Medical syllabus outdated, full of inadequacies: educationist
Islamabad: The country's current medical curriculum is outdated and replete with gross inadequacies, which have a negative bearing on the character, talents, enthusiasm and performance of a doctor, country's leading medical educationist Prof Dr Anwarul Haque said in an interview.
He warned that the quality of medical education as well as overall healthcare would further dip if immediate corrective steps were not taken.
Dr Haque, who also heads Pakistan Institute of Medical Sciences (PIMS) Pathology Department, said that a critical look at the medical curriculum revealed gross inadequacies, which were directly yet amply reflected in their products i.e. doctors. He said the deficiencies were multidimensional and adversely impacted the character, capability, zeal, care, commitment and performance of a doctor. He said that poorly trained and defectively formed doctors greatly contributed towards 'failed and incompetent' health system.
He said that current medical curriculum didn't educate students about ethical values and impact of costly yet useless investigations.
He said that defective curricula coupled with ill-formed strategies led to the 'killing' of lots of potential medical scientists and researchers. He said like other parts of the world, all stakeholders like teachers, students and community members should be given due share in development and assessment of the medical curricula.
"The students overcome the gross and severe deficiencies of medical education system by their natural abilities and hard work; but at the same time this masks the deficiencies in our medical education system. This is gradually deteriorating the quality of doctors being produced," he said.
He regretted that curriculum evaluation had been limited to the 'whims and inclination' of bodies, which developed medical curriculum, adding no feedback is sought from the doctors, faculty members and medical students.
Dr Haque also insisted that the present pre-medical curriculum was lengthy and the students were burdened by details, which they would never require during the later medical education. "Irrelevant material should be extricated from the curriculum and replaced by useful material. This will require updating the textbooks and training the teachers," he said.
According to him, undergraduate medical curriculum consists of lengthy courses and too much information most of which the students forget after a year or so. He emphasised that learning should be student-centred.
"This requires addition of problem-based learning and tutorials in the teaching methodology, integration of clinical and pre-clinical studies, coupled with a reduction in the redundant and useless factual knowledge, content and minimising the strict boundaries of identifiable," he said.
The educationist also pointed out that the pre-medical years gave too much importance to subjects like botany, which was hardly ever used by doctors in their practical lives. He suggested that instead of botany in great details, practical parasitology, mycology and bacteriology might be taught at pre-medical level.
"Such subjects will not only be useful in medical education but will also raise the awareness level of diseases in general public," he said.
He further said that instead of teaching frog, cockroaches and earthworm anatomy, basic human anatomy and physiology along with their practical applications could be taught to students. He said at all levels, curriculum and teaching strategies should instil better reading, writing, presenting and analytical skills into medical students.
"At medical college level, the distinction between basic and clinical subjects needs to be diluted. There is a need for both horizontal and vertical integration. Basic life saving skills and surgical procedures must be inculcated. All subjects may be taught in an integrated form from very beginning," he said.
Dr Haque said that anatomy of different parts should be preferably taught by the surgeons of respective disciplines.
"Anatomy of head and neck should be taught by the neurosurgeon and ENT surgeon and physiology and pharmacology by respective physician like cardiologist should teach the physiology of heart, vessels and circulation. Histology should be taught by the pathologists, who can bring fresh specimens from the laboratory for students' examination. While teaching a bone for example, the radiologist may show various images, pathologist may show its microscopic structures and relevant pathology and orthopaedic surgeon may show fractures and their implications," he said.
He said if the idea could not be put into practice for any reason, then regular small group clinical discussions of students with respective clinicians and surgeons should be held.
He said that research, presentations and publications along with critical analysis of journal articles needed to be encouraged. He further said that moral and ethical values needed to be strengthened at all levels and in all spheres. "I strongly feel that open debates with open minds and hearts will evolve a health system which is just right for mankind," he said.
He said the country needed to constantly evaluate our curricula and teaching strategies to produce balanced, competent and humane doctors possessing great spark and motivation for hard work, research and teaching. He said medical education must undergo significant change to better prepare physicians for rapidly evolving health care needs.
"There's a urgent need to identify opportunities for improving the four phases of physician education – pre-medical, and medical college education, residency training, and continuing medical education," he said. Daily Times
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