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Department of Medical Chemistry, Biochemistry and Clinical Chemistry
Zagreb University School of Medicine
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Tihana Žanić Grubišić. Education of Masters of Science in Medical Biochemistry at the Faculty of Pharmacy and Biochemistry, University of Zagreb: How did we fit in the Bologne process. Biochemia Medica 2008;18(2):143-53. http://dx.doi.org/10.11613/BM.2008.014
Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
 
*Corresponding author: tzanic [at] pharma [dot] hr
 
Abstract
 
The recent reform of the university education in Republic of Croatia is undertaken to attain the main objectives set up by Bologna Declaration on promoting global competitiveness of European Higher Education. The Declaration that was signed by 29 countries is the common commitment to reform the structures of respective higher education system in a convergent way and to produce the national framework of readable and comparable degrees.
New concept for the university degree in Medical Biochemistry is particularly emphasising the multidisciplinary character of the profession in order to enable application of scientific knowledge in the medical context. Curriculum is harmonised with the recommendations that are accepted in the majority of European countries, and consists of an integral five years programme leading to the degree of Master in Medical Biochemistry. The multidisciplinary approach is achieved by introducing various disciplines into curriculum: 1. Fundamental natural sciences; 2. Biomedical disciplines (anatomy, physiology, pathophysiology, histology, cytology, immunology, microbiology and parasitology, etc.); 3. Professional medical biochemistry disciplines (clinical biochemistry, haematology, coagulation, clinical immunology, blood banking, analytical toxicology, molecular diagnostics, etc.; and knowledge, competences and skills in communication, laboratory management, automation, and informatization of laboratory system. The relative proportion of the subjects during the five year study is: 28% fundamental natural sciences, 12% of biomedical, 45% professional and 15% elective subjects.
The fundamental and professional subjects would be intensively correlated, and training in the hospital laboratory will start already from the first year. The ECTS credits will be assigned to the each subject, and student mobility would be encouraged. There will be great cooperation with the teaching hospitals related to Faculty, in particular for the courses Integral laboratory diagnostics and Professional laboratory practice.
At completion of the new Medical Biochemistry curriculum the graduate would have a through knowledge of all aspects of medical biochemistry science relevant to the discipline, and competences to organize laboratory practice and apply current techniques, to evaluate the diagnostic data and to provide an expert opinion in the medical team, or to pursue a career in the fundamental and applied scientific research. The new concept comprises relevant knowledge in clinical cytology, microbiology, clinical immunology, blood banking, analytical toxicology, molecular diagnostics thus concurring with the current trends in Medical Biochemistry and Laboratory Medicine.
 
Magna Charta Universitatum – the fundamental document of the Bologne Process
Significant changes that are happening during the last few years in the European higher education system have influenced the overall education reform on all faculties of Croatian universities. The starting point of the reform is the Bologne Declaration with the basic mission of the establishment of the European Higher Education and Research Area. This objective should be accomplished by the year 2010.
In today’s globalized world of knowledge and research, the right results can be obtained only by a cooperation that is based on clearly defined principles, acceptable by every European nation and country. The future increasingly depends on cultural, scientific and technical development that is created in the centres of the culture, science and research, such as universities are.
Magna charta universitatum” is a charter based on such standings and the principles of development of European Universities are set in it. On the rector meeting in Bologna 1998, on the 9th centennial of the University of Bologna, the oldest European university, it was decided that the Universities must enforce their 9 century old basic mission to safeguard perseveringly the knowledge, which has been gathered for a long time and now is being widened and completed or substituted with the new ones and is critically transmitted to the generations to come. For safeguarding and transmitting knowledge libraries are not sufficient, either traditional or electronic. Live human critical ability is needed, a continuous checking and researching where the achievements of the new times and experiences meet the inheritance of the predecessors.
It is important to see that the Bologne Declaration is an academic but also a political project. The European Community member countries have recognised the importance and the need of the overall integration as a precondition for creating a better and more influential Europe, able to participate equally in a global process of construction and strengthening of intellectual, cultural, social, scientific and technological values of the new world. By signing the Declaration on 19th of June 1999 in Bologna, the governments of 29 countries took over the responsibility to support and enable the global transformation of the own higher education structure. Our country signed and accepted the Declaration in 2001.
A Europe of Knowledge persists in creating a unique higher education area, important for promoting citizen mobility and their employment, and for the overall development of the continent. Vitality and efficiency of every civilisation can be measured by the fact how attractive its culture is to the other countries. Thus it is important to ensure that the European higher education system becomes attractive all over the world, in accordance to its exceptional cultural and scientific tradition. The need for a reform of the educational system arises primarily out of understanding that the European university studies last too long, they are too expensive and not efficient enough, they do not provide enough qualification for higher educated specialists. Studying must become faster and cheaper and the students should fit faster and easier into working environment after finishing studies. However, although those objectives are very simple and clear, the road to their implementation is very complicated, insecure and extremely demanding, so it requires a high level of coordination and dedication of all factors involved in higher education. The reform which would change the efficiency of the studying is far more complex than simple curriculum widening. It reaches deep into the methods of teaching performance, and to the ultimate goal of the educational process. The today’s education provides students the knowledge. The tomorrow’s education should provide them the knowledge, skills and competences.
Such consideration makes the fundament of the Bologne Declaration, which is formulated as follows:
1. Acceptance of a system of easy readable and comparable academic degrees and introducing a special supplement to higher education diploma that contains the complete list of audited subjects, knowledge and competencies achieved during the study period (Diploma Supplement).
2. Acceptance of higher education system based on the three cycle structure (bachelor, master and doctorate). The first cycle has two aims: education of undergraduates for a professional work on tasks of limited independence or for continuation of graduate study. The second cycle leads to the academic degree of magister of science in professionand qualifies for independent problem solving in interdisciplinary environment. There are exceptions to this scheme primarily related to biochemical area, where all studies have accepted the unique structure of integrated undergraduate and graduate studies that last five to six years. Postgraduate doctor studies lead to degree of doctor of science.
3. Establishment of ECTS system (European Credit Transfer System – system of credits) that should allow an easy recognition of accomplished educational level The ECTS credits represent a value that is assigned to a studies unit (subject or module) and reflects student’s work in order to successfully complete it – it expresses the overall work for each subject needed to complete the full academic year in an institution, what includes lectures, seminars, practical work (training), individual work outside the institution and preparation and participating in examinations and similar.
4. Promotion of student and teacher mobility.
5. Promotion of European co-operation in quality assurance with a goal of developing comparable criteria and methodologies.
6. Promotion of European values in higher education.
7. Development of the lifelong education concept.
8. Emphasis on the role of students in developing and managing of higher education. The University is focused on students because the curriculum is based on work and achievements of students and not teachers. Similar to that the learning result and not the content is being evaluated. Working methods put students into the centre of the teaching process, because through a larger choice of optional subjects they have the opportunity to create their own way through the study and so start their lifelong studying and future employment.
All mentioned aims are set to promote the attractiveness of the European higher education area towards global competition. Some countries must work on the internationalisation of their own educational systems by promoting compatibility and comparability of its studies to the European ones, but with an obligation of keeping their own educational specifics and their educational institution autonomy.
Qualifications and competencies in the European higher education area
Integration of European higher education area requires from all Bologna Declaration signatory countries to prepare a national framework in their own higher education systems. This framework will describe qualifications in terms of teaching achievement requirements, levels, learning results, competencies and profiles. It is also required to define clearly qualification frame, so that each education level has its owndefined learning result – a set of knowledge and skills that a student can understand or is able to perform at the end of a learning period. The first and the second cycle, bachelor and master, must have different profiles in order to fulfil different individual and academic needs and the needs of the labour market. Such organisation creates fundaments for recognition of international qualifications and improves student mobility. Criteria that have to be satisfied in order to accomplish each level are presented in table 1.
 
Table 1. Criteria for description of degrees in higher education
 
 
Comparability and recognition of qualifications at European and national level
Comparability of qualifications is a precondition of student mobility assurance and graduated specialists in the European higher education area. To achieve that aim a system of clear and comparable (transparent) levels has to be established. That enables the recognition of qualifications acquired on different universities and in different countries.
The recognition issue can relate to:
Recognition of institution at national level
Recognition of higher education programmes (curriculum)
Recognition of acquired qualifications at national and European level
Recognitions are implemented at the academic and professional level.
Academic recognition understands acceptance of audited and completed subjects, acquired qualifications and diplomas from a foreign university, needed for continuation of the study or out of wish to make an academic career at a foreign institution.
Professional recognition implies the right to work and acquiring of a professional status in accordance with acquired qualification. The fundamental document that regulates the academic recognition in Europe is UNESCO’s document “Convention on the Recognition of Qualifications concerning Higher Education in the European Region” that emphasizes the necessity of directing to global estimation of the qualification level and profile and comparing the learning results and acquired abilities, instead of pure comparison of programme characteristics
For a successful higher education reform implementation The Ministry of Science, Education and Sports (MZOS) has enforced a number of provisions and bills that regulate the national educational framework and describe educational levels and their mutual correlations. A scheme of educational levels in university and professional studies is shown at figure 1. In an efficient and well organised society each of the mentioned levels should have a defined role in the society.
 
 
Figure 1. Scheme of the structure of educational levels in university and professional studies (according to network websites of the MZOS, 2008)
How do the Faculty of pharmacy and biochemistry and the medical biochemistry studies fit into these criteria?
The reform of medical biochemistry studies is based on the criteria accepted in the majority of the European countries for employment in laboratories of medical biochemistry, which can be found in a document “European Syllabus for Post graduate for the training in Clinical Chemistry”. The programme includes an academic education (4-5 years) completed with an obligatory training in clinical biochemical laboratories and postgraduate specialisation that lasts 4 years. The European Forum EC4 implies keeping the existing undergraduate education developed in each country, and it regulates the detailed harmonisation regulations for the specialisation curriculum.
The Curriculum of the Faculty of Pharmacy and Biochemistry predicts a five-year education cycle which leads in accordance with the Law on Science and Higher Education to a degree of Master of Science in Medical Biochemistry. All other faculties within the biomedical group planed such integral educational cycle. The studies are conceived so that professional subjects are included into the Curriculum already in the first year and a large number of elective subjects are offered. In the five-year education the Curriculum subjects are organised into following relative proportions:
28% fundamental natural sciences
12% biomedical
45% professional
15% elective (optional) subjects
The fundamental and professional subjects of the Curriculum are intensively correlated and the training in the hospital laboratory starts already during the first year. The ECTS credits are assigned to the each subject and are transmittable among different faculties. Due to that fact students can continue their studies on another faculty, what should encourage student mobility, but also the mobility of teachers. The suggested Curriculum is performed in cooperation with teaching hospitals of the Faculty. This refers especially to the courses of Integral Laboratory Diagnostics and professional Laboratory Practice, which ill be organised in clinical laboratories during the 9th semester. The practical part of teaching will be performed in the teaching hospitals and a part of lectures will be held by teachers from the clinical departments that cooperate intensively with the Faculty.
The Curriculum setting for the Medical Biochemistry studies is led by a principle to develop the profession within the scope of interdisciplinary area, whose scientific knowledge is applied in the health care system aiming for successful diagnostics, monitoring and prevention of illness. The modern medicine, closely connected to development of science and technology, is unthinkable without good medical biochemical diagnostics. Medical Biochemistry integrates the knowledge of general and analytical biochemistry and cellular and molecular biology with physiological and pathophysiological processes, and it enables the understanding of pathological processes at the molecular level as well as obtaining new diagnostic and prognostic illness indexes.
The Medical Biochemistry studies are interdisciplinary and students acquire:
fundamental knowledge (mathematics, chemistry, physics, statistics, biochemistry, biology, molecular biology);
biomedicine knowledge (anatomy, physiology, pathophysiology, histology and cytology, immunology, genetics, microbiology and parasitology, pharmacology, toxicology and haematology);
professional medical biochemical knowledge (general and pathological clinical biochemistry, haematology with coagulation and immunohaematology, clinical immunology, blood banking, clinical cytology, microbiology, analytical toxicology, molecular diagnostics, emergency laboratory medicine, point of care laboratory testing, rational laboratory diagnostics, etc.);
knowledge, competences and skills in communication, laboratory management, automatsation, electronic data processing, organisation and managing of laboratory of medical biochemistry and informatization of laboratory system.
The studies curriculum like this enables a graduate to make competent interpretations of laboratory test results and makes him/her an important member of a professional medical team for patient management or a member of a scientific team that develops and researches new scientific knowledge. After they successfully complete the 10th semester of their studies the graduates, Masters of Science in Medical Biochemistry can work in their health care area at all levels of laboratory health care justifying their position in a laboratory team as well in big clinical hospitals as in other type of hospitals or in the basic health care. The modern education of medical biochemists with a lot of knowledge of cytology, microbiology, immunology and blood banking provides a successful participation in development of the profession that aims towards an overall laboratory science, Medical Biochemistry and Laboratory Medicine. By applying biochemical, haematological, molecular biological and chemical methods and examination techniques and technologies of biological materials they will successfully contribute to stating the cause of an illness, to better health maintenance, to illness prevention, to treatment monitoring as well as to new scientific knowledge. The Curriculum of the Medical biochemistry studies on the Faculty of Pharmacy and Biochemistry is comparable with those in the Czech Republic, Poland, Hungary and Israel.
Postgraduate doctor studies
The Faculty of Pharmacy and Biochemistry proposed and received an acceptation for implementing of postgraduate doctor studies in the “Pharmacy and Biochemistry” sciences, which leads to a degree of Doctor of Science in area Biomedicine and Health Care. The studies are organised into two modules: Pharmacy sciences and Biomedical sciences. The objective of the doctor studies is to educate a graduate for an independent research work in scientific research institutions and in clinical practice and to offer a thorough research experience in specific areas of medical biochemistry.
The studies are designed for medical biochemists, pharmacists and other experts from the area of Biomedicine and health care and other Natural sciences.
Innovation of the Doctor Curriculum
The Curriculum proposal is extremely interdisciplinary. However, the integration is achieved by interlacing contents of natural, fundamental and applied clinical sciences, and very important information and communication sciences. The Curriculum teaching is based on diversity of research projects on the Faculty of Pharmacy and Biochemistry in cooperation with numerous scientific educational cooperative institutions and with clinical departments, industry and business sector. Through the scientific work it is necessary to strengthen innovation, to enable technology transmission and through research and educational activity it is important systematically to connect science with clinical practice. Teaching is organised with participation of cooperative institutions such as Ruđer Bošković Institute, teaching hospitals of the Faculty of Pharmacy and Biochemistry (Clinical Hospital Centre “Zagreb”, University Hospital “Sestre Milosrdnice”, University Hospital “Dubrava”) and guest teachers from the scientific and research institutes and faculties from Croatia and the world.
The studies include organised teaching – with obligatory, modular, methodological and elective subjects and active scientific and research work and finishes with a successful completion of examinations, positive evaluation of scientific activity, positive grade in the final doctor examination. The ECTS credit system is applied and it is compatible with the European. The organised teaching takes 20% of the overall teaching and the rest 80% refers to the scientific activity of graduates. The subjects are divided into four credit groups:
1st credit group represents fundamental subjects and characteristics for both models of the doctor studies. The objective of these courses is to introduce the graduate with the basics of the scientific work and to provide necessary knowledge to overcome modular, methodological and elective courses, scientific activity and writing of the doctor thesis (doctorate)
2nd credit group represents modular subjects according to the interest of the graduates. Their objective is to introduce the graduate with scientific knowledge of a narrow research area of a certain module in the doctor studies.
3rd credit group represents methodological subjects whose objective I to introduce the graduate with technological procedures and methods in different research areas for the purpose of making a practical part of the doctor thesis.
4th credit group represents elective subjects from a wide selection of curriculum subjects. However these could be also subjects planned for the postgraduate specialist studies on the Faculty of Pharmacy and Biochemistry and subjects from other doctor studies. There are constantly more proposals for elective subjects.
Postgraduate specialist studies
The Faculty of Pharmacy and Biochemistry proposed four postgraduate specialist studies from the area of Medical Biochemistry, Molecular Diagnostics, Pharmacology and Analytical Toxicology. These programmes are in the final phase of acceptance.
Experiences in implementation of the reformed studies
In the new concept of the studies professional subjects are introduced already in the first year and a lot of time is spent in the health care institutions doing practical work. The students have successfully accepted the organised practical training during the regular studies. The student’s practical training is organised in levels, which enables the comparison of the acquired theoretical knowledge with an essence and volume of the laboratory work in health care institutions.
1st year: Visit to a laboratory of medical biochemistry of a basic health care institution and to a laboratory of medical biochemistry in a clinical hospital. The students spend one working day in each of the laboratories, where they get an insight in laboratory organisation of each laboratory type. In the seminars students examine the environmental design (physical planning) of laboratory, the structure of employed professional experts, the types of the equipment and the range of tests.
2nd year: Training in a cytology and histology laboratory. Students spend one working day in a cytology and histology laboratory in a clinical hospital where they learn the basics of cytology and immunocytochemistry tests.
3rd year: Training in a clinical microbiology laboratory.
4th year: Training in a haematology laboratory
5th year: Training in a clinical biochemical laboratory that includes laboratory methods for examining of electrolyte, acid base balance, proteins, nonprotein nitrogen compounds, porphyrins, carbohydrates, lipids and lipoproteins, enzymes and isoenzymes, hormones and microelements in body fluids. Furthermore, it includes an introduction with performance of equipment and auto analyzer and with the methods of molecular diagnostics. Practical training also includes work in specialized laboratories for endocrinology, diagnostics of blood transmitted diseases and in the laboratory for biological toxicology expertise.
The fundamental principle of the Bologne Declaration is working with students in small groups in order to intensify the individual work of students. As the number of students on the Medical Biochemistry studies for many years counts around 20 per year, these principles were already implemented in previous practice. Systematic work of students is stimulated by constant knowledge examination, numerous seminars and presentations, what has given very good results.
A lot was done on the field of active promotion of student mobility in the scope of CEEPUS (Central European Exchange Program for University Studies). The program enables student exchange and supports teaching personnel mobility with objective to create a network of Central European Universities. Due to that program more than 100 students from Central Europe have come to specialised projects on the Faculty of Pharmacy and Biochemistry during the last ten years and numerous teachers and students from the faculty visited university clinics and universities in the Central European countries.
As a conclusion we can say that big steps have been done in improvement of the Medical Biochemistry studies. However, there are still a lot of issues that have to be discussed and solved in cooperation with the university of Zagreb, Ministry of Science, Education and Sport and Ministry of Health and Social Welfare with active participation of the experts, so that we could adequately adjust to the European dimension of laboratory service.
 
References
 
1.    [Kratak pregled visokog obrazovanja u Republici Hrvatskoj]. Havranek J, ed. Zagreb: Agencija za znanost i visoko obrazovanje; 2008. (in Croatian)
2.    [Prvi koraci u Bolonjskom procesu]. Polić-Bobić M, ed. Zagreb, University of Zagreb; 2005. (in Croatian)
3.    Kieviet W, Blaton V, Kovacs GL, Palicka V, Pulkki K. The Management of Clinical Laboratories in Europe: a FESCC Survey. Clin Chem Lab Med 2002;40:312-9.
4.    Zerah S, McMurray J, Bousquet B, Baum H, Beastall GH, Blaton V et al. EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine, version 3 - 2005. IFCC, FESCC AND EC4 PAPERS
5.    Beastall G, Kenny D, Laitinen P, ten Kate J. A guide to define competence required of a cosultant in clinical chemistry and laboratory medicine. Clin Chem Lab Med 2005;43:654-9.
6.    Sanders GT, Beastall GH, Kohse KP, Zérah S, Jansen R, Köller U, et al. The Practice of Clinical Chemistry in the European Union. Clin Chem Lab Med 2002;40:196-204.