COMMUNITY ORIENTED MEDICAL EDUCATION (COME) : EXPERIENCES AT THE INSTITUTE OF MEDICINE

Abstract

ABSTRACTSince its establishment, Institute of Medicine (IOM) has been pursuing Community Oriented MedicalEducation (COME) in training medical graduates in the country. The community orientation of the MBBSprogram of IOM is achieved through community based learning divided into different experiences like fieldbased community diagnosis, concurrent field with families with sick members, district hospital managementthrough posting in the district hospitals. The aim of this article is to review the organization of the COMEat IOM, identify the strengths and weaknesses of this approach and suggest measures for improvement. Areview of the educational activities related to community based learning experiences was done, and focusgroup discussions were carried out among the current and the past students. Besides these two activities,literature was searched and concerned authorities were informally interviewed to find out if there has beenany consensus regarding the effectiveness and desirability of this approach. The review revealed that theprogram at IOM has partially incorporated the concepts of COME in its teaching learning activities. Studentsand graduates of the program tend to like the program and value its contribution in their education.International bodies and educational experts in the country view this approach with great favour. There arecertain areas, particularly in orientation of the students, supervision and logistic support that needimprovement. In conclusion, COME though not formally evaluated so far, seems to have made a stronginfluence on the education of physicians in Nepal. It needs continuous support and strengthening in order toproduce doctors with social relevance in future as well.Key Words: Medical Education, Community Oriented, Evaluation, Nepal.