Publication: Comparative study of community medicine practice in MBBS curriculum of health institutions of Nepal
Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: A revolution in health care is occurring as a result of changes in the practice of medicine and in society.
Medical education, if it is to keep up with the times, needs to adapt to society's changing attitudes. Presently medical
education has been criticised for its orientation and insensitivity to people’s need. The MBBS curriculum of medical
institutions of Nepal has been focusing on community-based approaches and is still guided by the same notion. The
question put forward is whether it has been appropriate to nurture the present health needs and aspiration of people.
Objective: The objective of the present study is to review the existing community based medical education in health
institutions of Nepal to strengthen the components of community care.
Materials and methods: Qualitative study was done by reviewing the curricula and existing community medicine
courses/activities in MBBS curriculum of Institute of Medicine (IoM)/Tribhuvan University, BP Koirala Institute of
Health Sciences (BPKHIS) and Kathmandu University School of Medical Sciences (KUSMS).
Findings and Discussion: The curriculum of all the health institutions have addressed significantly on community
medicine practice. As per Institute of Medicine, the community medicine practice is achieved through community
based learning experiences like community diagnosis, concurrent field with families of sick members and district health
system management practice. In BP Koirala Institute of Health Sciences, community medicine practice is undertaken
through exposure to community diagnosis program, health care delivery system, family health exercise, applied
epidemiology and educational research methodology, management skills for health services and Community Oriented
Compulsory Residential Rotatory Internship Program (COCRRIP). In KUSMS, community medicine module is carried
out as- community diagnosis program, community health intervention project, school health project, occupational health
project, health delivery system functioning, family health care activities and Compulsory Residential Rotatory Internship
Program in outreach clinics. In the practice the practical aspects are largely unstructured that waste too much time in
non-educational activities and rely on learning and doing. Meanwhile, expectation of the community is increasing and
the challenge of nurturing their demands has come in forefront. Community has perceived that the medical schools are
concentrating on fulfilling the demand of their curriculum rather directing on their health care need.
Conclusion: Health institutions need to be accountable to take the responsibility of strengthening the health status of the
community of their catchments areas. The practice of community medicine need to be done in an innovative way and
these schools should execute continual intervention activities and complement other institutions working in their areas.
Key words: Community medicine, curriculum, field practice
Description
Marahatta SB 1, Sinha NP 2, Dixit H3 , Shrestha IB 4, Pokharel PK5
1 Assistant Professor, Department of Community Medicine, 2Professor, Department of Community Medicine, KathmanduUniversity School of Medical Sciences, Dhulikhel, Nepal, 3Professor, Department of Paediatrics, Kathmandu Medical College, Kathmandu Nepal, 4Professor, Community Medicine and Family Health, Institute of Medicine TribhuvanUniversity, Kathmandu, Nepal, 5Professor, Department of Community Medicine BPKIHS, Dharan Nepal Kathmandu Nepal