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060505P - MUSLIM PHYSICIAN EDUCATION: INDONESIAN EXPERIENCE and NEW CHALLENGES[1]

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Paper presented at a 1-day workshop on the Muslim Physician Education held at the Yarsi University Faculty of Medicine on 5th May 2006 by Dr Omar Hasan Kasule MB ChB (MUK), MPH (Harvard) and DrPH (Harvard) Professor of Epidemiology and Islamic Medicine, Universiti Brunei Darussalam.


ABSTRACT
Yarsi Faculty of Medicine has over the past 39 years succeeded in inculcating Islamic values in its graduates using a consistent and broad Islamic education program that is parallel to the medical curriculum. This paper describes the program suggests that the Islamic education program should be integrated into the medical program to be able to resolve the nagging problem of dichotomy in knowledge that is a major crisis in modern Muslim education

1.0  HISTORICAL BACKGROUND
My personal contact with the Yarsi education programs dates to 1980 when I met Prof Jurnalis at the First International Conference on Islamic Medicine organized by the Kuwaiti Public Health Ministry. I remember him describing in detail the Islamic input program for medical students that was used from the inception of the Yarsi Medical College in 1967 and continued after 1989 when the college became the Yarsi University Faculty of Medicine. The program is essentially 10 credit hours of Islamic instructions distributed in all the 5 years of medical training. In addition to classroom teaching students are expected to write a research paper and are also taught practical aspects of Fiqh as they relate to patients. The program has been maintained for the past 39 years. As we prepare to enter the fourth decade of Yarsi’s valuable contribution to Islam, we have a firm background to consider further developments in the program.

2.0 THE YARSI ISLAMIC INPUT PROGRAM[2]
The Yarsi University Faculty of Medicine was the first Muslim medical college in Indonesia established in April 1967. The Christian University of Indonesia School of Medicine had been established earlier in 1960. There are 56 medical schools in Indonesia, 27 being state-owned and 29 being private. There are 14 private Muslim medical schools.

The mission of the Yarsi Faculty of Medicine according to Prof Jurnalis is to ‘… produce a Muslim physician who is not only a qualified physician but also one who puts into practice his/her profession in line with Islam as part of his/her total obedience to Allah the almighty’. Over the past 39 years this mission has been pursued very successfully and with good results. This is in accord with the constitution of the Yarsi University that stipulates that the aqidah of the organization is Islam.

Regarding the graduates of the Yarsi Faculty of Medicine, Prof Jurnalis is of the view that Muslim physicians are those qualified physicians who practice their professional knowledge and skills in line with Islam and at the same time observe all their religious duties regardless of time and space. They are fully aware of the dual status: vicegerents of and slaves of Allah. They continuously obey Allah and His messengers regardless of time and space. Their goal is to pursue not only happiness in the world but also happiness in the hereafter. If choices are to be made, they prefer suffering and sacrifice of wealth as well as life in this world to guarantee happiness in the hereafter. To achieve these goals they will always stick to the basic guidance of the Qur’an and hadith and hold them as a paradigm of all their deeds including professional activities. Total obedience to Allah is the keyword of success in their lives. For Muslim physicians science and technology are merely a means to get them nearer God the almighty (takarrub ila al llaah). As a consequence they will never adopt anything that contradicts Qur’an and hadith, the basic guiding paradigms, except in cases of necessity.

According to regulations of the Indonesian Ministry of Education, the curriculum of a private university has to be distributed as 80% determined by the government and 20% determined by the private university. This enabled Yarsi to develop its Islamic input curriculum. Islamic religious classes are allocated 10 credits which is 5 times what is allocated in government universities. The allocation was previously 12 credit hours but had to be reduced to 10 due to introduction of classes on humanities, psychology, research methodology, medical ethics, and medical law. The total credit hours needed for graduation from medical school is 200 offered in 12 semesters. Thus Islamic religious classes constitute 5% of the total curriculum.

The Islamic classes are offered throughout the course with 2 credits in semester 1 and thereafter 1 credit for each semester from semester 2 to semester 7. The remaining 2 credits are for preparing a term paper based on researching an allocated health issue. In addition to classroom instruction, students trained in reading and writing Qur’an (if they did not do this earlier in life), memorization of some chapters of the Qur’an, recitation of the Qur’an according to the 7 styles of recitation, delivering Friday sermons (khutbah), and how to be Islamic propagators (muballigh). Practical instruction using simulation is given on performing acts of worship (salat, saum, & zakat) and funeral procedures (janazat).

A special class is offered on Islamic Medicine. Students can earn 1 credit hour for attending 16 sessions of 50 minutes each plus 2 sessions for mid-semester and end-semester examinations. The class has three topics: The concept of medicine as viewed by western philosophy and by Islam, the contribution of Islamic heritage in the development of science and technology, and materia medica as mentioned in the Qur’an, hadith, and classical as well as contemporary Islamic literature. The topics covered under the concept of medicine are: concept of knowledge, acquired and revealed knowledge, Islamization of knowledge, approaches to production of knowledge (eg rationalism, empiricism, deduction, & induction), concept of health, characteristics of Islamic medicine as contrasted to western medicine, health systems, Islamic vs Muslim medicine, alternative medicine, and fiqh rulings on various medical issues. Contributions of Muslims to medicine are illustrated by study of the work of the following physicians: al Razi, al Zahrawi, Ibn al Nafis, Ibn Hytham, Ibn Sina etc). The section on materia medica includes discussion of honey, siwaak, etc.



2.0  DIFERENT WORLD VIEWS
The system of medical education reflects the world-view of the educators. There are basically three world-views that we can discuss: the Christian, the secular, and the Islamic. Identification and discussion of different world-views is for purposes of improving mutual understanding and not debate or controversy.

The Christian world-view is promoted in Christian medical schools in Indonesia. According to Professor Jurnalis2 ‘… all the Catholic and Christian schools right from primary up to tertiary education will imbibe the students with Christian norms and values. Christianity classes will be strongly recommended to all students regardless they are Christian or Muslim’.

The secular world-view is misunderstood because many people mistakenly take secularism to be absence of religion or treating religion as a private matter to be separated from public life. Modern secularism as imported from Europe is actually an extension of the ancient Greco-Roman world view. This world-view had suffered in oblivion in the period when the Christian Church was in the ascendant (4th to 12th century). With the renaissance the Church started losing its grip on European public life and Europeans rediscovered their Greek and Roman roots. Over the past 600-700 years the influence of the Church has been waning while the influence of ancient Rome and Greece was on the ascendant. Thus the secular out-look in its various manifestations (humanism, modernism, post-modernism etc) is a return to the European Greco-Roman heritage. When European powers colonized virtually the whole world by the 18-19th centuries of the Christian era they spread the Greco-Roman world-view in many parts of the world. For purposes of communication and dialogue with people of religion, it would be appropriate to include secularism among belief systems that deserve to be tolerated like any other religion or belief system. It would be very confusing to consider secularism as absence of religion.

The Islamic world-view, al tasawwur al islami, is an integrative paradigm that underlies Islamic culture and all endeavors of an Islamic society. It is based on the creed of tauhid, aqidat al tauhid, which in essence if affirmation of One All-powerful God, tauhid al al dhaat al ilaahiyyat, the  Creator for the universe, tauhid al rubuubiyyat, and who is alone is to be worshipped, tauhid al uluhiyyat. Under the paradigm of tauhid the teaching and practice of medicine should be integrated into the norms, values, and laws of Islam.

3.0  THE PROBLEM OF DUALITY
There is a crisis of duality or dichotomy manifesting as teaching Islamic sciences separately from medical disciplines by different teachers and in different institutions. The duality may occur even within the same institution when Islamic and medical disciplines are taught separately under the same roof. Students may be confused when confronted by contradictions that they cannot resolve between assertions of medical disciplines based on the secular world-view and the assertions of ‘aqidat al tauhid reflecting the Islamic world-view. The crisis of duality is seen most acutely when matters of ethical nature are discussed. Both students and teachers unable to reconcile the contradictions just decide to have split intellectual personalities. They alternate between operating in the secular world-view and operating in the Islamic world-view which creates even more confusion.

4.0 TOWARDS AN INTEGRATED CURRUCULUM
The present challenge to Yarsi and similar Muslim institutions is to think seriously about integrating Islamic values into the medical curricular. This integration will resolve the crisis of duality by insisting that Islamic concepts should be taught by the same people who teach medical disciplines. This may require that medical lecturers go through a Diploma in Islamic Studies (DIS) to acquire the Islamic world-view. After this we must make sure that we integrate Islamic values and concepts in the teaching and examination of basic and clinical medical sciences. The expectation is that medical graduates will be able to integrate Islamic moral and legal values in their practice of medicine because they went through an integrated education system.

An integrated medical curriculum follows the Islamic paradigm of reading 2 books, the book of revelation, kitaab al wahy, and the book of empirical science, kitaab al kawn. Both books contain signs of Allah, ayaat al llaah, and must be read together. It is a mistake to read one of the books and neglect the other. The solution to the crisis of duality in the ummah starts from joint reading of the 2 books, al jam ‘u baina al qira atain. Thus medical scientists who are involved in IIMC read the signs in both books.

The vision of an integrated curriculum has two separate but closely related components: Islamization and legal medicine. Islamisation deals with putting medicine in an Islamic context in terms of epistemology, values, and attitudes. Legal medicine deals with issues of application of the Law (fiqh) from a medical perspective.

The integrated curriculum has 5 main objectives: (a) introduction of Islamic paradigms and concepts in general as they relate to medicine, mafahiim Islamiyat fi al Tibb. (b) strengthening faith, iman, through study of Allah’s sign in the human body (c) appreciating and understanding the juridical, fiqh, aspects of health and disease, al fiqh al tibbi. (d) understanding the social issues in medical practice and research and (e) Professional etiquette, adab al tabiib, from the Islamic perspective.

The integrated curriculum will prepare the future physician prepare for the heavy trust, the amanat of being professionally competent. He must be highly motivated. He must have personal, professional, intellectual, and spiritual development programs. He must know the proper etiquette of dealing with patients and colleagues. He also must know and avoid professional malpractice. He needs to be equipped with leadership and managerial skills to be able to function properly as a head of a medical team.




[1] This paper write-up has incorporated comments made by the author during the discussion sessions following his paper presentation
[2]All this section is reproduced from an unpublished paper ‘Muslim Physician Education: The Indonesian Experience’ by Professor Dr Jurnalis Uddin Chairman, Board of Executives, Yarsi Foundation, Jakarta April 2006.