Teaching of preventive medicine in a medical school in Malaysia

Developments and problems regarding the teaching of preventive medicine in the Faculty of Medicine, University of Malaya, Malaysia.

The teaching of preventive medicine started with the admission into the Faculty of Medicine, University of Malaya, of the first class of medical students in 1964. and has developed as these students. Progressed from the first to the final year of the medical course. The present structure of the course in social and preventive medicine (as it is designated) includes the following:

Year I

• Learning in a university
• Descriptive statistics

Year II

• Inferential statistics
• Principles of epidemiology
• Epidemiology and control of communicable diseases

Year III

• Introduction to Social medicine
• Elementary sociology and medical sociology
• Nutrition and dietetics
• Health statistics
• Community health
• Rural health survey

Year IV

• Patient and family studies
• Public health problems
• Fertility statistics
• The population problem
• Maternal and child health
• District health services

Year V

• Patient and family studies
• The problem of specific diseases/conditions and their prevention.

Two periods of three weeks and two weeks respectively are spent in the field – the first in a study of how people live in a rural area with emphasis on health aspects, and the second in a study of health services offered and their use within a district.

The teaching of preventive medicine is not confined to the Department of Social and Preventive Medicine, but is contributed to by other departments, in particular, the Department of Psychological Medicine, Obstetrics and Gynaecology, and Paediatrics. In addition, there are two clinical postings, of two weeks each, given to the study of leprosy and tuberculosis, during both of which prevention is stressed.

The major problem regarding the teaching of preventive medicine is in the attracting of staff of adequate calibre. From this stem other problems. With inadequate staff, both quantitatively and qualitatively, it is difficult to implement the desired programme, or practice desired teaching methods. especially the tutorial and seminar, or maintain desired academic standards. The education and training of staff, academic and auxiliary, slows down, it becomes difficult to arrange time for gaining experience in areas where this is not adequate, and research suffers. This has an adverse effect on the development of individual staff members and on enthusiasm. With limited staff time, a further problem arises of whether time should be equally shared among all students, or special groups given additional time. The tendency has been to give extra tuition to weak students, with the result that the good students, from among whom future teachers will be drawn, do not get the stimulus and guidance so necessary for their development.

While today’s student enters the University with more factual knowledge than his counterpart of twenty years ago and with a tremendous ability to memorize facts, his comprehension of the language of instruction, his basic skills of reading, being able to express himself clearly in writing or verbally, and of learning on his own are deficient.

Sending students out to work in the field in a “multiracial” society that has not yet become an integrated one is not without difficulties, even dangers. Careful preparation and supervision of students are necessary to avoid untoward incidents and to maintain the goodwill of the communities which we study.

The problem of evaluation is a difficult one. Certain sections of the course can be dealt with by examination, but we do not find it easy to devise examinations that test understanding and skills and not merely the ability to recall factual knowledge. We have not yet been able to measure the development of desired attitudes in students nor changes in their behaviour as a result of our teaching programme.

Submitted by W. Danaraj, Professor of Social and Preventive Medicine and Head of Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia for the Third Regional Seminar on Education and Training: Teaching of preventive medicine in Medical Schools – Country Report Malaysia held in Manila, Philippines from the 13 to 19 October 1970.

The fulltext of the report is available on the WHO WPRO IRIS website.