Rationale

Drawbacks and shortcomings of classical system

Major among these is lack of full response to community needs and a tendency to continue maintaining the status quo in curricula and educational methods rather than updating and using more effective and relevant teaching/learning methods in accordance with current, evidence-based medical education. Moreover, students are passive during lectures, which are the dominant feature, and there is lack of integration between disciplines and insufficient preparation of the students for continuing their own education after graduation and for applying what they have learned to actual practice.  

Merits of Community-Based/Problem-Based programs

Earlier studies on 10 innovative, community- oriented, PBL schools(Richards & Fulop, 1987) showed that the graduates from these schools were” more skilled in clinical work especially in dealing with patients….more concerned, more committed to patients, better communicators and strong patient advocates”. They compared favorably in examination on knowledge of basic sciences, and were better off in the knowledge and its application in relation to health needs. Woodward (1996) has reported, in reference to certain studies, that PBL graduates were more motivated, they enjoyed their studies and that students used the library more, did more self-learning and their clinical knowledge and skills were judged slightly better. Their retention, retrieval and application of basic science knowledge were also better (Network: TUFH, 2003). It has also been reported (Jones et al., 2001) that “there is evidence that students in a PBL curriculum become better self-directed learners, that their confidence and feeling of belonging to the medical school increases, and that scores in some exams could be higher. Some have suggested that…..the work environment for students and teachers is much better.” (Jones et al., 2001).        

Changing needs of the health system

"The focus of health care... has shifted from the individual to the community, from cure of disease to preservation of health, from episodic care to continuous and comprehensive care, and from an individual approach, provided by single primary care physicians, to comprehensive, community-based care, provided by primary-care teams...  These changes have significant implications for educational institutions" (Jones et al., 2001).

The revolution of information technology making health science information available and fairly accessible to the public and profession.

The change in epidemiological milieu of diseases e.g. HIV/AIDS, malaria and tuberculosis.