Medical Education: Current Issues and Solutions
The education system of Pakistan is far from perfect. The students get admitted to medical colleges after a nerve wrecking competition only to be entangled in an interconnected web of problems,where one issue triggers another and one cannot pin point the cause of problems in medical education system to a single source.What our education system lacks is innovation, autonomy and rigorous assessment. Instead of prompting the students to think and question, our students are taught passively, with absolutely no motivation or reward apart from passing a certain number of exams.
If we are to solve a problem, first we have to identify the problem. This can be done by conducting extensive researches on the education system, the syllabus, teaching strategies and student satisfaction etc. There are very few researches conducted in Pakistan and even fewer researchers. As a result there is hardly any data which means we have little information on the epidemics and endemics prevalent in the country and as a consequence, our syllabus comprises of books from foreign authors with more stress on diseases that are prevalent in developed countries instead of focusing on locally endemic diseases e.g. Alzheimer’s disease is given more significance in the books than tuberculosis(TB), whereas TB in Pakistan comprises 62% of the regional TB burden.
Poor retention of students in the country after graduation can be attributed to the fact that the doctors are taught more about international crisis and diseases rather than the problems at hand. This in turn alienates them to the local problems. WHO is promoting a community oriented medical education via its projects and many countries have restructured their medical education to meet the demands of the community. On the other hand, a recent survey by WHO showed that even though maternal and infant mortality is high in Pakistan, very few doctors were skilled at performing newborn resuscitation.
Community oriented education is the need of the hour. Support should be provided to students conducting researches along with other incentives to promote critical thinking and innovation among medical students. The syllabus for medicine is taught in 5 years; basic sciences in the first two years and special medicine in the later years. This should be converted into semester system with patient interaction starting from day one following an organ-system approach.
Such strategies will not only give students a superior problem based education but will also prevent overlapping of concepts. This system has been implemented in a few medical colleges like Aga Khan University and Dow University of Health Sciences and should be implemented in the rest of the country as well. Moreover, the class lecture should focus more on students-centered activities and discussion. Another cost effective and innovative way of teaching would be to start online projects like edX by Harvard and COURSEARE etc. wherein a single website is designed for online medical education.
Medical students should have access to all the free courses, contributed by every registered university under PMDC. This will not only increase the quality of education by giving access to free courses round the clock but also to students from all over Pakistan will get opportunities to interact among each other increasing medical collaboration. Another problem is untrained faculty, even if a doctor is an excellent physician, he is not necessarily a great teacher. There should be a defined set of criteria all over Pakistan, chalking out the minimum requirements for eligibility of teachers.
There is also a lack of student counseling and guidance which can be tackled by establishing departments for medical education and assigning advisers to students from the faculty. Our current system is evaluated by PMDC once a year by examination evaluation and once every 5 years by a detailed assessment; however, there is no qualitative assessment and measure of student satisfaction at all. Surveys devised by educational psychologists should be conducted at the end of every year to check the kind of problems faced by students and proper ways to alleviate these problems, moreover, while devising any educational policy, educational psychologists must be included along with student representatives to ensure an education policy and syllabus that is both quantitatively and qualitatively productive, devised within minimum resources and promotes inter-sectoral collaboration.
In a nut shell, our current medical education requires a huge shift from orthodox syllabus, method of teaching and educational policy to student friendly, research oriented flexible education that embraces new studies with the changing demands of medical system. This can only be achieved by hard work and collaboration on all fronts.
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2. ArshiaSaminNaqvi,Problems of Medical Education in Pakistan.JPMA November, 1997 4261 available at: http://www.jpma.org.pk/full_article_text.php?article_id=4261
3. WHO EMRO: Estimation of TB burden in Pakistan available at: http://www.emro.who.int/tuberculosis/infocus/estimation-tb-burden-pakistan.html
4. M. A. Bangash,Pragmatic Solutions for Problems in the Undergraduate Medical Programmes in Pakistan.JPMA July, 2002 2317 available at: http://jpma.org.pk/full_article_text.php?article_id=2317
5. WHO: WHO consultation on the transformativescale-up of medical, nursing and midwifery education,First technical reference group meeting:medical education experts June,2010. available at: http://www.who.int/hrh/resources/medical_experts_first_meeting.pdf
6. http://pakedu.net/pakistani-education-news/medical-colleges-urgede-in-semester-system/ 7. http://www.pakistanherald.com/Article.aspx?chk=1&art_id=2394
About the Author: Muneeba Azmat is a student of 4th year M.B.B.S studying in Ayub Medical College, Pakistan. She can be reached at [email protected]
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