Integrated Curriculum in Medical Schools in Pakistan – What? Why? When? and How Much
DOI:
https://doi.org/10.21649/akemu.v30i4.5618Keywords:
Integrated curriculum, integration, competency, developing countryAbstract
Medical profession is undergoing rapid transition to address the challenges of modern-day healthcare delivery.
Therefore, medical education and training have come under scrutiny to ensure medical practitioners are not only fit to
practice medicine but also maintain social accountability. Medical education in Pakistan is undergoing changes to
address local healthcare needs and to remain accredited in line with standards delineated by the World Federation of
Medical Education. Yet, the majority of medical schools in Pakistan have maintained traditional curriculum consisting
of pre-clinical and clinical divide. Elsewhere, undergraduate curricula have moved away from teacher-centered
pedagogy, are more flexible, and have introduced innovative teaching methods, integrating content vertically and
horizontally. The modern-day doctor must demonstrate competency in multiple roles while remaining sensitive to the
context of the community they serve. We argue that medical schools in Pakistan must adopt integrated curriculum, and
student-centered learning activities.
References
1. Yeganeh H. An analysis of emerging trends and transformations in global healthcare. Int J Health Gov. 2019;24(2):169–80.
2. Barber C, van der Vleuten C, Leppink J, Chahine S. Social accountability frameworks and their implications for medical education and program evaluation: A narrative review. Acad Med. 2020;95(12):1945–54.
3. Gilliam CA, Lurie B, Winn AS, Barber A, Jackson D, Weisgerber M, et al. The role of competency-based medical education in addressing health inequities and cultivating inclusive learning environments. Curr Probl Pediatr Adolesc Health Care. 2024;54(9):101641.
4. Accreditation Council for Graduate Medical Education. Milestones by specialty. Chicago: ACGME; 2025 [Internet].[cited 2024 Dec 11]. Available from: https://www.acgme.org/milestones/milestones-by-specialty/.
5. Taylor DCM, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach. 2013;35(11):e1561–72.
6. Desai S, Burk-Rafel J, Lomis K, Caverzagie K, Richardson J, O'Brien C, et al. Precision education: The future of lifelong learning in medicine. Acad Med. 2024.
7. World Federation for Medical Education. WFME global standards for basic medical education 2020 [Internet]. Ferney-Voltaire: WFME; 2020 [cited 2024 Dec 11]. Available from: https://wfme.org/wp-content/uploads/2022/03/WFME-BME-Standards-2020.pdf.
8. Brauer DG, Ferguson KJ. The integrated curriculum in medical education: AMEE Guide No. 96. Med Teach. 2015;37(4):312–22.
9. Ghias K, Khan KS, Ali R, Azfar S, Ahmed R. Stretching the boundaries of medical education: A case of medical college embracing humanities and social sciences in medical education. Pak J Med Sci. 2016;32(4):911–6.
10. Quintero GA, Vergel J, Arredondo M, Ariza MC, Gómez P, Pinzon-Barrios AM. Integrated medical curriculum: advantages and disadvantages. J Med Educ Curric Dev. 2016;3(1):18920.
11. Dent JA. The continuing use of the SPICES model in ‘SAVOURING’ curriculum development. Med Teach. 2023;45(7):760–5.
12. Hafeez A, Jamil B, Khan AF. Roadblocks to integration; Faculty’s perspective on transition from traditional to integrated medical curriculum. Pak J Med Sci. 2021;37(3):788–93.
13. Khan AA, Asher A, Ahmad A, Iqbal S, Khan NA. Frame factors for implementation of integrated curriculum in public sector medical college-faculty’s perspective. Pak Armed Forces Med J. 2016;66(6):891–7.
14. Thistlethwaite JE, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, et al. The effectiveness of case-based learning in health professional education: A BEME systematic review: BEME Guide No. 23. Med Teach. 2012;34(6):e421–44.
15. Qin Y, Wang Y, Floden RE. The effect of problem-based learning on improvement of the medical educational environment: A systematic review and meta-analysis. Med Princ Pract. 2016;25(6):525–32.
16. Nandi PL, Chan JN, Chan CP, Chan P, Chan LP. Undergraduate medical education: Comparison of problem-based learning and conventional teaching. Hong Kong Med J. 2000;6(3):301–6.
17. McParland M, Noble LM, Livingston G. The effectiveness of problem‐based learning compared to traditional teaching in undergraduate psychiatry. Med Educ. 2004;38(8):859–67.
18. Khan H, Taqui AM, Khawaja MR, Fatmi Z. Problem-based versus conventional curricula: Influence on knowledge and attitudes of medical students towards health research. PLoS One. 2007;2(7):e632.
19. Grant A, Kinnersley P, Field M. Learning contexts at two UK medical schools: A comparative study using mixed methods. BMC Res Notes. 2012;5(1):1–8.
20. Tayyeb R. Effectiveness of problem-based learning as an instructional tool for acquisition of content knowledge and promotion of critical thinking among medical students. J Coll Physicians Surg Pak. 2013;23(1):42–6.
21. Lucieer SM, van der Geest JN, Elói-Santos SM, de Faria RMD, Jonker L, Visscher C, et al. The development of self-regulated learning during the pre-clinical stage of medical school: A comparison between a lecture-based and a problem-based curriculum. Adv Health Sci Educ. 2016;21(1):93–104.
22. Laven G, Keefe D, Duggan P, Tonkin A. How was the intern year?: Self and clinical assessment of four cohorts, from two medical curricula. BMC Med Educ. 2014;14(1):1–10.
23. Higher Education Commission of Pakistan. MBBS revised curricula 2010-2011. Islamabad: HEC Pakistan; 2011 [Internet]. [cited 2024 Dec 11]. Available from: https://hec.gov.pk/english/services/universities/RevisedCurricula/Documents/2010-2011/MBBS-Draft-2010-11.pdf.
24. Sethi A, Khan RA. Curriculum integration: From ladder to ludo. Med Teach. 2020;42(12):1421–3.
25. Akram A, Rizwan F, Sattar K, Hadi JI, Meo SA. An approach for developing integrated undergraduate medical curriculum. Pak J Med Sci. 2018;34(4):804–10.
26. Haq H, Khan RA, Yasmin R. Healthcare needs of the Muslim patient community in the undergraduate medical curriculum – Are we there? Pak J Med Sci. 2019;35(3):836–40.
27. Kayani ZA, Gilani I, Mahboob U. Perceptions of medical teachers about integrated curriculum: A qualitative study. J Ayub Med Coll Abbottabad. 2018;30(3):381–5.
28. Wijnen-Meijer M, van den Broek S, Koens F, Ten Cate O. Vertical integration in medical education: The broader perspective. BMC Med Educ. 2020;20(1):1–5.
29. Wijnen-Meijer M, Ten Cate OTJ, Rademakers JJ, Van Der Schaaf M, Borleffs JCC. The influence of a vertically integrated curriculum on the transition to postgraduate training. Med Teach. 2009;31(11):e528–32.
30. Ten Cate O, Carraccio C. Envisioning a true continuum of competency-based medical education, training, and practice. Acad Med. 2019;94(9):1283–8.
31. Zuberi RW. Problem-based learning: Where are we now? Guide supplement 36.2 – Viewpoint. Med Teach. 2011;33(3):e123–4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Annals of King Edward Medical University
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk