Dermatology is a minor module in internal medicine undergraduate curriculum. Limited time is allocated for its teaching. Most graduates are inadequately prepared to diagnose and manage skin diseases. We aimed to identify the core content of a more effective dermatology module.
Background: Clinical reasoning is the name given to
the cognitive processes by which doctors evaluate and
analyse information from patients. It is a skill developed
by experiential learning and is difficult to assess
objectively. The script concordance test, an assessment
tool introduced into the health sciences about 15 years
ago, is a way of assessing clinical reasoning ability in
an objective manner and allows comparisons of the
decisions made by medical students and experts in
situations of uncertainty.
Methods: Twenty-six final year medical students from
the International Medical University, Kuala Lumpur,
were tested on their decision making skills regarding a
young febrile patient. The students evaluated different
pieces of information in five different scenarios and
made decisions on a five-point Likert scale in the
standard format of the script concordance test. Their
decisions were compared to the decisions of a panel of
experienced clinicians in Internal Medicine.
Results: The script concordance test scores for the
different scenarios were calculated with higher scores
being indicative of greater concordance between the
reasoning of students and doctors. The students showed
poor concordance with doctors in evaluating clinical
information. Overall, only 20 percent of the choices
made by students were the same as the choices made by
the majority of doctors.
Conclusion: Medical students vary in their ability to
interpret the significance of clinical information. Using
the script concordance test, this preliminary study looked
at the ability of final year medical students to interpret
information about a patient with a febrile illness. The
results showed poor concordance between students and
doctors in the way they interpreted clinical information.
The script concordance test has the potential to be a
tool for teaching and assessing clinical reasoning.
BACKGROUND: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done.
AIMS: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization.
MATERIALS AND METHODS: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences.
RESULTS: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301 participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects.
CONCLUSIONS: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.
KEYWORDS: China; First year medical students; Malaysia; Medical Education; Post-Graduation; SAARC country
Context: Community-based medical education (CBME) has become widely accepted as an important innovation in undergraduate medical education. In curriculum featuring CBME, students are acquainted with the community early in their studies however; the impact of this training can be judged best to see them practice the required aspects of CBME. Malaysia is a multiracial country with a very strong community dependant life style. Main national health problems have called for a change in health profession education from traditional hospital based health care to community-based delivery system. Three major university's medical schools that either practice community oriented or community based medical education in undergraduate medical curriculum are evaluated. Universiti Sains Malaysia (USM) has a community based medical education (CBME) curriculum as Community and Family Case Study (CFCS) compared to a community oriented education curriculum (COE) adopted by Universiti Malaya (UM) and Universiti Kebangsaan Malaysia (UKM). However, UM at the time of undertaking this study back in 2005 was though practicing COE has also later opted CBME as CFCS.
Objective: To determine whether medical graduates from USM with a community-based medical education in its curriculum for more than 25 years are inspired to have stronger commitment towards community health as shown in their on-job practice of medicine compared to other graduates from UM and UKM, who have adopted community-oriented medical education program.
Method: A questionnaire-based pilot study with 12 items (variables) was designed to obtain supervisor's opinion on commitment of interns towards the health of community they serve. The questionnaire was administered to a randomized group of 85 specialists supervising the internship training program in five major disciplines including internal medicine, surgery, orthopaedic, gynaecology and obstetrics and paediatric medicine. The data received from 62 respondents from five major disciplines was analyzed utilizing SPSS version 12.0.1.
Result: The responses received from 62 supervisors on an inventory in which 9 out of 12 variables were directly related to community commitments of interns. It was shown that the USM graduates who were taught through a CBME curriculum have performed better than the graduates from UM and UKM who followed a COE curriculum. P-value (< 0.001) was highly significant and consistent with higher mean score in those variables.
Conclusion: The graduates taught through a CBME curriculum performed better in community commitments towards patients care compared to graduates from COE curriculum.