The effect of healthcare transformatıon ın a Turkısh medıcal school

In Turkey there are 83 medical schools and the oldest six are regarded as the best institutions. Marmara University School of Medicine (MUSM) is one of the 6 leading institutions. MUSM Hospital was delivered to Turkish Ministry of Health (TMoH) for its operational management in 2010. In this study, we aim to assess the current status and trend of productivity and attractiveness of MUSM, by comparing them to other medical schools which are run independently from TMoH. The data between 2010 and 2016 were collected, and eight medical degree programs in 6 medical schools were included in the study. The numbers of publications, ranking in entrance exams and score of graduate students during residency entrance exam, were investigated for comparison. In the ranking of university entrance exams, MUSM ranked 8th in 2010 and dropped to 18th in 2016, while others except one remained stable. When the postgraduate exam for specialist in medicine results were taken into consideration, MUSM ranked 7th in 2008 and 37th in 2016, showing the same downhill slope; while others remained stable or even improved. The ranking of MUSM declined in exams after cooperation, while other medical programs in 5 schools kept their positions or even improved. High work load and low teaching times in pay-for-service system seem to have a negative impact on medical education. Key words: Medical education, pay-for-service, health care reform.