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080820L - SIX ISSUES IN MEDICAL EDUCATION

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Background material by Professor Omar Hasan Kasule Sr. for Year 1 Semester 1 Med PPSD session on 20th August 2008


THE ISSUE OF PURPOSE
The purpose of medicine is to restore, maintain or improve the quality of remaining life. It cannot prevent or postpone death because the lifespan is in the hands of the Creator. The aim of medical education is producing physicians whose practice fulfills the 5 purposes of the Law. They 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, understand society, scientific capability, clinical expertise, and leadership.

THE ISSUE OF INTEGRATION
A lot of modern biomedicine is fragmented by organ or disease process and is not holistic. We need to practice holistic medicine within an integrative paradigm to replace the current world-view that is atomistic, analytic, and not synthetic. Holistic medicine requires taking into account physical, social, psychological, and spiritual aspects in caring for a patient. This ensures that an intervention in one aspect does not lead to negative consequences in another aspect of care.

THE ISSUE OF BALANCE
 In the absence of an integrating paradigm, medicine lacks balance and equilibrium in its therapeutic approach. Extremely aggressive medical interventions may therefore be accompanied by side effects that are worse than the disease. Some interventions may lead to new illnesses. Balance, moderation, equilibrium, and action-reaction considerations should underlie medical interventions.

THE ISSUE OF SERVICE
Medicine should be taught as a social service with the human dimension dominating the biomedical dimension. Medicine should be practiced as of mutual social support. Medical education 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.

THE ISSUE OF LEADERSHIP
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, akhlaq, 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.