gms | German Medical Science

The structure of Medical Education in Europe: Implementing Bologna – On the way to a European success story?
International Conference hosted by the German Rectors' Conference (HRK)

10 - 11 October 2008, Berlin

International, national and institutional use of the Bologna Model implemented at the Iuliu Hatieganu University´s Medical School - impact on medical education

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  • corresponding author presenting/speaker Anca Buzoianu - University of Medicine and Pharmacy 'Iuliu Hatieganu', Medical Faculty, Cluj-Napoca, Romania
  • A. Achimas - University of Medicine and Pharmacy 'Iuliu Hatieganu', Medical Faculty, Cluj-Napoca, Romania

The Structure of Medical Education in Europe: Implementing Bologna – On the way to a European success story?. International Conference hosted by the German Rectors’ Conference (HRK). Berlin, 10.-11.10.2008. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc08hrk21

doi: 10.3205/08hrk21, urn:nbn:de:0183-08hrk215

Published: January 13, 2011

© 2011 Buzoianu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: Romania signed the Bologna Declaration on the 19th of June 1999, joining other 45 European countries, which accepted to involve themselves actively in fulfilling the established goals. The Romanian Republic participated actively on the meetings in Prague 2001, Berlin 2003, Bergen 2005, London 2007, and Leuven 2009.

The Bologna Process is a European reform process aiming at the creation of the ‘European Higher Education Area’ until 2010. It is actually joined by 46 countries in co-operation with international organizations such as the European Council.

The Bologna Process is not a treaty. It has a flexible structure; therefore the implementation of agreed principles is up to each of the involved countries.

According to this process, the European Higher Education Area should be organized as followed by 2010 and beyond:

  • Simplified movement from one country to another for study or employment.
  • Increase of attraction towards the European Higher Education Area and labour market for non-European citizens.
  • Provision of high quality education contributing to the development of European countries within a stabile, tolerant, and peaceful community.

The Bologna principles stated in the Bologna Declaration (1999) are

  • adoption of a system of easily readable and comparable degrees.
  • adoption of a system essentially based on two main cycles, undergraduate (Bachelor) and postgraduate (Master and Doctorate/PhD).
  • adoption of a system of credits - such as the European Credit Transfer System (ECTS).
  • promotion of mobility by overcoming obstacles to the free movement of students, teachers, researchers and administrative staff.
  • promotion of European co-operation in quality assurance.
  • promotion of the European dimensions in higher education.

During the Prague meeting (2010), the following principles were added:

  • Promotion of Life-Long Learning (LLL).
  • Promotion of student’s participation (in all decisions and initiatives at all levels).
  • Promotion of the attractiveness towards the European Higher Education Area.

From the Berlin meeting (2003):

  • Establishment of the European Research Area as main support for a knowledge-centred society.

In this contribution, the Faculty of Medicine of the University of Medicine and Pharmacy 'Iuliu Hatieganu' in Cluj-Napoca will present how it adapts its curricula, particularly its medical curriculum to these principles.

Curriculum development: The Medical Faculty of Cluj offers six undergraduate curricula: Medicine (360 ECTS, 6 years, Midwifery (240 ECTS, 4 years), Nursing (240 ECTS, 4 years), Radiology and Medical Imaging (180 ECTS, 3 years), Clinical Laboratory (180 ECTS, 3 years) and Physiotherapy and Medical Recovery (180 ECTS, 3 years).

Earlier as the Bologna Process started, the Medical Faculty initiated already in 1996 curricula reforms. Main goal was the implementation of principles such as introducing student-centred, flexible, and life-longlearning didactic formats to stimulate independent critical and analytical thinking with the use of scientific methods, to develop social, ethical, and economic and communication skills as well.

From 2002 on the Medical Faculty was, in Romania, the leading higher education institution in the negotiation process on European Parliament’s Directive 93/16/EEC and 2005/36/EC about the recognition of diplomas and qualifications in higher education.

Implementation of Bologna Recommendations

1. Adoption of a system of easily readable and comparable degrees

Within the European Higher Education Area, EU Parliament’s Directive 2005/36/EC Art. 24.2 defines that ‘basic medical training shall comprise a total of at least six years of study or 5 500 hours of theoretical and practical training provided by, or under the supervision of a university’.

In Romania, the criteria to become recognized in the Diploma Supplement have been implemented into the curricula of all medical faculties in accordance with the Law on Medical Curricula OMEN3659/200 and OMEN3741/200 Art. 20c from 2005. In consequence, university diplomas are accompanied by supplements to assure international transparency and enhancing professional integration. It contains brief information in both Romanian and English language about the attended curriculum to secure a save practice of medicine.

2. Adoption of a system essentially based on two main cycles, undergraduate and postgraduate

Introduction of the system consisting of a 2-cycle structure in medical education is perceived at this moment with concern about possible negative consequences for the medicine curriculum. Up to date, at the Medical Faculty of Cluj efforts have been concentrated on an integrative spiral curriculum. This curriculum stresses upon the early integration of basic study objects and clinical science as being essential for the training and education of competent doctors who are going to have a competitive integration on the European health services market. This type of curricula does not allow the curriculum to become fragmented into two cycles; such separation is against the integrative spiral principle. Meanwhile, based on the spiral principle the medical faculty has implemented Master curricula with 3, 4, or 6 year duration based on 60 credits per year.

3. Adoption of a system of transferable credits - the European Credit Transfer System

Implementation of the essential principle of adoption a system of transferable credits – as the ECTS – is necessary for achieving an increased flexibility in the study process to ensure credit accumulation and transferability.

At the same time, it supports the access of graduates on the European labour market and ultimately contributes in increasing the attractiveness of the European Higher Education Area. ECTS’s fundamental principle implies that 60 credits represent the entire workload for a student per year, 30 credits for each semester. The credits for a discipline cannot be fragmented.

In case of student movement, there are four compulsory ECTS documents to regard:

The Student Application Form
The Learning Agreement,
The ECTS Study Guide (Course Catalogue) and
The Transcript of Records.

At the Medical Faculty of Cluj, as well as in the entire Romanian higher education area, implementation of the ECTS was introduced by law in 2005. Each discipline became assigned a certain number of credits which the student accumulates by graduating the exam.

Initially, credits were allocated after the number of course hours, practical activities, and clinical internships as contact hours. This allocation method, does not meet the definition and signification of the ECTS. Therefore, the Medical Faculty is now undergoing a process of re-calculating ECTS credits considering student’s workload for each discipline.

However, the faculty is not yet prepared to implement the third approach of ECTS allocation, implying learning outcomes ( In order to achieve a correct and steady implementation of the ECTS, and student evaluation criteria, there is the need to define for each discipline its specific teaching and learning activities. These definitions will result in precise descriptions of the curriculum units (as modules and courses), their contents, level, learning/teaching methods, and evaluation, in the faculty’s ECTS Study Guide (

4. Promotion of mobility

The Bologna Process has as one main goal the continuous growth in international student mobility by increase in transparency, diploma recognition, financial support, foreign language courses, and involvement of student associations to organize this mobility. The Medical Faculty of Cluj promotes students’ mobility through bilateral and multilateral partnership within the Erasmus framework, the Central European Exchange Programme for University Studies CEEPUS as well as through the national programme TransMed.

Every year many students participate in international mobility programmes in whose selection student organizations are actively involved. At the university level there is an International Relations Department dealing with co-ordination of student and teachers mobility within European programmes. In each faculty, there is an ECTS responsible person to coordinate the recognition process of studies carried out abroad and the validation of these studies.

5. Promotion of European co-operation in quality assurance

To achieve this high priority goal of the Bologna Process the Medical Faculty of Cluj is involved in a variety of international organizations, such as the World Federation of Medical Education (WFME), the Association for Medical Education in Europe (AMEE), the Association of Medical Schools in Europe (AMSE), the International Federation of Medical Students Associations (IFMSA), the European Medical Student Association (EMSA), and activities as the European Thematic Network Project MEDINE (financed by a grant from the European Commission 114063-CP-1-2004 -1- UK- Erasmus – TNPP) to increase its competences in the field.

6. Promotion of the European dimensions in higher education

Considering the aspect of promotion of the European dimensions in higher education the Medical Faculty of Cluj has ensured for its students the opportunity to improve their foreign languages skills. The main foreign languages English, French, and German are scheduled in the faculty’s curriculum as both compulsive and optional courses. Even faculty have been evaluated for their foreign language skills. To assure language competences of both students and faculty, the university offers foreign languages courses taking into serious account that curricula are offered in English and French.

7. Promotion of life-long learning

Life-long learning is an essential element in building the European Higher Education Area (, (, [1]. Within the Medical Faculty of Cluj continuous medical education (CME) and, more complete, continuous professional development (CPD) promote life-long learning through modern interactive teaching methods, long distance courses and, particularly, offering students individual learning packages depending on their skills and abilities by a diversity of electives and optional courses.

8. Promotion of student's participation (in all decisions and initiatives at all levels)

Implementation of the principle that students should participate in all university’s decisions and initiatives involves a necessarily close partnership between higher educational institutions and students as beneficiaries of the educational act. In Romania, the recognition of students as competent, active, and constructive partners is stipulated by the Law on Education: students should be represented in 25% of all academic and administrative structures being actively involved in taking decisions.

9. Promoting the attractiveness of the European Higher Education Area

The Medical Faculty of Cluj is highly engaged in promoting the attractiveness of the European Higher Education Area through attractive training and educational offers for both European and non-European students.

This engagement resulted on success by implementation of English and French teaching programmes. These programmes were introduced in 1997 (English) and 2000 (French) respectively, undergoing continuous improvements. Nowadays, these programmes show about 1,000 students (30% of faculty’s student body) enrolled from 54 countries around the world.

Cluj’s Medical Faculty has the biggest number of foreign students in Romania. This is because of its attractive educational offer, skilled academic lecturers, and a convenient study environment. Its balanced student/teacher ratio (5:1) allows intensive practical learning experiences and direct patient contact what is characteristic for Romanian medical education. Professional and cultural integration of the foreign students is one of the big challenges for faculty and university to accept. Its multicultural dimension is experienced as a great gain and opportunity for professional and personal development of both teachers and students.

10. Establishment of the European Research Area – as main support for a knowledge-centred society

In accordance with legal stipulations of the issue to support the establishment of the European Research Area, the PhD programmes on the University of Medicine and Pharmacy ‘Iuliu Hatieganu’ Cluj-Napoca have been organized within a ‘Doctoral School’. This school offers one year of advanced doctoral education: 60 ECTS credits to become awarded by the study of several disciplines as, for example, scientific research methodology, scientific research ethics, research legislation, and publishing – with the aim to improve the research abilities of its students. Beyond this, a 2-year training programme on Scientific Research Methodology, honoured with a Master Degree has been established.

Conclusion: The implementation of a 2-cycle structure (Bachelor and Master) in medical education does not suit our faculty’s medical curriculum. For the moment, the Medical Faculty of Cluj is concerned about the possible negative consequences involved by the implementation of two cycles. However, in spite of this opinion this structure has been implemented in short study programmes with dimensions of 180 and 240 ECTS. Though the faculty cannot agree upon the 2-cycle structure, it has applied the rest of the Bologna principles as a continuous and dynamic process.

In order to improve, before acting and thinking on local level, institutions must have a global view upon the implications of creating the European Higher Education Area after 2010.


WFME. Global Standards for Quality Improvement, Basic Medical Education. Copenhagen: WFME Office: University of Copenhagen; 2003. Available under: External link