¹ETH Swiss Federal Institute of Technology, Department of Health Science and Technologies, Zürich, Switzerland
²University of Bern, Institute for Medical Education, Bern, Switzerland
³University of Fribourg, Department of Community Health, Fribourg, Switzerland
⁴University of Lucerne, Faculty of Health Sciences and Medicine, Lucerne, Switzerland
⁵ETH Swiss Federal Institute of Technology, Department of Health Science and Technologies, Switzerland
⁶University of Basel, Faculty of Medicine, Basel, Switzerland
⁷University of Geneva, Faculty of Medicine, Geneva, Switzerland

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Objective: For more than 20 years Switzerland has had a binding set of learning objectives to guide medical education at universities. The learning expectations, compiled in the Principal Relevant Objectives and Framework for Integrative Learning and Education in Switzerland (PROFILES), were first published in 2017 and revised in 2023 [1]. PROFILES 2 provides a generic description of outcome-based competencies that cover the field of medicine without focusing on specific disciplines and consists of three interdependent chapters: the competencies and roles (CRs), the Entrustable Professional Activities (EPAs) and the Situations as Starting Points (SSPs). The objective of this work is to describe the revision process and highlight the changes and updates in PROFILES 2.

Methods: A working group (WG), composed of experts from undergraduate, postgraduate and continuing medical education as well as medical students, was mandated by the Joint Commission of the Swiss Medical Schools to carry out the review. The revision process was based on the first three steps of Kern’s six-step approach to curricula development and comprised the following phases:

1. inquiry of needs,
2. analysis and
3. validation [2].

For the inquiry of needs relevant stakeholders were invited to submit proposals for changes to PROFILES. The gathered proposals were analyzed by the members of the WG and a consensus was reached including exact formulations. The consensus document was validated by the Joint Commission of the Swiss Medical Schools and the deaneries of all faculties of medicine in Switzerland.

Results: In total, 128 proposals were submitted by medical schools and other invited stakeholders. The original PROFILES document comprised 479 items.

About half (46%) of the proposals concerned specification, re-wording or elimination of duplicates of clinical issues in EPAs or SSPs. 38% of proposals were related to content changes concerning three areas: planetary health; diversity, equity and inclusion (DEI); and digitalization. The remaining proposals dealt with clarifying the terminology of CRs, EPAs and SSPs and highlighting the interdependence between the three main chapters.

Discussion: The revision process revealed that rapid changes in medicine and the health care system have occurred and that these issues should be reflected in the national framework for medical education. The added themes – planetary health, DEI and digitalization – are global megatrends and their integration into the medical curriculum is a prerequisite to deal with major challenges of the future healthcare system.

Take home messages: It is worth looking at initiatives in different countries and institutions for inspiration concerning current trends in medical education, which should be reflected in a national competency framework for medical education.The revised PROFILES 2 reflects the current best practice in medical education and will help to meet the needs of the future healthcare system.

Literatur

[1] Michaud PA, Jucker-Kupper P; The Profiles Working Group. The “Profiles” document: a modern revision of the objectives of undergraduate medical studies in Switzerland. Swiss Med Wkly. 2016;146:w14270. DOI: 10.4414/smw.2016.14270
[2] Thomas PA, Kern DE, Hughes MT. Curriculum Development for Medical Education: A Six-Step Approach. Baltimore, (MA): Johns Hopkins University Press; 2022.