2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
CURRENT STATUS AND FUTURE TRENDS IN MEDICAl EDUCATIoN
Shabih H. Zaidi MBBS, DLO–RCP&S, FRCS, FACS, FICS, FCPS Dean and Chairman Academic Council,
The American University of Barbados, School of Medicine
Education is a process that brings about a visible, palpable, Thus arrived the science based curriculum, which we call the
tangible change in a person. It is the hallmark of human Traditional curriculum. It has been in vogue for more than
development and evolution, Cultivating, gathering and a hundred years. There are strong objections and concerns
disseminating knowledge is an art as well as science. Teaching about its relative application today, but it continues to
and learning run pari pasu, as one is incomplete without the function in many parts of the world.
other. Prometheus, a Greek god is acclaimed to have thrown
down an ember from the heavens into abyss of the universe. The main features are its economy in terms of delivery
It was the ember of knowledge which grew into a lamp that through didactic lectures, and subject orientation of a student
illuminated the world. Zeus and other powerful gods did of many elements of health Care. Thus, a pupil can become
not approve of it, and punished Prometheus, just as later day a physician anatomist, physiologist, surgeon and a forensic
lords and the masters did in the early centuries. They felt pathologist; etc. It is teacher centred, presuming that the
threatened with the awakening of mankind and loss of their student has an immature mind and can not decide what is
might.required; so a teacher, a symbolically wise person will decide
for him as to what he needs to learn. Knowles called it the
The first word revealed to Prophet Mohammad in Quran is Pedagogal approach.
Iqra…Read. All religions command and promote knowledge
more than any other element. In early days, education was Many academicians did not approve it. In 1950s McMaster
confined to the elite, and jealously guarded by the monks, came up with an idea of improvising the curriculum and
monasteries, savants, pundits and mullah. Gallelio and tailoring it to meet the students needs of modern times.
Copernicus spoke truth to enlighten the world and were They considered it wiser to teach what is needed to make
heavily punished.pupil a competent problem solver rather an encyclopaedia
Greeks served the cause of education through the sophists and of knowledge with limited applicability. They called it the
the philosophers. Romans did no such thing. They promoted Problem Solving Methods. Maastricht refined it further,
martial arts. That too was a form of education. After all brain and identified its steps to make it more practical. Many
must be cultivated along with the brawn! Then came other universities across the globe have adopted the PBL method
periods and eras. The process continued.in their Academic programs; though many others continue
There are two forms of education. Informal, that begins at
birth and continues throughout life. And formal, that begins No doubt PBL is a fine methodology. It is student based and
at the time of entry into a primary school and all but finishes student centred.It is exciting and challenging, but it has many
with the degree from a higher seat of learning; albeit not for drawbacks. For instance, it is expensive requiring larger
all. Some folks love it so much, that they live only to learn logistic support and lacks a wider knowledge base.
and teach.Many universities are now employing the hybridised version,
Medical education has gone through a seachange over combining didactic lectures as introduction to the topic in
millennia. It was the process of long and enduring a system based, holistic teaching, followed by small group
apprenticeship and Hippocrates, Galen and Hakim Ajmal discussions. PBL is good for mature minds that is after a four
Khan, just to name a few stalwarts, used for the transfer of year liberal arts or graduate degree, as in the US, and Canada,
knowledge and skills to their pupils. A process of osmosis but not if the students enter a medical school after finishing
enabled the chela to imbibe as much as he could from his the high school, as is customary in the Indian sub – continent.
formal medical education in the eighteenth century, but it was In the West, most students are mature enough to delve in the
the Carnegie foundation in US, which gave us the planned luxury of cerebral exercise as they come from a back–ground
education program in the early parts of the twentieth century.of analytical teaching. Even then some universities have
Abraham Flaxner wasEJMR an educationist. He was hired by refused to adapt the PBL culture fully.USMLE is one fine
the Carnegie foundation to design a curriculum in 1910. example where the problem solving strategy is the backbone
His terms of reference were none, but he devised them as of the teaching and learning exercise. It has many good but
a planned activity based upon the knowledge of science of some bad points. The best point of course is that it allows a
contemporary times, with a view to produce a doctor capable young doctor to join the finest health care delivery system
of doing all the basic tasks.in the world, despite its shortcomings and the nuisance of
Managed Health Care as against the Egalitarian approach of
4041 2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
the NHS in UK. The bad point is that the knowledge base transcript, some believe, may seriously jeopardise the chances
in USMLE may be poor at the outset, as it is focused on the of a foreign graduate to gain a residency placement. So should
issues rather than subjects.one scrape D altogether and raise the passing bar to 70% i.e.
The current principle of medical education is..’ Core C grade as the lowest , and if so how should one allocate the
knowledge at undergrad level and more knowledge through marks in the Formative and Summative evaluations.
out life’... Life long active studentship is recommended Finally, the complexities of the credit and contact hours,
by the maestros. So, the deficiencies and lacunae noted so vital of an American system of education is not fully
in undergraduate programs are continual lay filled , and understood by those teaching in different parts of the globe.
replenished.A clear concept of GPA system is also alien to the non
University of Dundee has contributed a great deal in modern American set ups.
medical education. Ronald Harden is a pioneer of radical A contact hour is a unit of measure that represents an hour
reforms. The SPICES model of curriculum designed by him of scheduled instructions given to a student. It is however
and his team is now in practice in many universities.different to a credit hour or credits, which is a unit of measure
Harden’s Spiral curriculum is extremely innovative and the representing the value of time equivalent to an hour (usually
best form of integration of the so called basic and clinical 50 minutes) of instruction or active teaching per week over
subjects . It also integrates the curriculum horizontally. Each the entire term.
subject is imperceptibly yet tangibly merged nay submerged The contact hours and calculation of credit hours is a
into another subject. Revisiting the subjects each semester specialised task. One teaching session of 90 minutes may
or in successive years combing the triangle of education get 6 course credits, and so on. The time of actual teaching
ie knowledge, skills and attitude , can not be betters than or lab work plus self study or preparation are also added
in a spiral curriculum. But it is intensive and exhaustive, according to formula , and the credit hours calculated. for
demanding huge efforts on the part of the faculty as well as instance 290 lecture of 435 contact hours will be awarded
the students.29 credit points.
Another great contribution by that genius is the concept of Currently, the USA accreditation authorities demand a
curriculum mapping. It is so useful that every deanery should fulfilment of quota of 3050 contact hours and between 110–
seriously consider employing it for the main beneficiary 140 course credits for the basic sciences only. The American.
namely the student. A curriculum map not only monitors day University of Barbados is providing 136 credit hours and
to day academic activity but also inter institutional progress,
laterally as well as vertically.2040 contact hours at present .They will reach the limit of
3050 or more in the Fall semester.
In the field of instructional strategies, much debate continues
to rage amongst the academicians. Didactic lectures continue Credit hours are needed for fulfilling the requirements of a
to enjoy the popularity , despite the firm opposition by the degree, diploma, certificate or other awards.
diehard supporters of small group discussions. Lecturing is An MD program is different to an MBBS program in many
an art, which may not need any adventurous support if the ways. They both aim to reach the same goal albeit through a
speaker is fully conversant with communication skills. Many different course of action.
however, believe that additional tools like animations are of
immense value in clarifying the concepts. The ageless quote Rudyrad Kipling , the famous novelist duly highlighted the
that ‘a picture is with a thousand words’ applies more to polarity of cultures and their implications, which would
animation than any other item on the agenda.include education, in one of his writings... ‘The East is East
and West is West’.
Assessment and evaluation are a rapidly evolving speciality.
There are experts within the field of medical education who So, the moral of the story is... Different horses for different
have sub specialised in this field. They continue to evolve courses. It is the job of an educationist to do his utmost to keep
newer and more precise tools for assessment and evaluation.the interest of the student at the highest altar and endeavour
to produce the world leaders in the respective fields with
The debate on the grading system based upon the ABCD honesty, integrity, dedication, and above all altruism.
and F versus pass or fail is another issue. A display of D on a