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UNDERGRADUATE MEDICAL
CURRICULUM IN MALAYSIA: IS
BANGLADESH READY TO ADVANCE?
atm emdadul haque
Faculty of Medicine, Universiti Kuala Lumpur
Royal College of Medicine Perak, Malaysia
“Realizing Quality in Medical Education: Opportunities & Challenges”
May 13, 2017
HEALTHCARE CHALLENGES AND TRENDS
Rising costs
Changing demographics
Filling the resource gap
Easy access
Focus on quality
Becoming customer-driven
cgi.com/health© 2014
CGI GROUP INC.
The American medical educational system has come under attack for its failure to train and prepare physicians for the challenges created by the changing health care market.
The medical schools have been criticized for producing too many specialists and for not providing sufficient training in ethics and moral reasoning, care of the terminally ill, health care economics, alternative medicine, and the role of spiritual and religious values in healing.
Patel K. Physicians for the 21st century. Challenges facing
medical education in the United States. Eval Health Prof. 1999 Sep;22(3):379-98.
The central mission of medical education is to improve the quality of healthcare. Hence, what doctors do, and how & when they do it, depends on the quality of medical education.
“We need to get it right.”
(Bligh & Parsell, 2000)
Concern is being expressed that substantial change in the orientation of medical education towards greater relevance to the needs of society is necessary, unavoidable and urgent.
(Towle, 1998)
Therefore, it is time to respond assertively and correctly to the rapid changes in medicine and medical education, to ensure that the graduates are well equipped to meet the challenges of medical practice in the years ahead.
“An academic who only presents facts is not a teacher, a teacher is one who nurtures the learning process and thereby modifies behavior and patterns of thinking for a lifetime.”
(Woosley, 1997)
The six areas of activity of the teacher are summarized as:
The teacher as information provider
The teacher as role model
The teacher as facilitator
The teacher as assessor & curriculum evaluator
The teacher as curriculum & course planner
The teacher as resource developer and study guide producer
(Ronald Harden, AMEE Guide No. 20)
CURRICULUM
A curriculum is about what should happen in a teaching program, about the intention of the teachers & teaching and about the way they make this happens.
Key elements in the medical curriculum should include:
Integration of basic science and clinical learning across all 5 years
Direct faculty feedback for ongoing student learning and improvement
Active, experiential learning
Competency/outcome-based student assessment
REVIEW OF CURRICULUM: WHY?
Tremendous increase in medical knowledge
Evolvement of information technology
Changes in disease pattern
Changes in healthcare delivery system
Increased demand for social accountability
Increased expectation of the patients
Different students body (Gen ‘Z’)
TRENDS IN MEDICAL EDUCATION
Outcome-based education
Integration of basic & clinical sciences
Problem-based learning
Task-based learning
Peer-assisted learning
Early exposure to clinical problems/skills
Incorporation of professionalism & ethics
Core & electives
Virtual learning environment (VLE)
Massive open online course (MOOC)
Changes in assessment methods
Changes in healthcare delivery system
Changes in medical education
Changing role of faculties and learners
Redesigning Malaysian Higher Education
KUALA LUMPUR, the Garden City of
Lights, is the capital state of Malaysia.
MBBS (UNIKL) PROGRAMME
05 (five) year course (02 year Housemanship)
Phase I - Preclinical Years: Year-1 and Year-2
Phase II - Clinical Years: Year-3, Year-4 & Year-5
100% attendance is compulsory.
Absenteeism without any valid reason is unacceptable.
A student may take maximum 07 years to complete the course.
Any particular ‘Year’ can be repeated only ‘once’.
Final professional exam must be passed in maximum 3 (three) consecutive attempts.
Year Total
Year-1 PPD
2W
FOMS-1
9W
FOMS-2
9W
MSSK
8W
CVS
8W
Respiratory
6W
Break/Module Resit Exam
4W
Holiday (4W)
HR, CNY, in between 1W & at the end
1W
50W
CPD (Self-management, Critical thinking, Character development, Co-curricular activities)
ICE Module
Year-2 GIT
9W
Endocrine
6W
SSM
4W
Urinary &
Repro.
7W
NS Module
8W
Revision &
Module Resit
exam
4W
Self-study
2W
First
Professional
Exam1W
Revision &
self-study
4W
Supple
exam
1W
Holiday
HR, CNY,
1W & 1W
4W
50W
CPD (Self-management, Critical thinking, Character development, Co-curricular activities)
ICE Module, Medicine and Society Module, and Communication skills
Year-3 PH
8W
BCC
4WMedicine
8W
Surgery
4W
O&G
4W
Paediatrics
4W
Orthopaedic
4W
Break/Module Resit Exam
4W
Holiday (4W)
HR, CNY, between 1W
& at the end 1W
48W
In&Mnt; CS
GS (4W)
Entrepreneurship; CPD (Ethics & professionalism; Critical thinking, Character development, Co-curricular activities)
Year-4 SRP
6W
Mental
Health
8W
Specialty-1
8W
Specialty-2
8W
PCM
8W
Elective
6W
Break/Module Resit Exam
4W
Holiday (4W)
HR, CNY, between 1W & at the end
1W
52W
CPD (Ethics & professionalism; Critical thinking, Character development, Co-curricular activities)
Year-5 Medicine
8W
Surgery
8W
O&G
8W
Paediatrics
8W
Orthopaedic
8W
Revision &
self-study
3W
Final Professional
Exam
1W
PRHO
2W
Holiday (3W)
HR, CNY, 1W in
between
49W
Entrepreneurship and CPD (Ethics & professionalism; Critical thinking, Character development, Co-curricular activities)
ASSESSMENT & STANDARD SETTING
The assessment is integrated, no individual subject is separately assessed, and there is no “fixed mark”.
There are formative, continuous and summative assessment at module/Professional Exam level.
The pass mark in professional exams are deduced through standard setting methods. ‘Modified Angoff’ method is used for theory papers, and Borderline Group method for OSCE paper.
A panel of judges’ (usually 8-12) examine the EMQ items/MCQs/MEQs/OSPEs, and estimate the probability that the minimally competent (Borderline) students can answer the question correctly.
Then the scores are discussed in the panel and a consensus is reached. Each judge’s estimate scores are added up and a mean/median value is taken.
The test standard (cut score) is the mean/median of the estimates of all the judges.
A ‘Borderline student’ is usually the one who has a 50% chance either to pass or fail in the exam.
Students score 75% and above are called for ‘Distinction viva’ and may be offered ‘Pass with distinction’ through a satisfactory interview (viva voce) by a special board of examiners.
Digital Bangladesh is one of the nation's dreams, hence special emphasis is given on the application of digital technologies to realize Vision 2021. By 2021, after 50 years of independence, our goal is to be a middle-income country with peace, prosperity and dignity.
Bangladesh: Current Context
Foreign Currency Reserve = >32 billion USD
Medical Colleges = >100
Medical Universities = 3
Medical Graduates = 10,000/year
Padma Bridge
