Changing social demands made it necessary for the Medical Faculty of the University of Malaya to accommodate students with a wider range of academic experience than before. However, teachers sought to achieve comparable academic standards to those in the West by striving to maintain a close resemblance to the Western model of medical education in other respects. As a result teachers failed to adapt their teaching methods, assessment techniques and curriculum design to meet the educational needs of the students, thus compromising academic standards. Many students lack basic academic skills and do not know how to learn effectively. In order to help students overcome their learning difficulties innovative teaching was required during the first year at university, designed to foster the joint development of knowledge and basic skills. In the case of less well-prepared students who lack self-confidence, a caring and supportive learning environment is crucial to the achievement of meaningful learning. Lecturers needed to become facilitators of learning rather than transmitters of knowledge. However, teachers' objective to retain international recognition of the degree, which presumably reflected the importance of teaching, was not operationalized in terms of its incentive structure such that teachers were constrained not to try to fill the new roles demanded of them. It was assumed that academic distinction accrued through scientific research was essential for the achievement of academic excellence. However, under the prevailing circumstances the two aims were mutually exclusive and incompatible and teaching quality deteriorated.
Medical practice is changing, and the foundations of the paradigm shift lie in the development in research over the last four decades. Today, it is no longer adequate to treat a patient purely on clinical experience alone without a clear demonstration of evidence based on research, particularly the use of randomised controlled clinical trials. What is thought to be an effective mode of treatment currently may not necessarily hold true by the time medical students begin his/her medical practice. As a consequence, many medical schools worldwide are increasingly promoting evidence-based medicine (EBM) teaching in their medical curriculum along with problem-based learning (PBL). Teaching of EBM requires a paradigm shift in itself, as students must possess additional skills that are not traditionally part of medical training. These include the ability to acquire the skills in 'means of answering questions' than just 'knowing the answer to questions'. This paper aims to describe what EBM is and to highlight the formative experience of the teaching of EBM at the medical undergraduate level in the University of Malaya. Challenges and opportunities towards successful adoption of evidence-based practice are discussed.
The New Integrated Curriculum at the Faculty of Medicine, University of Malaya, Which comprises three major longitudinal strands, was first implemented in 1998 to provide better integration of clinical and basic medical sciences. One of these longitudinal strands, the Doctor, Patients, Health and Society (DPHS) module, emphasizes the importance of developing good communication skills as well as introducing students to behavioural sciences, public health medicine, statistics and epidemiology. Community Family Case Studies (CFCS), within this module, have been used as a means for students to focus on these aspects, as the students are introduced to patients, their families and their community in Year 1 of the medical course and are required to follow them up throughout their five-year training period.
Critical appraisal refers to the skill of reading a piece of research in a very objective and structured way. It allows for the reader to assess the quality and validity of the evidence put forward. With the emphasis on evidence-based practice in the medical profession, the ability to critically appraise the literature should be instilled into medical students. Currently, the push to encourage research shows great effort in the medical curriculum, through the incorporation of elective research programmes, by many medical institutions. But how ready are the students to even understand the research literature, let alone conduct a research? The current system throws these students into 'the deep end' of research conduct without equipping them with the tools necessary to do so. Very often this becomes a problem that snowballs through specialist training right up to the practice of medicine. The possibilities and means of introducing the skills of critical appraisal via the curriculum should be explored. In this age of self-directed and problem-based learning, a purely didactic teaching method of "how to read the literature" is surely outdated. The concept should be integrated into medical teaching, including within the implementation of the PBL system, in both the clinical and non-clinical settings, and by the introduction of the 'journal club' concept. Training of the trainers should also be considered. With the early training of critical appraisal, it can hopefully become an unconscious competence of medical graduates, who not only can produce quality research, but also able to identify quality information.
A cross-sectional study was carried out through a postal survey of a random sample of registered medical practitioners in Malaysia to explore the pursuit and practice of CAM among them. A response rate of 42% was acquired. 27.1% of the medical practitioners are currently using CAM on themselves or their own families and 22.2% actually have referred patients to CAM practitioners. Analysis showed that only 14.9% of the medical practitioners who responded were exposed to CAM during their undergraduate days. Out of 28 respondents graduated from USM, 15 (53.6%) were exposed while out of the 80 graduates of UM, only 6 (7.5%) were exposed and out of 58 respondents graduates of UKM, only 5 (8.6%) were exposed to CAM during their undergraduate teaching. These differences are statistically different (p < 0.001). Analysis also showed that more (72.6%) medical practitioners are for having training in CAM during the medical undergraduate studies. Only 9.1% of the respondents have attended any training in CAM post graduation and 36.8% would like further training on CAM postgraduate and would pay for it. The findings illustrate the need for training in CAM in medical undergraduate education especially in this new age where alternative therapy is in demand by the consumers.
Mental health is becoming an important issue. Several local and international studies have proven that the incidence of mental illness is on the rise. Doctors have also been able to make more accurate diagnoses and treat mental disorders more reliably with the aid of recent research and newer drugs. As such it is necessary for the medical curricula to respond to this shift. Medical students must now be exposed to new psychiatric disorders and ways of managing them. The time spent in psychiatry and the mode of teaching must also be revised and modified to the current needs of patients.
OBJECTIVE: The objective of this survey was to obtain a self-reported assessment of the use of Information and Communication Technology (ICT) by medical students at the International Medical University, Malaysia.
MATERIALS AND METHODS: Students' perceived skills and extent of usage of ICT were evaluated using a questionnaire. Chi-square analysis were performed to ascertain the association between variables. Further statistical testing using Chi-square test for trend was done when one of the variables was ordered, and Spearman rank correlation when both variables were ordered.
RESULTS: Overall, (98%) of students responded to the questionnaire. Twenty seven students (5.7%) did not use a computer either in the university or at home. Most students surveyed reported adequate skills at word processing (55%), e-mailing (78%) and surfing the internet (67%).
CONCLUSION: The results suggests that in order to increase the level of computer literacy among medical students, positive steps would need to be taken, for example the formal inclusion of ICT instruction in the teaching of undergraduate medicine. This will enhance medical students' ability to acquire, appraise, and use information in order to solve clinical and other problems quickly and efficiently in the course of their studies, and more importantly when they graduate.
This paper outlines issues related to curricular reforms, and strategies to be considered for planning and implementation so as to ensure that the change is institutionalised. In Malaysia, in general, some imminent curricular changes have been carried out to prepare graduates for future changes in the practice environment. Change of reform requires planning, with consideration of the directions in which the change is needed, and the possible educational approaches to be utilized. To ensure change can occur and be maintained there should be effort to induce a paradigm shift amongst teachers and administrators at all levels, there must be transparency and dissemination of information of the required change and why, there must be involvement of teachers in decision making to ensure better compliance.
OBJECTIVE: This paper compares the clinical experience in acute conditions of the undergraduate students of a medical school from a developing country (Malaysia) with those from a developed country (UK).
METHODS: This study was conducted at the School of Medical Sciences, Universiti Sains Malaysia (USM). Through questionnaire survey enquiry was made about 27 acute medical conditions (i.e. conditions related to internal medicine, paediatrics, and psychiatry), 15 acute surgical conditions (i.e. conditions related to general surgery, orthopaedics, ophthalmology, otorhinolaryngology, gynaecology and obstetrics), 15 surgical operations and 26 practical procedures. The results obtained were compared with published data from the UK.
RESULTS: Acute medical conditions were seen by higher number of the USM students but with less frequency than the British students. The USM students saw practical procedures more frequently than the British students did, but almost an equal number performed these procedures independently. The British students attended surgical operations more frequently than the USM students did.
CONCLUSION: Given the limitations of comparison (epidemiological, cultural and geographical differences, conventional curriculum (in the British medical schools) vs. problem based learning curriculum (in the Malaysian medical school)) the overall clinical experience of the medical students in the USM and the UK was comparable. The USM students had more opportunities to observe cases and procedures but "hands on" experience was similar to that of the British students.
The Russian Federation of higher medical institutions get State accreditation, if their activity conforms to criteria determined by the Ministry of Public Health and the Ministry of Education of the Russian Federation. Kursk State Medical University (KSMU) has a confirmed to requirement of accreditation by the Russian Federation, to conduct annually training of about 5000 students at 12 faculties. KSMU carries out pre-medical undergraduate and postgraduate training in the specialty "Doctor of medicine". For the first time in Russia KSMU was allowed to conduct a 6-year medical training with the use of English as an intermediary language by the Ministry of Public Health and the Ministry of Education. In this relation programmes of training teachers for conducting instruction with the use of an intermediary language (English) and training students Russian with the level necessary for free communication with Russian patients and staff of the clinics have been developed and realized.
Undergraduate medical training program accreditation is practiced in many countries, but information from developing countries is sparse. We compared medical training program accreditation systems in nine developing countries, and compared these with accreditation practices in the United States of America (USA).