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Background reading material by Professor Omar Hasan Kasule Sr. for Year 1 Semester 1 PPSD session on Wednesday 25th October 2006
MEDICAL EDUCATION and PURPOSES OF THE LAW
Medicine is closely associated with all the 5 purposes of the Law: morality, life, progeny, intellect, and resources. Thus the system of medical education adopted must aim at producing physicians who will uphold the higher purposes of the law in their medical practice.
Medical students should learn basic and clinical sciences in addition to learning how medicine and its practice influence or are influenced by social conditions. They should be able to appreciate the relationship of the social background to disease causation and disease prevention.
Study of medicine a communal obligation. Each community is obliged to make sure that it trains a number of physicians sufficient for its population and disease profile.
There are 6 conceptual issues in medical education: objective, integration, balance, service, leadership, and research.
OBJECTIVE OF MEDICAL EDUCATION
The objective of medical education is producing physicians whose practice fulfills the 5 purposes of the Law within a holistic context. Such physicians will have the following characteristics: health and not disease oriented, focused on quality and not quantity of life, humble to recognize limitations to their abilities, holistic in outlook, able to understand society, are endowed with scientific capability, clinical expertise, and leadership skills.
INTEGRATION OF MEDICAL EDUCATION
Modern medicine is fragmented by organ, disease process, and is not holistic. It is atomistic, analytic, and not synthetic. It lacks an integrative paradigm. The teaching of medicine was in the past fragmented as was the practice of medicine. This is however now improving with medical curricula emphasizing holistic approaches to medicine and integrating basic sciences with clinical sciences. Teaching basic and clinical sciences separately and by organ system had the advantage of in-depth knowledge but had the disadvantage of not integrating various parts of knowledge with one another. Modern teaching methods including the problem-based approach integrate knowledge but may not provide the detailed information that was found in the traditional system. The modern systems are more related to actual patient management which requires integration of information and skills in a multi-disciplinary context. The modern medical education systems also integrate social aspects in medicine which also reflects the reality of medical practice because the physician must understand the social background of the patients.
BALANCED HOLISTIC APPROACH
Lacking an integrating paradigm, modern medicine has until recently not been able to observe balance and equilibrium in its therapeutic approaches. The result has been therapeutic approaches that have caused side effects that are worse than the disease they were trying to cure in the first place. The harm could be physical, social, psychological, or even spiritual or moral. To ensure a balanced approach, physicians should be trained to have a holistic approach in medical practice.
MEDICINE AS SERVICE
Medical education should integrate the teaching of social service. It should prepare the future physician to provide service to the community. This will require skills of understanding and responding to community needs that can be acquired by spending part of the training period in a community setting away from the high technology hospital environment.
MEDICINE and LEADERSHIP
Leadership skills must be integrated into the medical curriculum. The medical school curriculum and experience should be a lesson in social responsibility and leadership. The best physician should be a social activist who goes into society and gives leadership in solving underlying social causes of ill-health. The physician as a respected opinion leader with close contact with the patients must be a model for others in moral values, attitudes, and thoughts. He must give leadership in preventing or solving ethical issues arising out of modern biotechnology. He must understand the medical, legal, and ethical issue involved and explain them to the patients and their families so that they can form an informed decision. He should also provide leadership in advocating for the less privileged and advocacy for human rights.