Governance in medical research and education

Background

In the nineties the strong separation between the health faculty and the academic hospital in terms of administration and governance became to experience as artificial and inefficient. Is was necessary to search for a new strategic approach. Since there was nevertheless more and more need for strong  administrative connections, the integration of  the health faculty with the academic hospital was a logical next step.

Aims and targets

• Carrying out patient bound scientific research on  causes and treatment of diseases and bringing this new knowledge to clinical application;  
• Providing high end healthcare to patients with rare and complex diseases, patients whose treatment requires expensive infrastructure, and patients whose treatment benefits from direct interaction with clinical research. Often the UMC functions as last resort;   
• Training healthcare professionals and medical and biomedical researchers in accordance with the very latest insights in the field.

Strategy and actions

To implement this policy the following actions have been undertaken: 

• The executive board  of the university and executive  board of the academic hospital have legal obligation  to establish a common policy body. This policy body approves a document holding the results of the appointments of the university and the hospital concerning medical education and research;
• Separate funding of the academic hospital for its functioning as clinical workplace;
• The academic hospital and the university (health faculty) are legally obliged to make common arrangements for medical  research and education. These arrangements are an prerequisite for funding.

Monitoring and evaluation

To monitor cooperation the plan documents are collected by the Ministry of Education and are analysed.

Funding/Cost effectiveness

Sustainability/Transferability

Outcomes/impacts

Achievements

Graduation: a relatively high percentage of medical students (comparing to other countries) receive a MD and go on to undertake the PHD.
Research output: the Netherlands comes second only to the United States in terms of the number of references to the country's medical publications. Dutch medical and biomedical publications are cited 40% more often than the global average.
Capacity to attract funding: third party revenue: 500 EUR million.

Success factors

Unintended impacts

Strengths and weaknesses

Strengths: Unique combination of research, education, cure by a still ongoing  process of merging medical faculties and university hospitals into an integrated organisational structure (UMC: university medical centre). The combined responsibility for all three main tasks of the UMC’s lies within the executive board of the UMC. It’s – compared to other countries- unique that the Ministry of Education, Culture and Science is involved in funding and regulating academic hospitals.
Weaknesses:  The accountability is complicated because of the mixture of funding sources and because research, education and cure are closely interwoven.

Curricular reform

Funding reform

• New models of funding
• Cost effectiveness
  
  

Governance reform

• Strategic partnerships
  

Management reform