Awais, Muhammad

Baloch, Noor Ul-Ain

Rehman, Abdul

English

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eCommons@AKUDepartment of Biological & Biomedical Sciences Medical College, PakistanFebruary 2015The artificial divide between biomedical sciencesand clinical medicine in undergraduate medicaleducationAbdul RehmanAga Khan UniversityNoor Ul-Ain BalochAga Khan UniversityMuhammad AwaisAga Khan UniversityFollow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_bbsPart of the Biochemistry Commons, and the Radiology CommonsRecommended CitationRehman, A., Baloch, N. U., Awais, M. (2015). The artificial divide between biomedical sciences and clinical medicine in undergraduatemedical education. Journal of the College of Physicians and Surgeons Pakistan, 25(2), 157.Available at: https://ecommons.aku.edu/pakistan_fhs_mc_bbs/666Sir,Undergraduate medical curriculum has traditionallybeen divided into two separate parts consisting ofbiomedical sciences and clinical medicine respectively.Lecture-based didactic strategies were employed in thepast to imprint basic science knowledge to medicalstudents. However, evidence-based strategies havenow shown that Problem-Based Learning (PBL) systemhas several advantages over the traditional lecturesystem.1 Consequently, many medical institutionsacross the globe have implemented changes in theirundergraduate medical curricula to integrate clinicalmedicine and biomedical sciences together, in order toimprove retention of basic science knowledge andenhance problem-solving capabilities of fresh medicalgraduates.2Over the past several decades, a growing body ofevidence has shown that a significant proportion ofknowledge taught during the basic science years ofundergraduate medical curriculum is lost in thesubsequent years.3-5 Decrement in basic scienceknowledge is seen across all disciplines with the mostprofound deficit developing in the fields of biochemistryand microbiology.5 The reasons for this decrement arevariable and the most often reported reason by medicalstudents themselves is that a substantial proportion ofthe course material taught during medical school is notrelevant to their later clinical work.4 Thus it can beinferred that the most important determinant of retentionof basic science knowledge is the perceived relevanceof this knowledge to future clinical practice.The importance of integrating biomedical sciences andclinical medicine together has been realized for the pastseveral decades. A number of strategies have beendevised in various parts of the world to integrate the twotogether including the use of a PBL system, modules ofback-to-basics in clinical years and a spirally designedcurriculum. However, we believe that a medicalcurriculum can be adopted, which, from day one,amalgamates biomedical and clinical sciences together.Although such a proposal may seem implausible at first,it is more pragmatic than the traditional approach. Freshmedical students, in such a curriculum, can be taughtalong the format of systematic modules, whereby, ineach module, students would learn all relevantbiomedical sciences in conjunction with the relevantclinical science. The theoretical merit of such anapproach is apparent in that students will be able toreadily perceive the importance of learning basicscience knowledge in order to grasp an understandingof clinical medicine. Moreover, all the knowledgegained in a particular module would be integratedwithin and across biological sciences and clinicalmedicine, resulting in greater retention and improvedcomprehension, analysis, synthesis and application ofknowledge (higher cognitive levels of Bloom's taxo-nomy). Although the burden of studying in this approachwould be higher (upto 10 different disciplines at thesame time), the theoretical merits of this approach arepromising and preliminary research studies on such anapproach have shown favourable results.In Pakistan, many medical schools continue to teach amedical curriculum based entirely on traditional lecture-based strategies, even though a growing body ofevidence suggests that PBL-based systems afford betteroutcomes. Medical education in the present eracontinues to moves towards an integrated and focusedapproach, and systems of medical education in Pakistanwill need to change and evolve over time to keepabreast with recent developments. In our opinion, acurriculum of medicine, which amalgamates biomedicalsciences and clinical medicine together, seems to be themost reasonable balance between retention of basicscience knowledge and acquisition of problem-solvingskills.REFERENCES1. Wood DF. Problem based learning. BMJ 2008; 336:971.2. Cate OT, Snell L, Mann K, Vermunt J. Orienting teachingtoward the learning process. Acad Med 2004; 79:219-28.3. Custers EJFM. Long-term retention of basic science knowledge:a review study. Adv Health Sci Educ 2010; 15:109-28.4. D'Eon MF. Knowledge loss of medical students on first yearbasic science courses at the University of Saskatchewan. BMCMed Educ 2006; 6:5.5. Ling Y, Swanson DB, Holtzman K, Bucak SD. Retention ofbasic science information by senior medical students. Acad Med2008; 83:S82-S85.Journal of the College of Physicians and Surgeons Pakistan 2015, Vol. 25 (2): 157 157LETTER TO THE EDITORThe Artificial Divide BetweenBiomedical Sciences and ClinicalMedicine in UndergraduateMedical EducationAbdul Rehman1, Noor Ul-Ain Baloch1 and Muhammad Awais2Department of Biological and Biomedical Sciences1 /Radiology2, The Aga Khan University Hospital, Karachi.Correspondence: Dr. Abdul Rehman, Flat E-6, Five Star LuxuryApartments, St-6/D, Block 14, Gulshan-e-Iqbal, OppositeD.C. Office, Karachi.E-mail: jsmawais@yahoo.comReceived: July 23, 2014;   Accepted: August 25, 2014.

The artificial divide between biomedical sciences and clinical medicine in undergraduate medical education

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The artificial divide between biomedical sciences and clinical medicine in undergraduate medical education

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