This week marks the 30th anniversary of the Edinburgh Declaration, an influential document which set out to promote “a sustained and organised programme to alter the character of medical education so that it truly meets the defined needs of the society in which it is situated”. Many will not know that the Declaration was the outcome of an initiative of the World Federation for Medical Education, starting in 1984. This note is about the history of how it happened.
When Henry Walton was President of WFME between 1983 and 1996, the single most important activity of the Federation was the “International Collaborative Programme for the Reorientation of Medical Education”.
The call to WFME to reform medical education internationally came in 1984. WFME initiated the most intensive global enquiry ever planned and conducted. A planning document covered six themes and posed 32 key questions, was translated into many languages and sent to the Deans of all medical schools in the world. The responses received were compiled into national reports, discussed in national conferences and analysed by the six Regional Associations of WFME. The regional report s were brought together to become the background material for the World Conference on Medical Education in Edinburgh in 1988.
The 1988 World Conference, at its final plenary session, expressed its recommendations in the ground-breaking Edinburgh Declaration.
Because so many of the recommendations emerging had legislative, legal and statutory implications, ministers of health and ministers of education were brought together with medical educators and health care administrators in a structured series of consultations in 1988 – 1989.
As well as being widely accepted by medical teachers, medical students, medical doctors and other health professionals, and the general public around the globe, the Declaration was discussed at the World Health Assembly in 1989, which endorsed The Edinburgh Declaration by adopting WHA Resolution 42.38 of 19 May 1989.
The Edinburgh Declaration was followed by a surge of reform worldwide greater than any since the start of the 20th century, and the Declaration remains an essential basis of reform and reorientation of medical curricula worldwide.
The Edinburgh Declaration was the subject of an entire issue of Medical Education, in January 2018 (Volume 52, Issue 1). Each of the lines of action proposed by the Declaration was examined in the issue. On every line, there has been great progress, but there is also far to go. In many areas, variable progress is the outcome of cultural differences. In some countries, the idea of “all health resources of the community, not hospitals alone” being used for education of medical students is anathema. The use of “measures of personal qualities” in the selection of medical students, not just academic achievement alone is proscribed in some jurisdictions.
The World Federation for Medical Education will continue to observe the evolution of all of the action lines in the Edinburgh Declaration. Despite evolution of medical education over thirty years since the Edinburgh Conference, the Declaration remains a powerful force for positive development.