Geneva was a pioneer 30 years ago when it radically reformed its medical education system. "However, the signals we are receiving from students, teachers and those in charge of supervision at clinical training sites indicate that our approach needs to evolve", points out Mathieu Nendaz, Vice-Dean in charge of pre-graduate teaching and professional identity. Among the points raised were learning formats, supervision training and streaming of courses, "which caused a certain amount of tension: some teachers saw it as a lack of respect linked to physical absence, or a lack of understanding of teaching logic, while the students demanded a pragmatic approach to flexibility in their work and study time".

Nevertheless, all agreed on a number of points: a lack of continuity between bachelor’s and master’s degrees, insufficient knowledge of the scientific method, and above all, a loss of meaning felt by students, a crisis shared by a good number of healthcare professionals. "To launch the project, in June 2024 we invited all people concerned to a day of joint reflection to identify strategic avenues", adds Mathieu Nendaz. "I'd also like to emphasise the collaborative nature of this co-construction process.  

New learning formats

Problem-based learning (PBL) has been one of the cornerstones of Geneva's education system. However, this format is running out of steam and is now evolving towards the Case-Based Collaborative Learning (CBCL) model, developed in partnership with Harvard University. This new approach maintains the principle of learning in groups around clinical problems, but unlike PBL, where students discover the problem during the session, CBCL requires prior individual preparation, followed by discussion in small groups, which should enable them to explain the issue to their peers. "We keep the collaborative aspect of learning, but reinforce the upstream, independent preparation. This means that the material must have been really understood to contribute to the group work, and not simply skimmed over, using summaries or AI", explains Mathieu Nendaz. This principle will be deployed from the start of the 2025 academic year, after a pilot phase last year.

The introduction of a progress test, which will enable students to test themselves each year starting from the 3^rd year of study at a level expected at the end of the course, is intended to help them determine their level and progress and to remedy any shortcomings.

The importance of the scientific method

In view of the challenges posed by artificial intelligence and massive access to information, the Faculty wishes to strengthen the teaching of the scientific method in a more explicitly longitudinal way. The aim is to develop critical thinking skills of future physicians so that they can better grasp the challenges of verifying and critically assessing information, skills that are essential in medical practice.

More broadly, AI has become an integral part of all aspects of medical training: for teaching, for assessment and for learning. It is now essential to take up the subject to provide a better framework for its use and to support training.  

Building professional identity in all its facets

The reform gives a much more central place to the construction of the professional identity of future physicians through several projects. First, the return of care assistant internships, which will have to be completed before the end of the bachelor's degree and should provide better support for the transition to the clinical master's degree, but above all offer more mature reflection on professional orientation. These internships will take effect from the start of the current academic year. Thematic workshops will explore various aspects of the profession that have not previously been dealt with, such as managing medical errors, caring for chronically ill patients and professional discouragement. Peer mentoring (by and for students) and coaching by teachers throughout their studies will complete the scheme. 

Enhancing the value of teaching 

The reform does not neglect teachers. A specific project to provide training in clinical supervision has been launched in the various hospital departments hosting trainees, to compensate for the sometimes inadequate mastery of curriculum content and the expectations that trainees are expected to meet. This approach is accompanied by a review of the value of teaching, in particular improving communication on the criteria for academic promotion and enhancing the value of teaching activities.

Evaluation and educational research

One of the strengths of the Faculty of Medicine also lies in its expertise in pedagogy and research in medical education. The implementation of these new proposals will be the subject of impact studies. "We have drawn up a general research protocol that complements the approaches specific to the various parts of the reform, in order to build a knowledge base on what we are putting in place", adds Mathieu Nendaz. At the same time, a working group is reflecting on the 1^st year on three aspects: the selection procedures, the content of the first year, and the student pathways according to the choices made. The various scenarios drawn up will serve as the basis for a pedagogical and political debate. Concerns about the 1st year of medicine are widely shared by all Swiss universities and EPFs. In this context, the UNIGE Faculty of Medicine is becoming a driving force at federal level, on behalf of Swissuniversities, the umbrella organisation of Swiss universities.

These reforms can only be achieved with the commitment and motivation of a large number of people, managers and teachers, administrative and technical support, whom Mathieu Nendaz would like to thank warmly on behalf of the Dean's Office.

Prof. Mathieu NENDAZ
Vice-Dean for undergraduate training and development of professional identity

More information
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