' professional competence. We accredit the bodies that deliver medical education and training and professional competence schemes against robust and validated international standards; and we ensure through a monitoring process that accredited bodies maintain and improve their standards. Where education, training and professional competence standards are not met, the Medical Council can take action in the public interest by applying conditions or refusing to approve relevant bodies and programmes. External accreditation ensures education and training is delivered to defined high quality standards, while also fostering institutional improvement and promoting a high-quality experience. It encourages organisations to think about, respond to, and deal with the strengths and weaknesses of their programmes.

In line with the Medical Practitioners Act 2007 and Medical Council rules, globally recognised standards are used in accreditation. We use the World Federation for Medical Education Global Standards for Quality Improvement in Medical Education: European Specifications 2007.

A standard procedure is used by the Medical Council in the application of these standards to its consideration of any programme of basic medical education. That procedure, and the approach of the Medical Council, has been externally reviewed and benchmarked by the US Department of Education’s National Committee on Foreign Medical Education, which provides assurance that a proper approach is taken by the Medical Council. The principles underpinning these accreditations ensure that they are based on a sound legal footing; are independent from the medical schools, the medical profession and government; are trustworthy and recognised by all; are fair; possess a high degree of transparency; and involve assessors who are respected in the field, and are recognised as such internationally.
The council’s accreditation teams normally comprise a combination of lay and medically qualified members of the Medical Council and external independent assessors. The external assessors have expertise in medical education or quality assurance, or represent the public interest. They are drawn both from within Ireland and from other jurisdictions. Dialogue with students is an important part of accreditation visits. We aim to meet students in every year of the programme. One of the key elements of the dialogue is that it is confidential. That is emphasised to students at the start of every session. Professionalism and ethical issues always feature in the discussions, particularly with students at the later stages of their training, who for that reason are experiencing real life on the ward or in a general or community-practice setting. The types of scenario they met in a more theoretical way earlier in the course are teased out in a more practical sense at a later point in the course.
Many medical schools in Ireland, approved by the Medical Council for the purposes of the delivery of programmes of basic medical education, have expanded operations to deliver medical education globally. The Joint Committee on Education and Social Protection will be aware of increasing delivery by Irish universities of third and fourth level education around the world and of the support of the Department of Education and Skills for such overseas activity. As the responsible body for approving programmes of medical education and training, and the bodies that deliver those in Ireland, the Medical Council has been invited to consider the same bodies' delivery of medical education internationally for the purposes of quality assurance. In the case of some programmes, these are co-delivered in Ireland and in another country; some are delivered in totality outside the State. The Medical Council has considered how it should approach such requests. In the context of increasingly globalised medical education and training, the Medical Council takes the view that, in safeguarding the reputation of Irish bodies’ role in medical education and training, it does consider requests to review programmes delivered by Irish bodies outside the State. We understand from the bodies that make this request that the quality assurance role of the Medical Council is highly valued. Indeed, the Department of Health has expressed to the council its view that programmes delivered under the auspices of an accredited Irish education body should be of equivalent standard and quality to a programme delivered within the State.
Medical education and training is increasingly globalised. Medical schools in Ireland welcome students from around the world, who enrich medical education in the State. Their study at Irish medical schools also makes an important contribution to the funding base for medical education in Ireland. The Medical Council has received and is processing a request to review the programme of basic medical education delivered by RCSI-Bahrain. The WHO standards and procedures will be used by the Medical Council to review the programme of basic medical education at RCSI-Bahrain and to inform a decision by the Medical Council in respect of that programme under section 88(2)(a) of the Medical Practitioners Act. At this stage, a review has not taken place but is being planned. An assessment team is being identified and pre-assessment visit information has been requested by the Medical Council from RCSI-Bahrain.
The Medical Council is conscious of the political developments in Bahrain; indeed, our earlier plans to review the basic medical education programme at RCSI-Bahrain were postponed owing to the political situation. The former president of the Medical Council, Professor Kieran Murphy, and the current president of the Medical Council, Professor Freddie Wood, have both written to a number of political leaders, including the Taoiseach, the Minister for Foreign Affairs and the Minister for Health, and to the Higher Education Authority expressing the Medical Council’s concern about the situation. In this accreditation visit, we will apply our standards and procedures to review the programme of basic medical education at RCSI-Bahrain and to inform a decision by the Medical Council in respect of that programme. That decision will, as with every decision by the Medical Council, be made in an independent, informed and objective way. The outcome of the decision and the report based on the review which informs it, including discussion of all issues germane to the standards and procedure used by the Medical Council to review the programme of basic medical education at RCSI Bahrain, will be available for public scrutiny.
I thank members for the opportunity to explain the role of the Medical Council in medical education and training and to set out for them the Medical Council’s process for considering the accreditation of programmes of basic medical education and training and the bodies that provide the programmes. At the present time, we must be careful not to pre-empt our visit and its findings, so as such we are somewhat limited in the information we can provide as we are constrained by the requirements of our work. As previously stated, the council has plans to visit RCSI-Bahrain later this year and we would be pleased to provide an update to the committee later in the year.