Students' perception regarding medical education in Nepal.
BACKGROUND
Medical schools and medical education look different as we advance into the 21st century. Nepal has seen a dramatic increase in the number of medical schools/colleges in the last decade. Most schools practice traditional teaching method while others are implementing problem based learning (PBL). It is important to explore the current advances and practices in medical education to meet the needs of the health services of the country.


OBJECTIVE
The objective of the present study is to explore the students' perception regarding present status of medical education in Nepal and provide recommendations to address future needs.


METHODS
The study design of the present research was descriptive and exploratory type. Structured Questionnaire was used to assess the students' perception relating to different aspects of medical education. A total of 24 students studying in the final year of MBBS from six medical colleges were selected randomly.


RESULTS
The traditional teaching/learning methodologies have been prevailing in the medical schools of the country. PBL suits many objectives of self directed learning (SDL) because students learn to reason and deduce facts and figures rather than rote learning. For the success of PBL and SDL students require learning resources and as per our findings although 71% of the students were satisfied with library facilities 54% were dissatisfied with computer resources. Community based approaches have been focused in the curriculum of all the medical schools of Nepal. About public health and community medicine teaching 86% of the students reported to be appropriate, of which 18% actually thought it was excessive. About the teaching of evidence based medicine (EBM), 50% students felt it was adequate and other half thought it was inadequate. Majority of the students i.e. 62% of the students also felt that the care of ambulatory patients was as well covered as the care of hospitalized patients. The areas of clinical practice which the students felt were inadequate included: nutrition (71%), geriatrics (70%), end of life care (71%), palliative care (67%), long term health care (70%), continuity of care (70%), ethical decision making (56%) and patient follow up (50%). In spite of completing their training, 25% felt they were not confident that they had acquired the clinical skills required to begin the residency program. As much as 60% felt they did not receive information about specialties and alternative medical careers. About 75% of the students had the feeling that medical profession will not be financially rewarding; 80% felt it would not be as respectable; 99% felt it would be more scientifically challenging.


CONCLUSIONS
The medical education of Nepal is still guided by the notion of the traditional approaches. The teaching methods should come up as per the advancement in contemporary medical education. The training needs to be more structured and focused in practical reality than only feeding students with theoretical knowledge.
Marahatta
S B
SB
Department of Community Medicine, Kathmandu University School of Medical Science, Dhulikhel, Nepal.
Dixit
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