New Strategies in Learning: Renewal of Undergraduate Medical Curriculum

AKU strives for excellence through continuous review of existing programmes and the introduction of new ones. Three aims are always at the forefront in such deliberations: quality, relevance and impact. Its undergraduate medical curriculum has accordingly been under scrutiny by AKU faculty since 1999. The renewed MBBS curriculum was implemented in the academic year beginning October 2002, for the Class of 2007. It builds on the strengths of the present programme, while increasing its flexibility. It also seeks to enable students to direct their own learning, to develop more broadly, and function effectively in any setting. The improved curriculum is based on the principles of adult learning and incorporates current Evidence-Based Medical Education precepts.

The change introduces an integrated curriculum including problem-based learning, early involvement with patients, increase in student electives and research options, and a deeper understanding of broader societal issues. Similar changes are required by the General Medical Council of the United Kingdom, and are pre-requisites for re-accreditation of all medical colleges in Canada.They have also been adopted at renowned medical schools. For example, Harvard Medical School (The New Pathway) in USA, McMaster University in Canada, and the University of Sydney in Australia, to name a few.

Problem-based learning emphasises the integration of clinical, basic and community health sciences where students learn medical science in the context of prevalent health problems common in everyday practice, emphasising the relevance to practice issue. Problem-based learning has several other desirable outcomes. It utilises small group learning where students learn to discuss and explore concepts and ideas. This inculcates the art of self-directed learning in students – necessary for continuous learning. This method also increases the use of library, web searches and other learning resources by students. It incorporates a broader role for faculty, a change from primarily imparting information to facilitate learning, with opportunities for frequent and closer faculty and student interaction. Early contact with patients also fulfils the students' aspiration of enroling in medicine, focusing on improving their work ethics, clinical and communication skills.

There will be increased opportunities in the new curriculum for student research and on and off campus electives. Electives include self-selection of some clinical clerkships at Hospital (AKU selectives), electives in Pakistanoutside AKU and the final year elective will remain open – anywhere in the world. Community health will continue to be emphasised. An increased prominence of broader issues also aims to produce physicians who are caring members of society.

With the renewed curriculum, AKU medical students shall learn to solve problems by dealing with unfamiliar presentations, questioning, reasoning critically, finding solutions, making decisions and defending them based on best current evidence in literature. Assessment will be used to provide feedback to students to facilitate learning and to determine whether institutional goals are met. The process of learning is as important as the content learnt, and both will be assessed in accordance with well-defined curricular objectives.