The Rijksuniversiteit Limburg, Maastricht, Netherlands: Development of medical education

The Netherlands is highly developed, densely populated, and possesses a generally well-functioning health delivery system. Geographic maldistribution of professional health personnel is not a problem, but even through medical care is provided through a system of general practice, the Netherlands' medical schools offer a specialty-oriented curriculum. The high cost of health care is a major concern. A new Faculty of Medicine was authorized in 1974 to be the first faculty of a new university in the Limburg region. The Faculty of Medicine's purpose is to develop a system of medical education particularly oriented towards primary care practice in relation to Maastricht and the Limburg region. The University participates in a recently founded Regional Medical Centre, which is the mechanism established by the Government to contain costs and improve the health care delivery system. The medical curriculum at Maastrict offers basic science instruction in an integrated way with the focus on medical or health problems. Students are expected to assume considerable responsibility for their own learning in order to acquire the important skills of self-assessment and self-education. The curriculum emphasizes an awareness of social needs and problems, and students are introduced to the practice of health care in their first year. The evaluation programme and process are a dominant feature. The evaluation plan takes into account student performance assessment, instructional programme evaluation, and institutional factors in immediate, intermediate and ultimate goals. The implementation of this carefully designed educational programme was helped considerably by the absence of two often-found constraints: the University's organizational structure was developed to be consistent with, and supportive of, the educational concepts, and, because the Netherlands has no national accrediting or licensing bodies, the school has a great degree of freedom to define its own graduation standards.