KUMJ | VOL. 7 | NO. 3 | ISSUE 27 | JULY-SEPT, 2009

Comparative study of community medicine practice in MBBS curriculum of health institutions of Nepal
Marahatta SB, Sinha NP, Dixit H

Background: A revolution in health care is occurring as a result of changes in the practice of medicine and in society. Medical education needs to adapt to society's changing attitudes. Presently medical education has been criticised for its orientation and insensitivity to people’s need. MBBS curriculum of medical institutions of Nepal has been focusing on community-based approaches and still it’s guided by same notion. The question put forward is has it been appropriate to nurture the present health need and aspiration of people.
Objective: The objective of the present study is to review the existing Community Based Medical Education in Health Institutions of Nepal to strengthen the components of community care.
Materials and methods: Qualitative study was done by reviewing the curriculum and existing community medicine courses in MBBS curriculum of Kathmandu University Medical School, Institute of Medicine/Tribhuvan University and BP Koirala Institute of Health Sciences.
Result: The curriculum of all the health institutions have addressed signifi cantly on community medicine practice. As per Institute of Medicine, the community medicine practice is achieved through community based learning experiences like community diagnosis, concurrent fi eld with families of sick members and district health systems management field. In BP Koirala Institute of Health Sciences community medicine practice is undertaken through exposure to community diagnosis program, health care delivery system, family health exercise, applied epidemiology and educational research methodology, management skills for health services and Community Oriented Compulsory Residential Rotatory Internship Program (COCRRIP). In KUSMS, community medicine module is carried out as- community diagnosis program, community health intervention project, school health project, occupational health project, health delivery system functioning, family health care activities and Compulsory Residential Rotatory Internship Program in outreach clinics. In the practice the practical aspects are largely unstructured that waste too much time in non-educational activities and rely on learning and doing. Meanwhile, expectation of the community is increasing and the challenge of nurturing their demands has come in forefront. Community has perceived that the medical schools are concentrating on fulfilling the demand of their curriculum rather directing on their health care need.
Conclusion: Health institutions need to be accountable to take the responsibility of strengthening the health status of the community of their catchments areas. The practice of community medicine need to be done in an innovative way and these schools should execute continual intervention activities and complement other institutions working in their areas.