Ex-post Evaluation

1. Background of the Project

From November 1989 to November 1994, a technical cooperation project aimed at basic medical education, “China-Japan Medical Education Center (SJMEC)” was implemented in CMU. Although the Project made considerable achievement, clinical medicine education was not included, and CMU requested another technical cooperation project focused on clinical medicine education to the Japanese Government. Adequacy and necessity of the request was confirmed after the examination. “The Clinical Medicine Education Project for the China-Japan Medical Education Center” was conducted from April 1995 to April 2000.

2. Project Overview

The project’s objective was to contribute to the development of medical education in China by consolidating relevant systems of the clinical medicine education in Japanese at SJMEC.

(1) Overall Goal

To improve medical technology and quality of research in China through the development of medical education.

(2) Project Purpose

To cultivate competent clinical medicine doctors at SJMEC as a central base of clinical medicine education in Japanese, in China.

(3) Outputs

(4) Inputs

Japanese side:

Chinese side:

3-1 Summary of Evaluation Results

(1) Impact

(1) The number of papers published in domestic medical conventions and medical journals was set as the key performance indicator of the overall goal of the Project. According to the result of a questionnaire survey^*, five doctors participated in 11 medical conventions and no papers were published during the Project. After the completion of the Project, they showed better performance, participating in 20 medical conventions and publishing 9 papers.

*The questionnaire was supposed to be sent to twenty-two doctors who attended a special training program during the Project, but since twelve doctors among them are currently studying in Japan, it was sent to ten doctors, and five of them responded.

After the completion of the Project, the counterparts have pursued their studies on the basis of past achievements from the Project and utilized it in the education field.

The twelve doctors are continuing the same study as the Project under the same academic supervisors. All the supervisory doctors remaining in China have become pivotal figures in each department, and two of them obtained research grants (190,000 RMB and 220,000 RMB for each) from the National Nature Scientific Fund.

(2) As for the unanticipated impact, an advanced laboratory management system was introduced from Japan, and at the same time, the supervisory doctors have familiarized themselves with the latest medical technologies.

(2) Sustainability

(1) Organizational Aspects

SJMEC, formerly an independent institution in parallel with CMU, was dissolved after the completion of the Project, and CMU incorporated their functions. The Clinical Medicine Education in Japanese (CMEJ) is under the management of International Exchange Center, Education Administration Department and Students Affairs department in CMU. As a result, the organization management work of CMU has sustainability and has also been improving its role as being the principle place of CMEJ.

(2) Financial Aspects

As noted above, CMU is responsible for the management of the CMEJ and the development of personnel resources of supervisory doctors for the Japanese class. Because of this, financial security is dependent upon the extent of support from CMU. In November 2003, the Liaoning Education Agency dispatched an examination team to investigate the quality of CMEJ, and gave the highest mark to overall education including the Japanese class. It proved that CMU has provided continuous financial support to CMEJ.

It is not possible to take actual statistics of the allocated budget put in CMEJ by CMU, because the Japanese class students have same educational curriculum and clinical training programs as other students.

(3) Technical Aspects

From the aspects of (i) language skill and expert knowledge of teachers of CMEJ, (ii) quality of educational materials in Japanese and (iii) environment of medical education in Japanese, Liaoning Education Agency has changed the Japanese class in CMU from a six-year course to a seven-year course, which includes a Master’s degree program. It is a proof of endorsement on the quality of CMEJ from the government as well as sustainable impact of the Project to CMEJ.

Medical technologies continue its remarkable development still today, and CMEJ materials have been updated in accordance with the National Education Outline.

(4) Sustainability of Project Effects

The counterparts obtained sufficient knowledge and skills of clinical medicine from the Project, and they have been able to continue their research activities on their own. When the Project was completed, most of them were lecturers, and since then, while continuing their research in the respective areas, they have been teaching in the CMEJ class. Based upon the results of achievement, some of them obtained Master’s degree, PH.D and post PH.D titles. Seven of them have been promoted to professional or vice professor status from assistant teacher and lecturer level. Two of them are in the director’s position. The above fact in addition to award-winning status from the National Scientific Fund reflects the sustainability of the Project.

It has shown an impact with its status as the core of CMEJ. In order to evaluate one of the project effects as a center of CMEJ, a questionnaire survey was conducted targeting the former Japanese class students. Most of them are now in a lecturer’s position, which is the same as the entry-level of counterparts of the Project. All the students were able to pass the National Physician Certification Examination, and the graduates from 1996, 1997 and 1998 have already become lecturers. The number of CMEJ students has increased continuously since the completion of the Project, reaching 60 in 2003. These facts prove the relatively high sustainability of the project’s effect as a centre of CMEJ.

3-2. Factors promoting sustainability and impact

(1) Factors concerning to Planning

As a commitment of the Chinese government, detailed provision in respect to required skills for clinicians and assistant clinicians was included in the National Physician Qualification Examination, contributing to the evolution of CMEJ.

(2) Factors concerning to the Implementation Process

CMEJ was the top priority project of CMU since before the JICA project started. It helped conduct the Project smoothly and facilitated its sustainable development after the completion of the Project. The SJMEC’s integration into CMU resulted in receiving continuous support from CMU technically as well as financially

3-3. Factors inhibiting sustainability and impact

N/A

3-4. Conclusion

After the completion of the Project, SMJEC also completed its role as an independent educational institute, and all the functions including personnel and education systems were integrated into CMU. Judging from the subsequent progress of CMEJ, it is obvious that the Project significantly enhanced the quality of CMEJ as well as the ability and skill of supervisory doctors. The textbook compiled for the Project has been revised continuously, and facilities of clinical medicine education helped to improve the overall quality of the clinical training and the affiliated hospital. All of the facts above prove that CMEJ has high sustainability in terms of organization, personnel, technology and finance.

During the three years after the completion of the Project, the counterparts have worked for further research based on the achievement of the Project period, and have used their knowledge in actual clinical trainings.

3-5. Recommendations

(1). Recommendations to CMU

The counterparts should put more efforts on public relations in respect to the achievements of the Project to disseminate their findings throughout the health industry so that other medical institutions can also benefit from it.

The counterparts should understand advanced management technology in addition to learning overseas medical technologies (from Japan), and carry out management system reforms accordingly. As technical matters are not the only issue that China faces, management reforms should be strengthened.

(2) Recommendations to JICA

JICA needs to strengthen follow-up activities of the Project by sending exceptional and experienced supervisory doctors to Japan again, in order to further enrich the research that they carried out in the Project.

3-6. Lessons Learned

When drawing up a plan for a project, it is important to adopt an appropriate cooperation method in order to reconcile the Project purpose and the long-term goal of the host country. The Project has perfectly satisfied the demand of the host country in the medical education area through the enhancement of CMEJ. In addition, careful consideration is necessary with respect to the pros and cons of creating an independent entity for a project. The most important thing is not to create an independent entity but to provide and evolve knowledge and technology, thereby promoting development in a particular area. Creating a new entity is not necessarily the best plan to adopt; the ideal way is to develop and enhance necessary ability of an existing organization in accordance with its capacity. JICA is able to develop and enhance the ability of an existing entity, while it is outside of their control to keep a new entity developed for the Project after its completion. The implementing section in China does not necessarily have the capability, either.

3-7. Follow-up Situation

N/A