Ayyaz Ali Khan1, Saima Chaudhry2, Syed Akhter Hussain Shah Bokhari3
1 Professor, Shaikh Zayed Federal Postgraduate Medical Institute / IADSR.
2 Lecturer , Shaikh Zayed Federal Postgraduate Medical Institute / IADSR.
3 Professor, University of Faisalabad.
Correspondence: Ayyaz Ali Khan
Medical education is the foundation for establishment of a good health care system. It has undergone major transformation along with the change in concepts of health and disease. The important driving factors for this transformation in medical education are the rising costs and inequities in health care. Production of disease oriented physicians relying on high-tech clinical settings had been attributed to the traditional technology-based western model of medical education. One of the consequences of which is the allocation of a large proportion of meager health resources to curative health care with little improvement in health of the population and ignorance of integral aspects of health promotion and disease prevention.
Community oriented medical education (COME) came in as an evolutionary approach tomedical education. It lays profound stress on community health needs, sociocultural aspects of health and disease and work in collaboration with the community for health promotion, disease prevention and cure. Hence promising the production of health oriented physicians equipped with multidisciplinary skills. The Edinburgh Declaration and the World Summit Recommendations of 1995 further reinforced this approach to medical education. Thus the educational institutions were urged to restructure curricula to encourage lifelong and self-motivated learning in hospitals and communities, along with government and community partnerships.
Dental education is no different. Many dentists and dental educators agree the innovativeCODE (Community Oriented Dental Education) program holds the promise of educating tomorrow’s dentists in an effective, nontraditional setting while delivering quality oral health care.
The choice of an educational philosophy will be driven by factors that may not be directly under the control or influence of the curriculum planner. For example resources, culture and available learning environments. It will be important that the curriculum must recognize the context in which healthcare will be delivered, and that the graduate be sensitive to issues of deprivation and poverty within their country / community.
Progression of approaches to dental curriculum design or philosophy have transformed from diseaseoriented through health-oriented to community oriented. It has been noted that developing countriesmay lag behind developed countries in their journey towards a community-oriented curriculum, and curriculum detail will be influenced by their country’s historical and professional contacts with various developed countries.A community-oriented curriculum is also a competencebased curriculum; however, due to the different demographic characteristics between developed and developing countries, the competence statements are likely to be different.
Dental education is regarded as a complex, demanding and often stressful pedagogical procedure. Undergraduates, while enrolled in programs of 4 years duration, are required to attain a unique and diverse collection of competences. It is commonly agreed that dental curricula should be scientifically based, clinically relevant, medically informed and promote social responsibility. There is a global acknowledgement that schools would need to develop curricula that recognized both patient and student diversity
A Curriculum is a complex, dynamic, and evolving entity, which needs constant attention. Curriculum designers should start by considering the knowledge, skills and attitudes that their graduate will need for contemporary and future dental practice. Creating a new curriculum structure is a challenge. It requires both leadership and management, with careful planning and a stepwise approach to ensure that the goals are achieved. Achieving the correct structure requires an investment in time, energy and expertise.
This investment is important to maximize the educational experience for each student and to produce dentists who are able to practice effectively, efficiently and with compassion in a world that is experiencing ever more rapid changes in knowledge, technology and cultural mores. Establishing the curriculum is the first stage in a sustained process of evaluation and developmentwhich is essential to ensure that it remains fit for purpose. It is important to involve as many faculty members as possible because people change more easily when they are involved in the process.
Inequalitieswithin dentistry are common and are reflected in wide differences in the levels of oral health and the standard of care available both within and between communities in Pakistan. The growth of mostly private dental schools has widened access for urban areas, often at the expense of rural areas. This calls for the redesigning of dental education system to cater for the health needs of the population; through the development of locally adapted curricula.
1 Khan A.A, Ijaz S. Integration of undergraduate dental education with primary oral health care in
Pakistan. Guest Editorial. J. Pak. Dent. Assoc. 2005 14: 65-66.
2 Bokhari SAH, Khan A.A. Dental Education in Pakistan. Are we not producing procedureoriented
technicians? Guest Editorial. Jrnl. Pak. Dent.Assoc. 2005 14: 189-190.
3 Khan A.A., Mumtaz R., Moeen F. Reengineering of Dental Education in Pakistan. Guest Editorial.
Jrnl. Pak.Dent.Assoc. 2007. 16: 123-126.