PHA-Exchange> Press release on MEDICAL EDUCATION -

[Claudio]

Press Release on Medical Education

Health care has been evolving through out the evolution of humanity. The practice of medicine however has undergone drastic changes during the past three or four decades with a plethora of new inventions and ideas that have resulted in it being very dynamic and interactive. On the contrary the medical education, which had followed the evolution of medicine in the early stages, has changed very little over the past three or four decades, comparing to the enormous changes in the medical practice.

The objective of medical education is to train young persons and equip them with the necessary knowledge and skills to respond to the health needs of the people and to assist these people and the state to achieve their health objectives. In today's continually changing health care environment, there is serious concern that medical students are not being adequately prepared to provide optimal health care in the system where they will eventually practice. 

The following are some of the shortfalls and reasons identified in the existing medical curricula in many developing countries' medical schools: 
* Lack of communication between health authorities and the medical schools
* No feed back given to medical schools regarding skills, knowledge, attitudes and competencies
* No balance between curative and preventive medicine and Curative based training makes students believe that drugs are powerful weapons  
* Predominance of departmental, subject oriented curriculum linked to high technology medicine 
* Primary Health Care (PHC) considered as the most important pathway to achieve Health For All (HFA) is poorly reflected in the medical curricula; Low priority of community health
* Medical ethics, Equity and Human rights have little place in the training
* Teacher dependent learning process and communication between teachers and students strictly one-way
* The social, economic and cultural dimensions of ill health are not addressed properly

If attitudes, behaviour, responsibility and interpersonal skills play a pivotal role in making a desirable doctor the selection criteria should not be solely on the aggregate marks or points. Access to medical education is not evenly distributed among various geographical and social groups in many counties. There should be ways and means to recruit medical students and other health workers from the range of backgrounds that makes up any society. 

Training the medical students into rational health care providers and rational prescribers is said to be the biggest challenge for any undergraduate medical education system. Irrational prescribing is widely reported in many teaching hospitals, while clinical teaching of undergraduate students is often insufficiently planned and supervised. This position paper deals with undergraduate medical education that should strengthen and sharpen the skills of the medical undergraduates to be tomorrows' care providers, decision makers, communicators, community leaders and team members. 

Based on the analysis of the evidence presented this paper, while recommending many general changes to take place in the curriculum, particularly emphasizes that the following areas pertaining to rational health care should be sufficiently emphasized in medical training:
* The need for formulating and implementing a National Drug Policy as an integral component of the overall National Health Policy and the concept of essential drugs and their rational use to be included in the National Drug Policy;
* The need for a more equitable allocation of the limited health care resources available in a country to enable a shift from hospital based, high technology curative medicine to community based primary health care
* The ability of the graduates to critically evaluate the promotional material put forward by the private pharmaceutical industry;
* The criteria necessary for weeding ineffective, irrational, needlessly expensive and harmful drugs and dosage formations from the market;
* The need for objective continuing medical education of practioners
* The need to communicate effectively to patients in a language they can easily understand to ensure that they become active members of the health care team

For further information contact: 
Information & Communications Officer, Health Action International Asia Pacific,
Email: passanna at haiap.org

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