The case for specialised medical universities – Part 5
This move will correct the inadequacies that previously bedeviled the training of medical and health sciences professionals, thereby leading to quality improvement and the onset of a new cohort of health professionals that will be better trained to address the health care needs of our people.
At this juncture, I would like to discuss some of the curriculum-related experiences that we have gained at UNIMED which I believe will be useful lessons for newly established Medical Universities in Nigeria. 1). Natural Sciences and Basic Medical Sciences Conundrum.
One of the initial contentious debates and challenges that emanated was whether we should focus exclusively on the Basic Medical Science courses and not be buoyed down by the Natural Science courses such as Biology, Chemistry, Physics, and Mathematics. This line of reasoning championed by some of our stakeholders was that we should not include a Faculty of Natural Sciences since other Universities in Ondo State were offering degree programs in the Natural Sciences. We are grateful that those who supported having the Faculty of Natural Sciences won the day.
After all, medical and allied health students in the traditional medical schools are often admitted at the 100 level after they have passed all the examinations in the natural sciences. This position reaffirmed the fact that medicine and other health sciences disciplines emanated as offshoots of the natural sciences.
Without a solid foundation in the arts and natural sciences, medical and allied health students are unlikely to do well in the clinical and professional courses. Our experience at UNIMED indicates that students who passed all the examinations in the natural sciences are more discerning, more conscientious and more amenable to training as they progress faster in their medical education.
Attempting to train medical and allied health professionals without a sound foundation in the natural sciences is akin to growing a tree with its branches rather than with its roots. Although some trees are known to blossom this way, it is often with great difficulties, and indeed, many withers away within a short period.
My first recommendation is that Medical Universities should include a Faculty of Natural Sciences that include Departments of Biology, Chemistry, Physics, Mathematics, and Computer Science in their curricular planning – This is the model that we fashioned at UNIMED with excellent learning outcomes, including the attraction of external grants from international agencies. Any Medical University that fails to have a Faculty of Natural Sciences will eventually find out that they have made a grave mistake which will be difficult to correct at a later date.
Indeed, I have reviewed the curricula of many Medical Universities around the world and have not found one that does not include the Natural Sciences as foundational courses.
A unique aspect of the UNIMED education is the integration of General Studies and Entrepreneurship (business aspect of medicine) courses into our medical, dentistry and allied health curricula. In addition to these unique courses, our students are encouraged to participate in rigorous clinical and community-based internships as part of their training. These experiences have the potential for liberating our graduates and not make them solely dependent on government jobs after graduation.
2). Name and Diversity: Another argument posited by some of our stakeholders is that Medical Universities should exclusively be for medicine and dentistry professions and not include any other health-related disciplines. Again, this is a short-sighted position as there are only a few universities in the world that focus on just one or two programs. In any case, such Universities will be costly as the number of students enrolled will be unable to adequately pay for the educational and residential services needed to run the institution effectively.
The academic and financially sound approach is that Medical Universities should offer an abundance of health disciplines, to provide for diversity in courses, and expansive learning and research experiences for the faculty and students.
At inception, a Medical University should start with a few disciplines, and diversify by offering other disciplines at a later stage when resources become more available. With diversity comes the debate about the name of the university. Should it be called a Health Sciences University rather than a Medical University? Naming it a Health Sciences University, some argue will provide a sense of ownership for all health professions. Others contend that the name Medical Sciences University embraces all aspects of medicine and other health professions.
In my view, the onus should be left entirely to the proprietors to decide on the name of the University. As long as the mission, vision and core value statements of the Medical University are well defined, useful time should not be spent on wrangling on a name.
3). Contextual and Strategic Measures: Establishing a Medical University (indeed, any new University) should be with a specific mission and end-points in mind. Such a University must have a unique purpose that will differentiate it from the existing Universities in the country.
The curriculum of the new Medical University should be designed to conform to global trends in medical education. The typical curriculum of a Nigerian medical school is deficient in the following non-clinical related contents: patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, informatics, organization and leadership theories, program administration, health care financing, essential drugs, supplies and human resource management, entrepreneurship, and pedagogy. The new Medical University must address these curricula deficits for its graduates to be able to practice effectively in the 21st-century healthcare system. It must never be “business as usual.”
Far too often Universities in Nigeria are established on sentiment and with sensational underpinnings, without concerted efforts made to align the expected outcomes to address the existing medical, societal and environmental challenges. This omission can lead to failure, creating a pathway that does not allow the new institution to grow substantively. It is essential that a new Medical University is academically guided by sound scientific principles and administratively embrace transparency, accountability, and anti-corruption philosophy.
Otherwise, the institution will have no justification for its existence, and will likely not survive the current national and global academic competitiveness for program quality and efficiency. It is essential that before establishing a specialized Medical University, the proprietors must devote sufficient time for consultation, stakeholders’ engagement, strategic planning, physical and environmental scanning, curriculum planning, and resource mobilization.
It is heart-warming and commendable that the NUC currently insists that these initial efforts are in place before applying for a license to establish a new University. Concerning strategic planning, a detailed SWOT analysis must be completed in consultation with experts in tertiary education, and the results widely published.
In a favorable academic milieu, both the teaching and non-teaching personnel are drawn typically from different cultural and socioeconomic backgrounds. These expectations do not always align with the vision of the University founders. Given this schism, it is essential that the strategic mission and vision of the University be made known at the onset, and efforts made to continually remind all internal and external stakeholders about the primary expectations of the University.
To be continued tomorrow
Professor Okonofua, is Vice-Chancellor, University of Medical Sciences (UNIMED), Ondo City, Ondo State is a keynote address delivered at the Seventh Professor Sofoluwe Memorial Lecture, organized by the Alumni Association of the University of Lagos, recently.
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