Medical Teacher
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Doctoral programs in health professions education Ara Tekian To cite this article: Ara Tekian (2014) Doctoral programs in health professions education, Medical Teacher, 36:1, 73-81, DOI: 10.3109/0142159X.2013.847913 To link to this article: http://dx.doi.org/10.3109/0142159X.2013.847913
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Date: 09 October 2016, At: 13:14
2014; 36: 73–81
Doctoral programs in health professions education ARA TEKIAN University of Illinois at Chicago, USA
Abstract The interest to pursue doctoral degrees in the health professions is increasing exponentially. Some reasons for this increase include innovations in curriculum and instructional strategies, competency-based assessment, particularly at the postgraduate level, and accreditation requirements. Through various electronic search methods, interviews, review of documents and site visits, 24 structured doctoral programs were identified worldwide that offer a PhD in health professions education (HPE) or medical education. A number of other programs were also identified that do not follow a structured curriculum; however, through supervision and guidance, candidates could complete a number of publishable projects thus meeting the requirements for a doctorate degree. Also, some institutions train fellows for doctoral degrees in HPE without necessarily advertising or labeling the programs as a PhD in medical or HPE. There are also discipline-specific PhDs, such as medicine and dentistry, which focus on education. For example, a student interested in studying surgical technical skills could be directed to take a PhD in kinesiology. It is time for institutions and individuals to start thinking about disciplinary diversity and not focus exclusively on studies of medical education.
The international medical education scene is witnessing numerous changes related to curriculum, instruction and assessment methods, leadership issues and accreditation. These changes have been the impetus for the exponential growth of Masters in Health Professions Education (MHPE) degree programs (Tekian & Harris 2012; Tekian & Artino 2013). Some specific reasons for this increased demand for MHPE programs include establishment of new medical schools, innovations in curriculum and instructional strategies, competency-based assessment particularly at the postgraduate level, accreditation requirements, and adherence to quality assurance principles and standards. Simultaneously, the demand for skilled health professions educators has encouraged many institutions offering Masters Programs in health professions education (HPE) to increase their intake, as well as to start a variety of programs leading to doctoral degrees. The proliferation and structure of these programs vary. Individuals who are interested in pursuing doctoral degrees in HPE have difficulty identifying the available programs worldwide, and there is no comprehensive list of them. This is partly due to the difficulty in gathering detailed information about issues, such as their organizational structure, the host college or department, the focus and name of the terminal degree, and the process of supervision within institutions of higher education offering doctoral degrees in HPE. The published literature about doctoral programs is scarce despite the growing in interest in and demand for such programs. In 1998, a compendium was assembled about HPE
Practice points . Currently, there are 24 structured doctoral programs in the HPE or Medical Education that offer a PhD or EdD in medical/HPE . It is possible to submit a thesis that consists of publishable peer-reviewed journal articles and obtain a doctorate in medical/HPE . To maintain the evolution of the HPE, it is important to continue to foster disciplinary diversity
programs, which included short-term fellowships, Master’s and PhD programs (Cusimano & David 1998). Only five PhD programs were listed in that compendium. Leja and Wardley (2002) explored future trends in HPE doctoral education. They recommended that more doctoral programs are needed and they should focus on interdisciplinary instruction and research preparation. In a UK-focused paper, Pugsley et al. reviewed the quality of research produced by students in Master’s and PhD programs in HPE, particularly exploring the breadth, depth and diversity of research topics (Pugsley et al. 2008). Through in-depth interviews and documentary analysis of dissertations, they found that the quality of the supervision process in HPE doctoral programs varied greatly and sometimes was suboptimal. Gill et al. provided 12 tips for studying medical education at the doctoral level. These tips for students in HPE doctoral programs included: planning the trajectory to completion from the outset, being realistic about the time commitment, carefully formulating the research questions,
20 13
Background
Correspondence: Ara Tekian, Department of Medical Education, College of Medicine, University of Illinois at Chicago, 808 S. Wood St., Chicago, IL 60612, USA. Tel: 312 996 8438; fax: 312 413 2048; email: [email protected] ISSN 0142–159X print/ISSN 1466–187X online/14/10073–9 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2013.847913
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being open-minded about research methodologies, and maintaining a healthy relationship with the supervisor (Gill et al. 2009). Authors of two recent articles – one from Croatia and the other from Taiwan – reviewed the doctoral programs in health sciences and health care. Their focus was on the organization of the training programs and the training in research methodology, such as the importance of identification of research questions and use of theoretical frameworks (Pan & Lee 2012; Marusic et al. 2013). The literature about HPE doctoral programs is mostly descriptive, relating trends, proposing tips for studying medical education, or identifying reasons for promoting medical education research. Despite the enormous need for training health professions educators, particularly at the doctoral level, there is no comprehensive directory of existing programs or any website that provides links to the various programs leading to a PhD in medical education or HPE. Therefore, the purpose of this study is to list and provide basic information about the institutions that offer a formal doctoral degree in HPE, and describe a variety of other programs and routes that lead to a doctoral degree with a concentration in HPE, but without having a formal structured program.
Methods An extensive web-search was initially conducted, using terms such as ‘‘doctoral programs in HPE,’’ ‘‘PhD in medical education,’’ ‘‘PhD in HPE,’’ and ‘‘doctorate and HPE’’. Extensive electronic communication was used to correspond with the program directors of these doctoral programs. In many instances, phone calls were used to clarify the details of the descriptions of these programs. In some instances, site visits were used to understand the structure and the focus of a program, or the advising/supervisory process for the doctoral students. Whenever available, documents describing these doctoral programs were requested and reviewed. In some instances, interviews were held with doctoral students and/or graduates of such programs. Finally, a literature review was conducted, using the same terms listed above, to locate publications about doctoral programs in HPE. The search engines used included PubMed, CINAHL (Cumulative Index of Nursing and Allied Health), EMBASE, ERIC, HINARI, MEDLINE through Ovid, SCOPUS, and Web of Knowledge. The data identified and presented might not be inclusive of all the HPE doctoral programs offered worldwide. The inclusion criteria for any program listed in this study was the existence of a structured or an unstructured/sponsored doctoral program offered in English, Dutch, German, French, or Turkish.
Results Currently, there are 24 doctoral programs in Health Professions (HPE) or Medical Education that offer a PhD or EdD in medical/HPE, or a concentration in HPE clearly specified on the graduation diploma (Table 1). This table does not include doctoral programs offered by institutions without a designated host department or college, or doctorate in Science degrees. It also does not include new programs that are initiated but have 74
not recruited any candidates, such as the program about to begin at the Uniformed Services University of the Health Sciences in Maryland, which is earmarked for the Department of Defense employees. Institutions at which doctoral students choose a supervisor with expertise in their thesis topic related to HPE, and complete a doctorate, are discussed under ‘‘Other Programs’’ section of this article. Eight of the 24 programs are offered by U.S. institutions, 10 by European institutions, 2 by Australian institutions, 2 by Canadian institutions, 1 by an institution in South Africa, and 1 by a university in New Zealand. Sometimes a formal collaboration exists between two institutions in different continents, such as the collaboration between University of California-San Francisco and Utrecht University in the Netherlands, and therefore they are listed both under US and European institutions. Most of the programs award a PhD in Medical Education or HPE or a PhD in Education or Health Sciences with a concentration in HPE. Some of the programs award an EdD (Doctor of Education) with a concentration in HPE. A few programs are exceptions – the University of Texas at El Paso offers a PhD in Interdisciplinary Health Sciences while the University of Glasgow offers a Professional Doctorate (DHPE) in HPE (Table 1). Most of the programs require a master’s degree or equivalent to be admitted. Some also require GRE scores, a minimum GPA of 3.0 on a 4.0-point scale and letters of recommendation (Table 1). A number of programs require that students also be employed or have experience working as a health professional, such as Simmons, the University of California-San Francisco and Utrecht University Medical Center, James Cook University, Nova Southeastern University and the University of Glasgow. Additionally, certain programs, particularly those outside of the United States, require a research topic and proposal agreement with a supervisor. Graduation requirements take various forms. Every program requires a dissertation or a thesis. Some programs state that they require a ‘‘dissertation’’ and others a ‘‘thesis.’’ By definition, the two differ in that a thesis requires primary research and analysis, whereas a dissertation may not necessarily require the student to perform his or her own research and instead the student may analyze data from secondary sources. The two terms are often used interchangeably. Most programs in the United States also require completion of a number of required courses that are a part of a structured curriculum. However, many European programs only require a few courses, while others require no courses at all. Certain programs, mostly in Europe, require a specific number of research papers that must be published or submitted to peerreviewed journals. Many of the doctoral programs can be completed through either full or part-time enrollment. Typically, the programs take about three to four years to complete on a full-time basis. If enrolling as a part-time student, the programs take about five to six years to complete on average. There are a variety of formats in which these doctoral programs in medical education are offered. Most of the programs offer classes and instruction either face to face in a classroom setting, online, or at a distance by correspondence.
Ph.D. Specialization in Adult &
North Carolina
PhD in Health Professions Education
PhD in Medical Education
Simmons – Boston, MA
University of California –
PhD in Curriculum Studies with a focus on Health Professions Education
PhD in Interdisciplinary Health Sciences
University of Illinois – Chicago
University of Texas at El Paso
San Francisco and Utrecht University Medical Center, Netherlands
PhD in Health Sciences
concentration in Health Care Education
EdD Doctor of Education with a
Seton Hall University – South Orange, NJ
Southeastern University – Fort LauderdaleDavie, FL
Nova
Community College Education: Health Professions Concentration
Professions Education
Omaha, NE
State University – Raleigh, NC
Ed. D: Doctor of Education with an emphasis in Health
Degree title
College of Saint Mary –
United States
Institution
- Master’s degree - GRE scores - 3 letters of recommendation
- Masters’ degree - 3 letters of support - GRE scores
- Current faculty/staff in a health professions education program
- Master’s degree in social or biomedical sciences (or MD)
- Practical experience in health care in past three years
- Master’s degree or higher (3.0/4.0)
- Interview
- Professional or master’s degree (3.0/4.0) - 2 letters of recommendation - GRE scores recommended
- Employment in degree field - GRE/MAT scores - 2 letters of recommendation
- Master’s degree (3.0/4.0)
4.0) - GRE scores - 3 letters of reference
- Undergraduate degree (3.0/
- Sample of graduate level scholarly writing - 2 references
- Health professions license - Master’s degree (3.0/4.0 GPA)
Admissions criteria
Research foundation courses Curriculum studies Other courses in specialization Research project
- Course completion - Dissertation
- Dissertation
-
- Annual progress interview in San Francisco - Thesis consisting of 4–6 published papers on one topic in peer reviewed journals - Thesis defense in Utrecht
- Completion of training objectives
- Course completion - Dissertation
- Course completion - Dissertation
courses - Conference attendance - Dissertation
- Completion of orientation and
courses completed - Dissertation and defense
- Course and specialization
- Research dissertation and defense
- Completion of required courses
Graduation requirements
3 years
Full time: 3 years Part time: 5–6 years
imum of 2 days per week
Maximum length of 6 total years requiring a min-
3–4 years
5–7 years (full or part time varies)
Three years
Part time: 5–6 years
Full time: 3–4 years
Full-time: 3 years
Duration
Face to face only
Face to face, online, combined
Face to face, online, combined
Face to face
Face to face, with some online course options
combined
Face to face, online,
combined
Face to face, online,
Face to face, online, combined
Format
Total cost (US$)
Total of 60 credit hours: Resident: $10,850 Non-resident: $23,236
Total of 64 credits Illinois residents: $27,252 Non-resident: $64,864
research, travel, and housing, but there is no tuition or fees. Fellowships are available to offer 20% salary support up to $30,000/year
Candidate must pay for all costs involved in
$975 per credit hour
Total of 66 credit hours: $68,178
$72,500
Total of 69 credit hours:
North Carolina Residents: $37,300 Out of State: $86,760
Four year:
Total of 84 credit hours: $55,104
Table 1. PhD programs in medical/health professions education.
http://chs.utep.edu/ihs/
http://chicago.medicine.uic.edu/cms/One.aspx? portalId=506244&pageId=11802856
http://meded.ucsf.edu/radme/doctoral-programhealth-professions-education
http://www.simmons.edu/gradstudies/programs/ education/health-professions.php
(continued)
http://www.shu.edu/academics/gradmeded/phd-health-sciences/
http://www.fischlerschool.nova.edu/edd/healthcare
college-education/doctoral/phd-educationalresearch-and-policy-analysis
http://ced.ncsu.edu/academics/departments/lpahe/adult-community-
Education/
http://www.csm.edu/Academics/Graduate_Programs/ Doctor_of_Education/Emphasis_in_Health_Professions_
Website
PhD in Health Professions Education
Maastricht University – The Netherlands
- Master’s degree - Research proposal submission and acceptance
- Agreed upon research topic and project with promoter
PhD in Medical Education
Ghent University – Ghent, Belgium
Preferred:
- 3.0/4.0 scale - 2 letters of recommendation
- Master’s degree
- Master’s degree and thesis (B þ average or higher)
equivalent courses
courses required at the Master’s level - If courses not completed, incoming PhD students can complete 3 specialization courses or request an exemption based on
- Completion of specialization
Admissions criteria
Master’s in Medical Education or Education (not mandatory) - Must submit 2–3 page research proposal and CV
PhD in Medical Education
PhD in Medical Education
Professions Education
PhD in Education with a concentration in Health
Medical Education
PhD in Medical Sciences-
Degree title
– Dundee, Scotland
Dundee University
University – Milano, Italy
Ambrosiana
Europe
Ontario, Canada
University of Ottawa –
Calgary, Alberta – Alberta, Canada
University of
Canada
Institution
papers are published in peer- reviewed journals by the date of the thesis defense - No obligatory courses but elective courses at extra cost
- Thesis contains at least 4 international papers that consist of 4 related studies - Highly preferred that an introduction and discussion chapter as well as half of the
- No courses - PhD thesis defense
- Dissertation
- PhD Thesis
- Candidacy examination - Dissertation submission and defense
- Completion of 4 courses
- Course completion - Dissertation
course applicable to thesis research topic - Medical Education Seminar Series attendance - Thesis
- Completion of 1 graduate-level
Graduation requirements
Full time: 3–4 years
2–4 years
Full time: 3 years
2–3 years (typically 3 years)
3–4 years
3–4 years
Duration
Format
Distance
Distance
supervision possible
Face to face, distance
combined
Face to face, online,
Face to face only
Face to face, distance
Table 1. Continued.
Four year total: $14,950
$660 (US) þ own expenses except research costs with promoter
$42,090 (US)
Total: $18,225
$20,235 International: $44,930
Four year: Canadian resident:
Canadian resident: $22,155 International: $50,281
Four year:
Total cost (US$)
http://www.maastrichtuniversity.nl/web/faculties/fhml/ theme/education/instituteforeducationfhml/ schoolofhealthprofessionseducationshe.htm
http://www.ugent.be/en/research/doctoralresearch
medical-education-centre/centremedical-education
http://medicine.dundee.ac.uk/
Medical/PhD/PhD_General.htm
http://www.internationalgme.org/
http://education.uottawa.ca/graduate/programs/ concentrations?lang=en
prospective-students/graduate-educationprograms/msc-andphd-programs/msc-and-phd-programs
http://www.ucalgary.ca/communityhealthsciences/
Website
PhD in Medical Education
Marmara University Institute of Health
Sciences Istanbul, Turkey
PhD in Medical Education
Dokuz Eylu¨l University Institute of Health Sciences Izmir, Turkey
Health Sciences Izmir, Turkey
Ege University Institute of
PhD in Medical Education
PhD in Medical Education
Utrecht University Medical Center -
Netherlands
Professional Doctorate (DHPE) in Health Professions Education
PhD in Medical Education
University of Glasgow, Scotland
Kingdom
University College London – United
Master’s degree
Master’s degree
Master’s degree
- Master’s degree
program
- A first degree, equivalent to a Bachelor of Science or Nursing - Current teaching experience and enrollment in a medical, clinical, or veterinary
preferred
- Primary medical qualification - Master’s in education or medical education is
Course completion Research Publications Dissertation and Thesis
Courses Dissertation
Courses Dissertation
Courses Dissertation
lished papers on one topic in peer reviewed journals
attendance - Training and supervision agreement with promoter - Monthly classes (Cycle of Theory and Literature) - Thesis consisting of 4–6 pub-
- 20 European Credits of coursework in relevant fields including conference
-
- Original research and written thesis - Demonstrating contribution
Full time, 4 years
Full time, 4 years
Full time, 4 years
4 years
2 years (full-time)
3 years (full-time) 5 years ( part-time)
Face to face
Face to face
Face to face
Face to face, distance
Face to face, online, combined
Online/distance
Free
Free
Free
year.
PhD students do not pay tuition or fees. Cost of living in the Netherlands is $16,000/
Full time Resident: $11,300 Full-time Distance: $11,300
International Full-time: $96,000 International Part-time: $80,000
EU Full-time: $21,000 EU Part-time: $17,100
http://saglik.marmara.edu.tr/aday-ogrenci/ programlar/ ( pages in Turkish)
http://www.deu.edu.tr/DEUWeb/Icerik/ Icerik.php?KOD=16419 ( pages in Turkish)
http://www.tead.med.ege.edu.tr/kategori.tsp? cat_yazi=19 ( pages in Turkish)
General PhD Information: http://www.umcutrecht.nl/research/student/phd/
http://www.gla.ac.uk/schools/medicine/ healthprofessionseducationprogramme/
http://www.ucl.ac.uk/ prospective-students/graduate-study/ prospectus/subjects/meded
(continued)
University of Otago – Christchurch, New Zealand
New Zealand
University of Stellenbosch – Cape Town, South Africa
PhD in Medical Education
PhD in Health Sciences Education
- Master’s degree - Supervised research, workbased research, or publications
MPhil in Health Sciences Education
- Research and thesis submission
PhD Dissertation
- Original contribution to knowledge - Thesis including the results of the original investigation
degree, or published research - Prior experience/degrees in education, psychology or clinical areas
Africa
- Minimum of 144 units of credit (uoc) and maximum of 196 uoc
- Previous research background through a master’s degree in a research program, honors
PhD in Medical Education
scholarly work including conference presentations and published papers - Publishing papers is encouraged
- Thesis including portfolio of
Graduation requirements
The University of New South Wales
- Master’s degree in Medical
Admissions criteria
Education or health-related discipline - Bachelor’s degree with approval - Must have professional experience (minimum 5 years)
Doctor of Medical Education
Degree title
University, Australia
James Cook
Australia
Institution
3 years
Full time: 2 years minimum Part-time: 5 years maximum
3 years full time
(4 max)
3 years
Duration
Format
Face to face only
Face to face, distance supervision possible
Face to face (some exceptions can be made for external locations)
exception of excellent preapproved off-site research)
Face to face only (with the
Table 1. Continued.
Offering a scholarship for three years at $17,014 (US) per year plus fees
1st year: $1553 (US) 2nd–5th year: $323 (US) per year
- Minimum: $97,920
- No fees for Australian/New Zealand residents - $680 per uoc
New Zealand residents ONLY by RTS scheme
Program covered for Australian/
Total cost (US$)
http://hedc.otago.ac.nz/ magnolia/meg/EducationResearch/PhD-in-Medical-Education.html
http://www0.sun.ac.za/pgstudies/postgraduate -programmes/faculty-of-medicine-and-health -sciences/programmes-offered/doctorates.html
http://med.unsw.edu.au/phd-medical-education
courseinformation/researchcourses/ JCUTST_058402#_Candidature
http://www-public.jcu.edu.au/handbooks2010/
Website
PhD programs in health professions education
Due to the autonomous nature of many of these programs, students often do their research and work at their home institution and thus it is appropriate for them to work at a distance from the degree granting institution. Online access often provides more flexibility to courses, supervision, and communication. However, an onsite class approach may be appealing and more helpful to some students, and so that is also available. The total cost of PhD programs in Medical or HPE varies widely among institutions. Excluding the free programs in Turkey, the least expensive program by far, Ghent University in Belgium, charges the tuition of $660 for the entire course of study, excluding research costs as discussed with the supervisor. The average cost, however, is about $41,000. Out of state or international students generally should expect to pay significantly more at an institution than local students.
Other programs/routes (not listed in Table 1) to get a doctorate in HPE In the United States, the avenue to obtain a PhD in Medical or HPE involves a structured academic program. Similar to an undergraduate degree or master’s degree program, students must meet admissions criteria, complete a series of specified courses, perform research under a supervisor, and submit a thesis. The programs tend to be highly structured with a series of goals outlined in a syllabus. There are European programs that require course completion as well as a thesis. Some programs also require applicants to apply and pay tuition each year they are enrolled and perform research. The majority of programs, though, simply require completion of research and a thesis, regardless of whether they do or do not charge tuition. In some European countries, particularly in the Netherlands and Belgium, most PhD programs are full-time or part-time research programs, with projects performed under the supervision of a professor with a chair in medical or HPE, often the head of the department. Applicants apply to a job opening in a field of interest and then are hired for the position, frequently related to external funding received by the professor or postdoctoral staff. Most of the HPE research in the Netherlands is done by hired PhD candidates under the formal supervision of one or two professors and one or two postdoctoral cosupervisors. Researchers are thus not students but rather employees of the university. Research can be done either on campus or at a distance, depending on the program and the proposal. PhD theses on medical or HPE are usually but not exclusively written in university medical departments. Psychology departments and even technical universities may offer positions for junior researchers leading to a PhD degree on a medical education topic. In other cases, a potential applicant may contact a professor or department head to submit a research proposal and coordinate the project and funds. This supervisor, for either a paid position or an unpaid position, is typically called a ‘‘promoter’’ and is responsible for advising and assisting with the research project. The terms advisor, supervisor, and promoter are synonymously used in many programs.
However, in Europe the most common term used to describe the role and functions of a thesis advisor is promoter. All candidates in European countries submit a thesis before receiving their doctorate. The thesis typically consists of submitted or published peer-reviewed journal articles. The required number varies based upon the institutional requirements. Gradually, at some places, these more or less informal arrangements are becoming more structured. At Maastricht University, Utrecht University and Groningen University in the Netherlands, the chairs of medical education have established most structured programs in centers for research in medical education, with the requirement of candidates meeting criteria in addition to completing a thesis of a set of related publications, constituting a research agenda, in peer-reviewed journals. Maastricht University and Utrecht University have programs that collaborate with centers internationally on doctoral programs. Maastricht is the only university that has organized, university-wide, a center for research in HPE and not confined it to a medical department (i.e. the university medical center). The following is a list of PhD programs in medical education in Europe that use paid/unpaid positions as a basis for doctoral training (Dutch listed from most structured to least structured): Maastricht University (Maastricht, the Netherlands) University Medical Center Utrecht, Utrecht University (Utrecht, the Netherlands) University Medical Center Groningen, Groningen (Groningen, the Netherlands) Free University Medical Center Free University (Amsterdam, the Netherlands) University Medical Center St. Radboud, Radboud University (Nijmegen, the Netherlands) Academic Medical Center, University of Amsterdam (Amsterdam, the Netherlands) Leiden University Medical Center, Leiden University (Leiden, the Netherlands) Erasmus Medical Center, Erasmus University (Rotterdam, the Netherlands) University of Leuven – KU Leuven (Belgium) Antwerpen (Belgium) Most of the European doctoral programs follow the standards for PhD education in biomedicine and health sciences articulated in a position paper by ORPHEUS-ASMEWFME (ORPHEUS position paper 2012).
Discussion As the field of medical education advances, it benefits from the contributions of individuals from a wide variety of disciplines. While doctoral training in medical education specifically is valued, many of the researchers/faculty in the top centers in the world have doctoral training in other areas, such as psychology, sociology, kinesiology, measurement, evaluation and statistics, anthropology, industrial and organizational psychology, and others. To maintain the
79
A. Tekian
evolution of the HPE, it is important to continue to foster this disciplinary diversity. It would be a mistake to focus exclusively on studies in medical education, because scholarly advances in the basic sciences of other disciplines can help to contribute to research and development in the HPE. With the explosion of interest in medical education, especially in countries outside of Europe and North America, there will be an enormous demand for doctoral programs. Just like medical schools in Europe and North America, they will need individuals trained in a wide variety of disciplines. Although structured doctoral programs are quite desirable, there are far fewer than the market demands. Therefore, other options leading to specialization in medical or HPE should be considered. Although there is no PhD in medical education, specifically, at many institutions that have a Master’s degree in HPE, a number of these institutions train fellows for doctoral degrees in HPE without necessarily advertising or labeling the programs as a PhD in medical or HPE. For example, the University of Toronto Wilson Center for Research supports the training of more than 20 fellows who are undertaking doctoral programs relevant to medical education. Recognizing that a PhD in medical education is not the only route to a career in medical education, the University of Toronto supports PhD training in disciplines such as higher education, sociology, psychology, measurement and evaluation, kinesiology and anthropology, as well as in discipline-specific PhDs, such as medicine, dentistry, nursing, and pharmacy, which focus on education. An applicant to the Wilson Center must identify a graduate program aligned with the research project that they intend to pursue. For example, if they intend to study surgical technical skills, they would be directed to a take a PhD in kinesiology. If they were interested in curriculum and assessment, they will be directed to take a PhD in the Faculty of Education. The way the Center insures the focus on health professions is to assign a supervisor from the Wilson Center. The Wilson Center fellows pay tuition to the Graduate School, but are hosted and supported by the Wilson Center, which furnishes a desk and funding for conferences and other forms of academic support, in addition to funded fellowship programs. The average doctoral student in such programs completes the PhD in five years. Another variation of doctoral level specialization in HPE is the model at the Karolinska Institute, where the graduate identifies a mentor; the doctoral degree, however, is in ‘‘medical sciences.’’ Besides the structured 24 programs described in Table One and the other European and Canadian programs, there are other routes to initiate and establish doctoral programs in HPE. One such possibility for programs or institutions that already have a Master’s degree in MHPE is to create a concentration in HPE through the collaboration with a doctoral program in colleges of education, or through collaboration with institutions that already have doctoral programs. Alternatively, institutions aspiring to have doctoral programs in HPE first need to build an infrastructure with individuals who have a Masters degree, and create a critical mass who have Master’s degrees in medical education. Then it 80
becomes possible to develop a more advanced cadre of individuals, with deeper expertise, such as in curriculum development, leadership, instructional technology, research methodology, and measurement and evaluation. Some of these areas might be best pursued outside of medical education to allow the necessary intensity of study or focus. For example, a sophisticated work in the economics of medical education would require training in an appropriate Faculty/Program of Economics or Business. The 24 programs listed in the table, as well as the rest of the doctoral programs mentioned in this article, are located either in North America, Europe, Africa, Australia or New Zealand. This is one of the reasons that applicants from South East Asia, Latin America, the Middle East, and Russian republics pursue their doctoral degrees in HPE in Europe, North America or in Australia and New Zealand. Graduates from these doctoral programs assume leadership positions at their home institutions in a relatively short period of time, thus further increasing the demand for establishment of PhD programs, concentrations in HPE, and alternative pathways leading to doctoral degrees in HPE. Institutions and individuals should also think about disciplinary diversity and not focus exclusively on studies of medical education.
Acknowledgements The author would like to acknowledge Prof. Th. J. (Olle) ten Cate from University Medical Center Utrecht, for his expert guidance on the context and description of the European doctoral programs. Declaration of interest: The author reports no declarations of interest. The author alone is responsible for the content and writing of the article.
Notes on contributors ARA TEKIAN, PhD, MHPE, is an Associate Professor, Department of Medical Education, and Associate Dean for the Office of International Education at the University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Glossary Promoter – The terms advisor, supervisor, and promoter are synonymously used in many programs. However, in Europe the most common term used to describe the role and functions of a thesis advisor is promoter
References Cusimano MD, David MA. 1998. A compendium of higher education opportunities in health professions education. Acad Med 73:1255–1259. Gill D, Griffin A, Woolf K, Cave J. 2009. Twelve tips in studying medical education at doctoral level. Med Teach 31:601–604. Leja JA, Wardley CS. 2002. Future trends in health care doctoral education. J Allied Health 31:227–231.
PhD programs in health professions education
Marusic M, Mimica M, Mihanovic F, Jankovic S. 2013. Doctoral degree in health professions: Professional needs and legal requirement. Acta Medica Academica 42(1):61–70. ORPHEUS 2012 position paper: Towards Standards for PhD education in biomedicine and health sciences. 2012. [Accessed 6 August 2013] Available from www.orpheus-med.org Pan YJ, Lee LS. 2012. Who wants to enroll in health care PhD programs? An analysis of a nationwide graduate destination survey. J Chinese Med Assoc 75:286–291.
Pugsley L, Brigley S, Allery L, MacDonald J. 2008. Making a difference: Researching master’s and doctoral research programs in medical education. Med Educ 42:157–163. Tekian A, Artino A. 2013. AM Last Page: Master’s Degree in Health Professions Education Programs. Acad Med 88:1399. Tekian A, Harris I. 2012. Preparing health professions education leaders worldwide: A description of maters-level programs. Med Teach 34:52–58.
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Doctoral programs in health professions education Ara Tekian To cite this article: Ara Tekian (2014) Doctoral programs in health professions education, Medical Teacher, 36:1, 73-81, DOI: 10.3109/0142159X.2013.847913 To link to this article: http://dx.doi.org/10.3109/0142159X.2013.847913
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Date: 09 October 2016, At: 13:14
2014; 36: 73–81
Doctoral programs in health professions education ARA TEKIAN University of Illinois at Chicago, USA
Abstract The interest to pursue doctoral degrees in the health professions is increasing exponentially. Some reasons for this increase include innovations in curriculum and instructional strategies, competency-based assessment, particularly at the postgraduate level, and accreditation requirements. Through various electronic search methods, interviews, review of documents and site visits, 24 structured doctoral programs were identified worldwide that offer a PhD in health professions education (HPE) or medical education. A number of other programs were also identified that do not follow a structured curriculum; however, through supervision and guidance, candidates could complete a number of publishable projects thus meeting the requirements for a doctorate degree. Also, some institutions train fellows for doctoral degrees in HPE without necessarily advertising or labeling the programs as a PhD in medical or HPE. There are also discipline-specific PhDs, such as medicine and dentistry, which focus on education. For example, a student interested in studying surgical technical skills could be directed to take a PhD in kinesiology. It is time for institutions and individuals to start thinking about disciplinary diversity and not focus exclusively on studies of medical education.
The international medical education scene is witnessing numerous changes related to curriculum, instruction and assessment methods, leadership issues and accreditation. These changes have been the impetus for the exponential growth of Masters in Health Professions Education (MHPE) degree programs (Tekian & Harris 2012; Tekian & Artino 2013). Some specific reasons for this increased demand for MHPE programs include establishment of new medical schools, innovations in curriculum and instructional strategies, competency-based assessment particularly at the postgraduate level, accreditation requirements, and adherence to quality assurance principles and standards. Simultaneously, the demand for skilled health professions educators has encouraged many institutions offering Masters Programs in health professions education (HPE) to increase their intake, as well as to start a variety of programs leading to doctoral degrees. The proliferation and structure of these programs vary. Individuals who are interested in pursuing doctoral degrees in HPE have difficulty identifying the available programs worldwide, and there is no comprehensive list of them. This is partly due to the difficulty in gathering detailed information about issues, such as their organizational structure, the host college or department, the focus and name of the terminal degree, and the process of supervision within institutions of higher education offering doctoral degrees in HPE. The published literature about doctoral programs is scarce despite the growing in interest in and demand for such programs. In 1998, a compendium was assembled about HPE
Practice points . Currently, there are 24 structured doctoral programs in the HPE or Medical Education that offer a PhD or EdD in medical/HPE . It is possible to submit a thesis that consists of publishable peer-reviewed journal articles and obtain a doctorate in medical/HPE . To maintain the evolution of the HPE, it is important to continue to foster disciplinary diversity
programs, which included short-term fellowships, Master’s and PhD programs (Cusimano & David 1998). Only five PhD programs were listed in that compendium. Leja and Wardley (2002) explored future trends in HPE doctoral education. They recommended that more doctoral programs are needed and they should focus on interdisciplinary instruction and research preparation. In a UK-focused paper, Pugsley et al. reviewed the quality of research produced by students in Master’s and PhD programs in HPE, particularly exploring the breadth, depth and diversity of research topics (Pugsley et al. 2008). Through in-depth interviews and documentary analysis of dissertations, they found that the quality of the supervision process in HPE doctoral programs varied greatly and sometimes was suboptimal. Gill et al. provided 12 tips for studying medical education at the doctoral level. These tips for students in HPE doctoral programs included: planning the trajectory to completion from the outset, being realistic about the time commitment, carefully formulating the research questions,
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Background
Correspondence: Ara Tekian, Department of Medical Education, College of Medicine, University of Illinois at Chicago, 808 S. Wood St., Chicago, IL 60612, USA. Tel: 312 996 8438; fax: 312 413 2048; email: [email protected] ISSN 0142–159X print/ISSN 1466–187X online/14/10073–9 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2013.847913
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being open-minded about research methodologies, and maintaining a healthy relationship with the supervisor (Gill et al. 2009). Authors of two recent articles – one from Croatia and the other from Taiwan – reviewed the doctoral programs in health sciences and health care. Their focus was on the organization of the training programs and the training in research methodology, such as the importance of identification of research questions and use of theoretical frameworks (Pan & Lee 2012; Marusic et al. 2013). The literature about HPE doctoral programs is mostly descriptive, relating trends, proposing tips for studying medical education, or identifying reasons for promoting medical education research. Despite the enormous need for training health professions educators, particularly at the doctoral level, there is no comprehensive directory of existing programs or any website that provides links to the various programs leading to a PhD in medical education or HPE. Therefore, the purpose of this study is to list and provide basic information about the institutions that offer a formal doctoral degree in HPE, and describe a variety of other programs and routes that lead to a doctoral degree with a concentration in HPE, but without having a formal structured program.
Methods An extensive web-search was initially conducted, using terms such as ‘‘doctoral programs in HPE,’’ ‘‘PhD in medical education,’’ ‘‘PhD in HPE,’’ and ‘‘doctorate and HPE’’. Extensive electronic communication was used to correspond with the program directors of these doctoral programs. In many instances, phone calls were used to clarify the details of the descriptions of these programs. In some instances, site visits were used to understand the structure and the focus of a program, or the advising/supervisory process for the doctoral students. Whenever available, documents describing these doctoral programs were requested and reviewed. In some instances, interviews were held with doctoral students and/or graduates of such programs. Finally, a literature review was conducted, using the same terms listed above, to locate publications about doctoral programs in HPE. The search engines used included PubMed, CINAHL (Cumulative Index of Nursing and Allied Health), EMBASE, ERIC, HINARI, MEDLINE through Ovid, SCOPUS, and Web of Knowledge. The data identified and presented might not be inclusive of all the HPE doctoral programs offered worldwide. The inclusion criteria for any program listed in this study was the existence of a structured or an unstructured/sponsored doctoral program offered in English, Dutch, German, French, or Turkish.
Results Currently, there are 24 doctoral programs in Health Professions (HPE) or Medical Education that offer a PhD or EdD in medical/HPE, or a concentration in HPE clearly specified on the graduation diploma (Table 1). This table does not include doctoral programs offered by institutions without a designated host department or college, or doctorate in Science degrees. It also does not include new programs that are initiated but have 74
not recruited any candidates, such as the program about to begin at the Uniformed Services University of the Health Sciences in Maryland, which is earmarked for the Department of Defense employees. Institutions at which doctoral students choose a supervisor with expertise in their thesis topic related to HPE, and complete a doctorate, are discussed under ‘‘Other Programs’’ section of this article. Eight of the 24 programs are offered by U.S. institutions, 10 by European institutions, 2 by Australian institutions, 2 by Canadian institutions, 1 by an institution in South Africa, and 1 by a university in New Zealand. Sometimes a formal collaboration exists between two institutions in different continents, such as the collaboration between University of California-San Francisco and Utrecht University in the Netherlands, and therefore they are listed both under US and European institutions. Most of the programs award a PhD in Medical Education or HPE or a PhD in Education or Health Sciences with a concentration in HPE. Some of the programs award an EdD (Doctor of Education) with a concentration in HPE. A few programs are exceptions – the University of Texas at El Paso offers a PhD in Interdisciplinary Health Sciences while the University of Glasgow offers a Professional Doctorate (DHPE) in HPE (Table 1). Most of the programs require a master’s degree or equivalent to be admitted. Some also require GRE scores, a minimum GPA of 3.0 on a 4.0-point scale and letters of recommendation (Table 1). A number of programs require that students also be employed or have experience working as a health professional, such as Simmons, the University of California-San Francisco and Utrecht University Medical Center, James Cook University, Nova Southeastern University and the University of Glasgow. Additionally, certain programs, particularly those outside of the United States, require a research topic and proposal agreement with a supervisor. Graduation requirements take various forms. Every program requires a dissertation or a thesis. Some programs state that they require a ‘‘dissertation’’ and others a ‘‘thesis.’’ By definition, the two differ in that a thesis requires primary research and analysis, whereas a dissertation may not necessarily require the student to perform his or her own research and instead the student may analyze data from secondary sources. The two terms are often used interchangeably. Most programs in the United States also require completion of a number of required courses that are a part of a structured curriculum. However, many European programs only require a few courses, while others require no courses at all. Certain programs, mostly in Europe, require a specific number of research papers that must be published or submitted to peerreviewed journals. Many of the doctoral programs can be completed through either full or part-time enrollment. Typically, the programs take about three to four years to complete on a full-time basis. If enrolling as a part-time student, the programs take about five to six years to complete on average. There are a variety of formats in which these doctoral programs in medical education are offered. Most of the programs offer classes and instruction either face to face in a classroom setting, online, or at a distance by correspondence.
Ph.D. Specialization in Adult &
North Carolina
PhD in Health Professions Education
PhD in Medical Education
Simmons – Boston, MA
University of California –
PhD in Curriculum Studies with a focus on Health Professions Education
PhD in Interdisciplinary Health Sciences
University of Illinois – Chicago
University of Texas at El Paso
San Francisco and Utrecht University Medical Center, Netherlands
PhD in Health Sciences
concentration in Health Care Education
EdD Doctor of Education with a
Seton Hall University – South Orange, NJ
Southeastern University – Fort LauderdaleDavie, FL
Nova
Community College Education: Health Professions Concentration
Professions Education
Omaha, NE
State University – Raleigh, NC
Ed. D: Doctor of Education with an emphasis in Health
Degree title
College of Saint Mary –
United States
Institution
- Master’s degree - GRE scores - 3 letters of recommendation
- Masters’ degree - 3 letters of support - GRE scores
- Current faculty/staff in a health professions education program
- Master’s degree in social or biomedical sciences (or MD)
- Practical experience in health care in past three years
- Master’s degree or higher (3.0/4.0)
- Interview
- Professional or master’s degree (3.0/4.0) - 2 letters of recommendation - GRE scores recommended
- Employment in degree field - GRE/MAT scores - 2 letters of recommendation
- Master’s degree (3.0/4.0)
4.0) - GRE scores - 3 letters of reference
- Undergraduate degree (3.0/
- Sample of graduate level scholarly writing - 2 references
- Health professions license - Master’s degree (3.0/4.0 GPA)
Admissions criteria
Research foundation courses Curriculum studies Other courses in specialization Research project
- Course completion - Dissertation
- Dissertation
-
- Annual progress interview in San Francisco - Thesis consisting of 4–6 published papers on one topic in peer reviewed journals - Thesis defense in Utrecht
- Completion of training objectives
- Course completion - Dissertation
- Course completion - Dissertation
courses - Conference attendance - Dissertation
- Completion of orientation and
courses completed - Dissertation and defense
- Course and specialization
- Research dissertation and defense
- Completion of required courses
Graduation requirements
3 years
Full time: 3 years Part time: 5–6 years
imum of 2 days per week
Maximum length of 6 total years requiring a min-
3–4 years
5–7 years (full or part time varies)
Three years
Part time: 5–6 years
Full time: 3–4 years
Full-time: 3 years
Duration
Face to face only
Face to face, online, combined
Face to face, online, combined
Face to face
Face to face, with some online course options
combined
Face to face, online,
combined
Face to face, online,
Face to face, online, combined
Format
Total cost (US$)
Total of 60 credit hours: Resident: $10,850 Non-resident: $23,236
Total of 64 credits Illinois residents: $27,252 Non-resident: $64,864
research, travel, and housing, but there is no tuition or fees. Fellowships are available to offer 20% salary support up to $30,000/year
Candidate must pay for all costs involved in
$975 per credit hour
Total of 66 credit hours: $68,178
$72,500
Total of 69 credit hours:
North Carolina Residents: $37,300 Out of State: $86,760
Four year:
Total of 84 credit hours: $55,104
Table 1. PhD programs in medical/health professions education.
http://chs.utep.edu/ihs/
http://chicago.medicine.uic.edu/cms/One.aspx? portalId=506244&pageId=11802856
http://meded.ucsf.edu/radme/doctoral-programhealth-professions-education
http://www.simmons.edu/gradstudies/programs/ education/health-professions.php
(continued)
http://www.shu.edu/academics/gradmeded/phd-health-sciences/
http://www.fischlerschool.nova.edu/edd/healthcare
college-education/doctoral/phd-educationalresearch-and-policy-analysis
http://ced.ncsu.edu/academics/departments/lpahe/adult-community-
Education/
http://www.csm.edu/Academics/Graduate_Programs/ Doctor_of_Education/Emphasis_in_Health_Professions_
Website
PhD in Health Professions Education
Maastricht University – The Netherlands
- Master’s degree - Research proposal submission and acceptance
- Agreed upon research topic and project with promoter
PhD in Medical Education
Ghent University – Ghent, Belgium
Preferred:
- 3.0/4.0 scale - 2 letters of recommendation
- Master’s degree
- Master’s degree and thesis (B þ average or higher)
equivalent courses
courses required at the Master’s level - If courses not completed, incoming PhD students can complete 3 specialization courses or request an exemption based on
- Completion of specialization
Admissions criteria
Master’s in Medical Education or Education (not mandatory) - Must submit 2–3 page research proposal and CV
PhD in Medical Education
PhD in Medical Education
Professions Education
PhD in Education with a concentration in Health
Medical Education
PhD in Medical Sciences-
Degree title
– Dundee, Scotland
Dundee University
University – Milano, Italy
Ambrosiana
Europe
Ontario, Canada
University of Ottawa –
Calgary, Alberta – Alberta, Canada
University of
Canada
Institution
papers are published in peer- reviewed journals by the date of the thesis defense - No obligatory courses but elective courses at extra cost
- Thesis contains at least 4 international papers that consist of 4 related studies - Highly preferred that an introduction and discussion chapter as well as half of the
- No courses - PhD thesis defense
- Dissertation
- PhD Thesis
- Candidacy examination - Dissertation submission and defense
- Completion of 4 courses
- Course completion - Dissertation
course applicable to thesis research topic - Medical Education Seminar Series attendance - Thesis
- Completion of 1 graduate-level
Graduation requirements
Full time: 3–4 years
2–4 years
Full time: 3 years
2–3 years (typically 3 years)
3–4 years
3–4 years
Duration
Format
Distance
Distance
supervision possible
Face to face, distance
combined
Face to face, online,
Face to face only
Face to face, distance
Table 1. Continued.
Four year total: $14,950
$660 (US) þ own expenses except research costs with promoter
$42,090 (US)
Total: $18,225
$20,235 International: $44,930
Four year: Canadian resident:
Canadian resident: $22,155 International: $50,281
Four year:
Total cost (US$)
http://www.maastrichtuniversity.nl/web/faculties/fhml/ theme/education/instituteforeducationfhml/ schoolofhealthprofessionseducationshe.htm
http://www.ugent.be/en/research/doctoralresearch
medical-education-centre/centremedical-education
http://medicine.dundee.ac.uk/
Medical/PhD/PhD_General.htm
http://www.internationalgme.org/
http://education.uottawa.ca/graduate/programs/ concentrations?lang=en
prospective-students/graduate-educationprograms/msc-andphd-programs/msc-and-phd-programs
http://www.ucalgary.ca/communityhealthsciences/
Website
PhD in Medical Education
Marmara University Institute of Health
Sciences Istanbul, Turkey
PhD in Medical Education
Dokuz Eylu¨l University Institute of Health Sciences Izmir, Turkey
Health Sciences Izmir, Turkey
Ege University Institute of
PhD in Medical Education
PhD in Medical Education
Utrecht University Medical Center -
Netherlands
Professional Doctorate (DHPE) in Health Professions Education
PhD in Medical Education
University of Glasgow, Scotland
Kingdom
University College London – United
Master’s degree
Master’s degree
Master’s degree
- Master’s degree
program
- A first degree, equivalent to a Bachelor of Science or Nursing - Current teaching experience and enrollment in a medical, clinical, or veterinary
preferred
- Primary medical qualification - Master’s in education or medical education is
Course completion Research Publications Dissertation and Thesis
Courses Dissertation
Courses Dissertation
Courses Dissertation
lished papers on one topic in peer reviewed journals
attendance - Training and supervision agreement with promoter - Monthly classes (Cycle of Theory and Literature) - Thesis consisting of 4–6 pub-
- 20 European Credits of coursework in relevant fields including conference
-
- Original research and written thesis - Demonstrating contribution
Full time, 4 years
Full time, 4 years
Full time, 4 years
4 years
2 years (full-time)
3 years (full-time) 5 years ( part-time)
Face to face
Face to face
Face to face
Face to face, distance
Face to face, online, combined
Online/distance
Free
Free
Free
year.
PhD students do not pay tuition or fees. Cost of living in the Netherlands is $16,000/
Full time Resident: $11,300 Full-time Distance: $11,300
International Full-time: $96,000 International Part-time: $80,000
EU Full-time: $21,000 EU Part-time: $17,100
http://saglik.marmara.edu.tr/aday-ogrenci/ programlar/ ( pages in Turkish)
http://www.deu.edu.tr/DEUWeb/Icerik/ Icerik.php?KOD=16419 ( pages in Turkish)
http://www.tead.med.ege.edu.tr/kategori.tsp? cat_yazi=19 ( pages in Turkish)
General PhD Information: http://www.umcutrecht.nl/research/student/phd/
http://www.gla.ac.uk/schools/medicine/ healthprofessionseducationprogramme/
http://www.ucl.ac.uk/ prospective-students/graduate-study/ prospectus/subjects/meded
(continued)
University of Otago – Christchurch, New Zealand
New Zealand
University of Stellenbosch – Cape Town, South Africa
PhD in Medical Education
PhD in Health Sciences Education
- Master’s degree - Supervised research, workbased research, or publications
MPhil in Health Sciences Education
- Research and thesis submission
PhD Dissertation
- Original contribution to knowledge - Thesis including the results of the original investigation
degree, or published research - Prior experience/degrees in education, psychology or clinical areas
Africa
- Minimum of 144 units of credit (uoc) and maximum of 196 uoc
- Previous research background through a master’s degree in a research program, honors
PhD in Medical Education
scholarly work including conference presentations and published papers - Publishing papers is encouraged
- Thesis including portfolio of
Graduation requirements
The University of New South Wales
- Master’s degree in Medical
Admissions criteria
Education or health-related discipline - Bachelor’s degree with approval - Must have professional experience (minimum 5 years)
Doctor of Medical Education
Degree title
University, Australia
James Cook
Australia
Institution
3 years
Full time: 2 years minimum Part-time: 5 years maximum
3 years full time
(4 max)
3 years
Duration
Format
Face to face only
Face to face, distance supervision possible
Face to face (some exceptions can be made for external locations)
exception of excellent preapproved off-site research)
Face to face only (with the
Table 1. Continued.
Offering a scholarship for three years at $17,014 (US) per year plus fees
1st year: $1553 (US) 2nd–5th year: $323 (US) per year
- Minimum: $97,920
- No fees for Australian/New Zealand residents - $680 per uoc
New Zealand residents ONLY by RTS scheme
Program covered for Australian/
Total cost (US$)
http://hedc.otago.ac.nz/ magnolia/meg/EducationResearch/PhD-in-Medical-Education.html
http://www0.sun.ac.za/pgstudies/postgraduate -programmes/faculty-of-medicine-and-health -sciences/programmes-offered/doctorates.html
http://med.unsw.edu.au/phd-medical-education
courseinformation/researchcourses/ JCUTST_058402#_Candidature
http://www-public.jcu.edu.au/handbooks2010/
Website
PhD programs in health professions education
Due to the autonomous nature of many of these programs, students often do their research and work at their home institution and thus it is appropriate for them to work at a distance from the degree granting institution. Online access often provides more flexibility to courses, supervision, and communication. However, an onsite class approach may be appealing and more helpful to some students, and so that is also available. The total cost of PhD programs in Medical or HPE varies widely among institutions. Excluding the free programs in Turkey, the least expensive program by far, Ghent University in Belgium, charges the tuition of $660 for the entire course of study, excluding research costs as discussed with the supervisor. The average cost, however, is about $41,000. Out of state or international students generally should expect to pay significantly more at an institution than local students.
Other programs/routes (not listed in Table 1) to get a doctorate in HPE In the United States, the avenue to obtain a PhD in Medical or HPE involves a structured academic program. Similar to an undergraduate degree or master’s degree program, students must meet admissions criteria, complete a series of specified courses, perform research under a supervisor, and submit a thesis. The programs tend to be highly structured with a series of goals outlined in a syllabus. There are European programs that require course completion as well as a thesis. Some programs also require applicants to apply and pay tuition each year they are enrolled and perform research. The majority of programs, though, simply require completion of research and a thesis, regardless of whether they do or do not charge tuition. In some European countries, particularly in the Netherlands and Belgium, most PhD programs are full-time or part-time research programs, with projects performed under the supervision of a professor with a chair in medical or HPE, often the head of the department. Applicants apply to a job opening in a field of interest and then are hired for the position, frequently related to external funding received by the professor or postdoctoral staff. Most of the HPE research in the Netherlands is done by hired PhD candidates under the formal supervision of one or two professors and one or two postdoctoral cosupervisors. Researchers are thus not students but rather employees of the university. Research can be done either on campus or at a distance, depending on the program and the proposal. PhD theses on medical or HPE are usually but not exclusively written in university medical departments. Psychology departments and even technical universities may offer positions for junior researchers leading to a PhD degree on a medical education topic. In other cases, a potential applicant may contact a professor or department head to submit a research proposal and coordinate the project and funds. This supervisor, for either a paid position or an unpaid position, is typically called a ‘‘promoter’’ and is responsible for advising and assisting with the research project. The terms advisor, supervisor, and promoter are synonymously used in many programs.
However, in Europe the most common term used to describe the role and functions of a thesis advisor is promoter. All candidates in European countries submit a thesis before receiving their doctorate. The thesis typically consists of submitted or published peer-reviewed journal articles. The required number varies based upon the institutional requirements. Gradually, at some places, these more or less informal arrangements are becoming more structured. At Maastricht University, Utrecht University and Groningen University in the Netherlands, the chairs of medical education have established most structured programs in centers for research in medical education, with the requirement of candidates meeting criteria in addition to completing a thesis of a set of related publications, constituting a research agenda, in peer-reviewed journals. Maastricht University and Utrecht University have programs that collaborate with centers internationally on doctoral programs. Maastricht is the only university that has organized, university-wide, a center for research in HPE and not confined it to a medical department (i.e. the university medical center). The following is a list of PhD programs in medical education in Europe that use paid/unpaid positions as a basis for doctoral training (Dutch listed from most structured to least structured): Maastricht University (Maastricht, the Netherlands) University Medical Center Utrecht, Utrecht University (Utrecht, the Netherlands) University Medical Center Groningen, Groningen (Groningen, the Netherlands) Free University Medical Center Free University (Amsterdam, the Netherlands) University Medical Center St. Radboud, Radboud University (Nijmegen, the Netherlands) Academic Medical Center, University of Amsterdam (Amsterdam, the Netherlands) Leiden University Medical Center, Leiden University (Leiden, the Netherlands) Erasmus Medical Center, Erasmus University (Rotterdam, the Netherlands) University of Leuven – KU Leuven (Belgium) Antwerpen (Belgium) Most of the European doctoral programs follow the standards for PhD education in biomedicine and health sciences articulated in a position paper by ORPHEUS-ASMEWFME (ORPHEUS position paper 2012).
Discussion As the field of medical education advances, it benefits from the contributions of individuals from a wide variety of disciplines. While doctoral training in medical education specifically is valued, many of the researchers/faculty in the top centers in the world have doctoral training in other areas, such as psychology, sociology, kinesiology, measurement, evaluation and statistics, anthropology, industrial and organizational psychology, and others. To maintain the
79
A. Tekian
evolution of the HPE, it is important to continue to foster this disciplinary diversity. It would be a mistake to focus exclusively on studies in medical education, because scholarly advances in the basic sciences of other disciplines can help to contribute to research and development in the HPE. With the explosion of interest in medical education, especially in countries outside of Europe and North America, there will be an enormous demand for doctoral programs. Just like medical schools in Europe and North America, they will need individuals trained in a wide variety of disciplines. Although structured doctoral programs are quite desirable, there are far fewer than the market demands. Therefore, other options leading to specialization in medical or HPE should be considered. Although there is no PhD in medical education, specifically, at many institutions that have a Master’s degree in HPE, a number of these institutions train fellows for doctoral degrees in HPE without necessarily advertising or labeling the programs as a PhD in medical or HPE. For example, the University of Toronto Wilson Center for Research supports the training of more than 20 fellows who are undertaking doctoral programs relevant to medical education. Recognizing that a PhD in medical education is not the only route to a career in medical education, the University of Toronto supports PhD training in disciplines such as higher education, sociology, psychology, measurement and evaluation, kinesiology and anthropology, as well as in discipline-specific PhDs, such as medicine, dentistry, nursing, and pharmacy, which focus on education. An applicant to the Wilson Center must identify a graduate program aligned with the research project that they intend to pursue. For example, if they intend to study surgical technical skills, they would be directed to a take a PhD in kinesiology. If they were interested in curriculum and assessment, they will be directed to take a PhD in the Faculty of Education. The way the Center insures the focus on health professions is to assign a supervisor from the Wilson Center. The Wilson Center fellows pay tuition to the Graduate School, but are hosted and supported by the Wilson Center, which furnishes a desk and funding for conferences and other forms of academic support, in addition to funded fellowship programs. The average doctoral student in such programs completes the PhD in five years. Another variation of doctoral level specialization in HPE is the model at the Karolinska Institute, where the graduate identifies a mentor; the doctoral degree, however, is in ‘‘medical sciences.’’ Besides the structured 24 programs described in Table One and the other European and Canadian programs, there are other routes to initiate and establish doctoral programs in HPE. One such possibility for programs or institutions that already have a Master’s degree in MHPE is to create a concentration in HPE through the collaboration with a doctoral program in colleges of education, or through collaboration with institutions that already have doctoral programs. Alternatively, institutions aspiring to have doctoral programs in HPE first need to build an infrastructure with individuals who have a Masters degree, and create a critical mass who have Master’s degrees in medical education. Then it 80
becomes possible to develop a more advanced cadre of individuals, with deeper expertise, such as in curriculum development, leadership, instructional technology, research methodology, and measurement and evaluation. Some of these areas might be best pursued outside of medical education to allow the necessary intensity of study or focus. For example, a sophisticated work in the economics of medical education would require training in an appropriate Faculty/Program of Economics or Business. The 24 programs listed in the table, as well as the rest of the doctoral programs mentioned in this article, are located either in North America, Europe, Africa, Australia or New Zealand. This is one of the reasons that applicants from South East Asia, Latin America, the Middle East, and Russian republics pursue their doctoral degrees in HPE in Europe, North America or in Australia and New Zealand. Graduates from these doctoral programs assume leadership positions at their home institutions in a relatively short period of time, thus further increasing the demand for establishment of PhD programs, concentrations in HPE, and alternative pathways leading to doctoral degrees in HPE. Institutions and individuals should also think about disciplinary diversity and not focus exclusively on studies of medical education.
Acknowledgements The author would like to acknowledge Prof. Th. J. (Olle) ten Cate from University Medical Center Utrecht, for his expert guidance on the context and description of the European doctoral programs. Declaration of interest: The author reports no declarations of interest. The author alone is responsible for the content and writing of the article.
Notes on contributors ARA TEKIAN, PhD, MHPE, is an Associate Professor, Department of Medical Education, and Associate Dean for the Office of International Education at the University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Glossary Promoter – The terms advisor, supervisor, and promoter are synonymously used in many programs. However, in Europe the most common term used to describe the role and functions of a thesis advisor is promoter
References Cusimano MD, David MA. 1998. A compendium of higher education opportunities in health professions education. Acad Med 73:1255–1259. Gill D, Griffin A, Woolf K, Cave J. 2009. Twelve tips in studying medical education at doctoral level. Med Teach 31:601–604. Leja JA, Wardley CS. 2002. Future trends in health care doctoral education. J Allied Health 31:227–231.
PhD programs in health professions education
Marusic M, Mimica M, Mihanovic F, Jankovic S. 2013. Doctoral degree in health professions: Professional needs and legal requirement. Acta Medica Academica 42(1):61–70. ORPHEUS 2012 position paper: Towards Standards for PhD education in biomedicine and health sciences. 2012. [Accessed 6 August 2013] Available from www.orpheus-med.org Pan YJ, Lee LS. 2012. Who wants to enroll in health care PhD programs? An analysis of a nationwide graduate destination survey. J Chinese Med Assoc 75:286–291.
Pugsley L, Brigley S, Allery L, MacDonald J. 2008. Making a difference: Researching master’s and doctoral research programs in medical education. Med Educ 42:157–163. Tekian A, Artino A. 2013. AM Last Page: Master’s Degree in Health Professions Education Programs. Acad Med 88:1399. Tekian A, Harris I. 2012. Preparing health professions education leaders worldwide: A description of maters-level programs. Med Teach 34:52–58.
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