SeriesChanging face of medical curricula
Section snippets
Changes in medicine and society
However indebted new doctors are to individual teachers, few will leave medical school confident that their own medical course has prepared them completely for their chosen career. Whether or not it is inevitable that the curriculum lags behind this challenge, there is no doubt that the content of current courses is under pressure from numerous external forces. Shifts in disease patterns and personal goals are continually altering what society expects of its doctors. The delivery of health care
Changes in curriculum design
The prototype medical curriculum in Europe was a first degree course lasting 5–7 years in which basic sciences, taught in the early years, were sharply demarcated from clinical exerience and learning, whereas a 4-year postgraduate course was the norm in USA. In the clinical years, hospital specialties dominated, and there was little scope for students to pursue individual interests. There was also often little regard for the needs and expectations of the health-care system in which the medical
Changes in curriculum content
The General Medical Council's (GMC) report Tomorrow's Doctors,9 sets out 13 principal recommendations, which have had a major impact on curricula in UK and beyond. Central to the GMC's recommendations is that the burden of factual information imposed on students should be substantially reduced. The GMC recommends learning through curiosity rather than by rote, and stresses the importance of encouraging appropriate attitudes of mind and behaviour. Proficiency in clinical skills is linked to the
Changes in curriculum delivery
As passive absorption of didactically-delivered information has been replaced with active learning, based on curiosity and problem solving, so the teaching methods used to deliver today's medical curricula have also changed. Integrated, problem-based curricula were piloted in sites in North America such as McMaster, and now form the core teaching methods of many universities, including Manchester26 and Liverpool.18 In Australia, six of the 11 medical schools use problem-based learning; the
Implementing curricular change
The challenges of implementing and sustaining curricular reform are well recognised and have been described in a number of studies. At the University of Washington, for example, “curricular drift” developed 5 years after a major curricular reform, with both basic scientists and clinicians showing regression to the mean in terms of reintroducing teaching topics, and expanding teaching time, partly in response to financial pressures. At the University of Trondheim, Norway, the introduction of a
Undergraduate and postgraduate curricula
The concept of a spiral curriculum in which topics are visited and revisited at time intervals, at different levels of intensity, and often with a different emphasis—eg, basic science, pathology, clinical science—has been important in curriculum design in many schools, and also in understanding the relation between undergraduate teaching and postgraduate training.30 A medical course designed to produce a “stem” or “pluripotential” doctor is followed by a programme of specialist or generalist
Achieving change
Medical education is changing rapidly, and many challenges remain for the future. Leadership of change is essential; balancing the need for academic stability, to build up a core of respected and skilled teachers, is at the centre of effective curriculum reform.
Feedback from students and patients is critical. Students will not know initially what they have to face and many parts of the curriculum, clearly vital, will often seem unpopular, so that excellent communication between staff and
References (30)
Medical curricula in European countries
WHO European Center for Integrated Health Care Services
(1999)- et al.
Can general internal medicine be taught in general practice? An evaluation of the University College London model
Med Educ
(1997) - et al.
Academic medicine meets managed care: a high-impact collision
Acad Med
(1996) - et al.
The patient-centredness of consultations and outcome in primary care
Br J Gen Pract
(1999) Revalidation for doctors in the United Kingdom: the end or the beginning?
BMJ
(2000)- et al.
Revalidation in Australia and New Zealand: approach of Royal Australasian College of Physicians
BMJ
(1999) Revalidation of doctors in Canada
BMJ
(1999)- et al.
The primary care specialties working together: a model of success in an academic environment
Acad Med
(2000) Tomorrow's doctors: recommendations on undergraduate medical education
(1993)- et al.
Medical students' evaluations of curriculum innovations at ten North American medical schools
Acad Med
(1998)
Psychological stress and burnout in medical students: a five-year prospective longitudinal study
J R Soc Med
US graduate medical education, 1999–2000
JAMA
The consortium of graduate medical schools in Australia: formal and informal collaboration in medical education
Med Educ
Problem-based medical education: development of a theoretical foundation and a science-based professional attitude
Med Educ
[Medical education in Norway: one common education, four different models]. [Norwegian]
Tidsskrift Norske Laegeforening
Cited by (218)
The Impact on Peer Mentorship After Implementation of a Competency-Based Residency Curriculum in Canadian Radiation Oncology Training Programs
2024, Advances in Radiation OncologyPediatric Resident Confidence in Assessing Neurological Cases: A Nationwide Survey
2023, Pediatric NeurologyThe road taken – changing one's professional focus at a large research university
2020, Developmental BiologyEarly clinical exposure in medical education: the experience from Debre Tabor University
2023, BMC Medical Education