Development of a New Clinical Teaching and Training module for fourth year students in Tikrit Medical College (TUCOM) 1992.

Medical Journal of Tikrit University (1997);3: ii

https://www.researchgate.net/publication/282506579_Development_of_a_New_Clinical_Teaching_and_Training_module_for_fourth_year_students_in_Tikrit_Medical_College_%28TUCOM%29_1992

Dear Editor,

Clinical teaching and training in medical colleges face number of challenges when different related educational activities are compared to innovative criteria like integration and systematic approach ⁽¹⁾. The traditional discipline-based rotation of the medical students’ groups in their first year of clinical phase (year4 medical study) is deficient. What is taught in different disciplines is largely opportunistic and usually based on unpredicted clinical situation and on patients’ availability and on interest of the staff concerned. In a planned and systematic teaching and training, all students cover all core and essential curriculum components. On the other hand, the newly graduated doctor face during the early years of residency and medical career ladder immense pressure and stress working as the first contact of patients in hospitals (compulsory rotational residency) and in Primary Health Care Centres (compulsory rural service). With innovation in medical education in recent years, there is a strong belief in Tikrit Medical College that the integration practiced in the first three years around problems to continue in clinical phase. Based on the clear job description of graduates for first 3-5 years as first point of contact with patients, the following new curriculum has been implemented in TUCOM for first batch of student in academic year 1992-1993 ⁽²⁾. We showed in a previous study discernible deficiency in undergraduate clinical training when compared with duties of newly graduated doctor ⁽³⁾.  When rapidly surveyed, junior and senior residents working at present in Saddam General Hospital, Tikrit collectively supported the proposed change. The new curriculum module is designed around body regions 8-week blocks with weekly discussion sessions with integrated disciplines around a common “patient complaint” ⁽²⁾. Three blocks (Abdominal, Chest and Head & Neck complaints) supported by a fourth block of practice in primary health care were spread across the 32-week course in forth year. A fifth block on “Trunk and limbs” is assigned with Orthopedics and Rheumatology in fifth year. The students in a typical week start with first discussion around a “complaint”  e.g. “abdominal pain” and drive their way during the week to reach diagnosis among the major four disciplines (Internal Medicine, surgery, Gyn-Obs and pediatrics) where they rotate according to planned schedule to cover the clinical training related to the complaint. Through discussion, self learning, lectures, clinical training and laboratory practicals, students find their way to recognize the disciplines related to the complaint and how is ultimately managed and treated. We believe this is the first kind of developed curriculum for undergraduate clinical training fulfilling the SPICES quality model ⁽¹⁾. Learning clinical discipline around complaints rather than diseases is the most appropriate approach in undergraduate medical study in the professional life of the new graduate and general practitioner years before any postgraduate discipline-based training.

G.Y. Mustafa-Alsheikh MD PhD Professor

Mohamad Sharif Abdula MD  Consultant Physician

Abed Allan PhD Lecturer

Tikrit University College of Medicine, Iraq.

 REFERENCES

1) Harden, R.M., Sowden, Susette and Dunn, William R. (1984) Educational strategies in curriculum development: the SPICES model. Medical Education, 18,284-297.

2) Nabeel D. Sulaiman and Ghanim Y.M. Alsheikh, (1995) The fully integrated problem based medical curriculum: experience in Tikrit University College of Medicine. Yemen Medical Journal, 1,78-82.

3) Al-Chalabi T.S., Al-Na’ama M.R., Al-Thamery M.D., Alkafajei A.M., Mustafa G.Y., Joseph G. and Sugathan T.N. (1983) Critical performance analysis of rotating residents in Iraq. Medical Education, 17 (6),378-384.