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Presented to freshmen students of the Faculty of Medicine Indonesia Islamic University Yogyakarta, Indonesia on Friday 7th September 2007 by Professor Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Islamic Medicine University of Brunei Darussalam and Visiting Professor of Epidemiology University of Malaya WEB: http://omarkasule.tripod.com
1.1 MOTIVATION TO CHOOSE A CAREER IN MEDICINE:
What motivates students to enter medical school will affect their commitment to practice of good medicine. Medicine is a vocation and success in it requires special aptitude and motivation. Two processes are going on. Schools and society form the character of the student and knowledge base pre-medical school. During medical school and after graduation, there are influences from the profession and from colleagues that affect the physician’s motivation. The motivating factors range from the idealistic to the pragmatic material rewards. It is difficult to undertake a valid survey research of the reasons for choosing a medical career. Many students will consciously or unconsciously talk about altruistic motivation. The real motivators may be prestige, status, family/peer pressure, and expectation of material rewards. Students are idealistic on entry into medical school. They talk about studying medicine to become physicians and serve the community. Towards the end of their education, many students talk about benefiting from their education to find a job, enjoy easy life and have a high social status.
1.2 MOTIVATION PRE-MEDICAL SCHOOL:
Choice of a medical career fulfils a communal obligation, fardh kifayat. In some cases it may be an individual obligation, fard ‘ayn, where there is no other physician in the community. Families and communities should encourage children to enter the medical profession where there is a shortage of medical manpower. Imaam al Shafie underlined the importance of medicine when he said: ‘I know of no discipline of knowledge after knowing the halal and the haram that is more noble than medicine. He regretted the monopoly of medicine by people of the book[1] when he said that that Muslims lost one third of all knowledge and left it to the Jews and Christians that Muslims lost one third of all knowledge and left it to the Jews and Christians. Students should be taught that study of medicine contributes to preparing the ummah’s strength, i’idaad al quwwat[2] and restoring Muslim dignity[3]
1.3 MOTIVATION DURING THE MEDICAL SCHOOL:
Including Islamic values in the medical curriculum will motivate students towards excellence. Including Islamic values in the curriculum inculcates in students the culture of service and putting the public good before personal interests.
1.4 MOTIVATION AFTER MEDICAL SCHOOL:
The following Islamic concepts are motivating for the physician: the search for excellence, ihsaan[4] and bearing witness against other communities[5], good deeds, and fulfilling amanat This implies that this ummat must lead the destiny of humanity and its members must excel in work as befits leaders who must set the example for others. Good work, ‘amal salih, is the basis for all human endeavors by a Muslim.
1.5 FINANCIAL COMPENSATION
The physician working in a materialistic society is torn between contradictory forces of greed and service. Service should have the higher priority but the material rights and privileges of the physician should not be forgotten because he also wants to live a happy life. The prophet talked a lot about payment of the physician. The physician fee should be fixed and known in advance. The prophet paid the cupper who operated on him[6]. The physician fee must be known in advance according to the general principle, idha istajarta ajiiran fa a’alimuhu ajrahu[7]. It is a sin to fail to agree on a fee for service in advance, ‘uqubat man lam yufi al ajiir ajrahu[8].
2.0 EARLY MUSLIM PHYSICIANS AS MODELS OF MOTIVATION
2.1 IMPORTANCE OF ROLE MODELS
The student should be taught about the Islamic heritage in medicine as a motivator for excellence. There are several good books about these physicians such as ‘Uyuun al anbau fi tabaqaat al atibba by Ibn Abi Usaibat in the 7th century of hijra. The model of the earlier physicians is inspiring to the young ones. They were encyclopedic and all-rounded in their knowledge. They would lead prayers in the mosque, go and research on medicine, and may be return to teach Qur’an. The main lesson for the young student is that the ancient Muslim physicians were able to excel while they maintained their Islamic identity. Islam is not incompatible with excellence in science or medicine. There are several accounts of achievements by early Muslim medicine written by Muslims and non-Muslims. The Muslims may overstate while the non-Muslims may understate and in-between lies the truth. Early Muslim physicians excelled in several medical fields.
2.2 PHYSICIANS OF THE 3rd CENTURY H
Abubakr Muhammad Bin Zakariyyah Al Razi (251-313H/865-923 CE), a Persian and a student of al Tabari, wrote more than 100 books the most famous being al Hawi al Kabir (in full ‘al Haawi fi Sina’at al Tibb) in 30 volumes. It was translated into Latin and reprinted many times in Europe. His other books were: al Mansuuri and Tibb al Ruuh. He was interested in chemistry and is said to have prepared absolute alcohol from fermented sugar. He invented a scale for measuring specific gravity. He made detailed clinical observations. He described smallpox. He investigated women’s diseases, obstetrics, hereditary diseases, eye diseases, small pox, and measles. He discovered surgical sutures. He used anesthetics. He used ammonia to control diarrhea. He considered psychological factors in the treatment of disease. He was director of hospitals in Baghdad and his native land in Rayy.
2.3 PHYSICIANS OF THE 4th CENTURY
Al Shaikh al Rais Abu Ali Al Hussain Bin Abdillah Bin al Hassan Ibn Sina (370-428 H / 980 – 1037 N) wrote many books the most famous being al Qanuun fi al Tibb, a 14-volume encyclopedia on disease classification and causes, therapeutics, simple and compound medicines, hygiene, and functions of the body. The book was translated into Latin and had a major impact on western medicine being taught until the 18th century CE. Ibn Sina recognized that TB was contagious. He accurately described the symptoms of diabetes mellitus. He discovered ancylostoma. Besides medicine, Ibn Sina made contributions to science, mathematics, chemistry, and philosophy.
Abu Al Qasim Khalaf Bin Abbas Al Zahrawi (b. 912 N, d. 404 AH/1013 N) practiced medicine in Qurtuba in the reign of the Omayyad Khalifat Abdurahman the Third who ruled 912-961 N. His fields of interest were: surgery, pharmacology, and anatomy. He designed over 200 surgical instruments. His book Kitaab al tasriif liman 'Zajaza 'an Ta'liif became a standard textbook of surgery. His other writings were Risala fi Tafdhil al ‘Asal ‘ala al Sukkar, Tadhkirat fi al Dawaa al Mushil [first medical encyclopedia in Andalusia], Maqala fi ‘ilal al Kula, Risalat fi al Baras, Kitaab al Iqtisad fi Islahi al Anfus wa al Jasad, Kitab al Aghdhiyat wa al Adwiyat, Kitaab al Jami fi al Ashribat wa ‘ilm al Ajinnat, Kitaab al Zina, Kitaab al Qaanuun al Muqtadab, Kitaab Mukhtasar Hilt al Bur li Jalinus. Al Zahrawi was an expert in cancer surgery and tooth extraction.
2.4 PHYSICIANS OF THE 5th CENTURY H
Ibn Zuhr produced 6 consecutive generations of famous physicians the most famous being Abu Marwan Abdu Al Malik Ibn Zuhr (b. 1091 or 1094 N d.487H / 1162 N), a contemporary of Ibn Rushd, who lived in Andalusia and Morocco. His main book was al Taysir whose full title is Kitaab al Taysiir fi al Mudaawat wa al Tadbiir translated into Latin and used in Europe.
2.5 6th CENTURY ONWARDS
Abu Al Waliid Muhammad Ibn Rushd (B. 1126 N d. 595 H / 1198 N) lived in Qurtuba in Andalusia. He was interested in philosophy and also practiced medicine medicine. He wrote a medical work called al Kulliyat translated in Europe. He made the observation that smallpox infected only once.
Alau Al Ddiin Abu Al Hasan Bin Abu Al Hazim Al Qurashi Al Dimashqi Ibn Al Nafees (d. 686H / 1288 CE) was born in Syria but practiced in Cairo. He described blood circulation before William Harvey but this was not noticed in Europe. He authored sharh tashriih al qanuun in which he explained pulmonary circulation.
[1] (Al Suyuti)
[2] (8:60)
[3] (5:54, 63:8)
[4] (2:185, 3:134, 3:148, 4:40, 5:85, 6:160, 7:50, 10:26, 11:115, 13:22, 16:30, 16:90, 16:96-97, 16:128, 17:53, 22:37, 23:96, 27:89, 28:77, 29:69, 39:10, 41:34-35, 42:23, 51:15-19, 53:31-32, 55:60, 57:11, 57:18, 64:17)
[5] (2:143, 3:140, 4:69, 22:78, 39:69)
[6] (Bukhari K34 B39)
[7] (Nisai K35 B44, Zaid 654)
[8] (Bukhari K37 B10, Ibn Majah K16 B4)