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Hiccups in Adopting a New Way of Teaching Medicine

ALEXANDRIA—Mohammad Younes still has one more academic year to graduate from the Alexandria University Faculty of Medicine and be among the first class graduating from the university through the internationally acclaimed “Integrated System.”

The integrated system, applied in the United States and European medical schools, seeks to present knowledge in a methodological pattern in integrated and progressive concepts covering different subjects without separating knowledge into different disciplines. The method demonstrates a unity of thinking and avoids illogical division among scientific disciplines.

“This system achieves integration among subjects,” Younes said. “We used to study the digestive system over the course of three years through anatomy in the first year, pathology in the second year, and pharmacology in the third year, but now we can study everything related to the digestive system in one semester, so we can understand the different parts of one system and their relationship with each other.”

Alexandria University started applying this system in 2009.

In explaining the newly adopted system, Mohammed Hesham, vice dean for educational and students affairs at the Alexandria University Faculty of Medicine, said that the rest of Egyptian medical schools still use  an old educational system teaching basic scientific material as separate disciplines, such as anatomy, physiology, and histology.

“Based on this new system, students now have a full picture of the digestive system and its diseases through the basic information that they acquire from the educational curricula,” he said.

Still, Hesham says he is only partially satisfied with the results of the new system.

“Some problems occurred when the new system was applied,” he said.

Hesham believes that the main problem lies in the increasing numbers of students. This year 1,196 new students have enrolled at the school, more than many international medical schools would even think of taking. In addition, international universities would train faculty members on a new system before applying it.

“Although there is a well-equipped hospital for the practical training of students, the large number of students makes effective practical training almost impossible,” he said. Meanwhile, the Faculty of Medicine is seeking to establish a separate hospital building to take in the increasing numbers of students.

Eman Nabil, professor of histology at Alexandria University, agrees with Hesham on the necessity of decreasing the number of students to ensure the success of the integrated educational system. “With the presence of large numbers of students and so much information, students do not have enough of a chance to practically use the information,” she said.

According to this new system, the importance of the grades differs from subject to subject, so students focus on high-grade subjects and ignore low-grade ones.

“Students do not pay much attention to low-grade subjects, because they focus on passing high-grade subjects, and as a result they do not acquire enough knowledge and information,” Nabil said.

Students’ views on the new system vary. Many believe that it involves more exams and subjects, in addition to the lack of practical training that has resulted and a shortage of well-trained professors.

Ahmed Nabil, a third-year student, said that the huge number of students affects the quality of education. “Exams assess students’ ability to memorize,” he said, “rather than their ability to understand and assimilate information.”

Mohamed Al-Banna, a fourth-year student, believes that the teaching period for each subject is insufficient compared to the material the students have to master. “Practical training is also inadequate compared to the amount of information we need to memorize,” he said, “which means that most of this information will be completely forgotten right after the exams, simply because we did not get a chance to apply it practically.”

The Faculty of Medicine is trying to address these problems by conducting a survey among students and professors to identify the types of problems that they face.

“We will form a committee to train the faculty members on the new system and we will reduce the number of exams,” Hesham said.

While Merna Mohammed, a third-year student, believes the integrated educational system is a good system, she says it has to be applied in the same manner applied worldwide. “We need to develop educational programs, where the quantity of material is relative to the time spent on teaching them, so that students can understand and benefit from the information,” she said.

Although the system has been applied for years in the United States and Europe, it may still be too early to evaluate its  effectiveness at Alexandria University. The final evaluation could be based on the number of students able to pass their final exams next year and the number of other Egyptian faculties of medicine that follow Alexandria University’s example.

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