Summary

A research elective program was designed to foster medical students’ investigative skills within the context of a research project. Though the program was mandatory, the topic and investigative questions for each course were selected by the student. For five years now, we have provided a positive opportunity for first- and second-year medical students to develop an investigative approach to medical problems. It was felt that, since medicine is in constant evolution, a future physician should be educated to understand scientific advances. This experience provided students with insights into scientific method and the discipline of research, that engendered an approach to medicine that is constantly questioning and self-critical. However, the benefits of research (according to those students who had the opportunity of embarking on a research project) go beyond the advancing of medical knowledge to encompass acquisition of analytical and communicational skills. The emphasis in this research program was placed on the method of study (process) rather than on experimental results. The fact that students attach individually to an elective program ensures that they will benefit from the opportunity to discuss (with someone with a good track record in research) the integration of basic science concepts into clinical problems. By adopting the method of problem-based learning, self-directed learning skills appear to be enhanced, thus fostering both continuing medical education and a scholarly, investigative approach to problems in medicine.

Program effectiveness, as reported by students, suggested that we should provide more opportunities for the students to broaden the spectrum of such an experience by engaging in laboratory or clinical research, or by obtaining additional practice in any particular field. Thus, a new curriculum was designed and implemented three years ago. It consists of a strong and carefully planned core knowledge program, supplemented by options (elective disciplines and special study modules). The core occupies 70% of the time available in the curriculum. Options run alongside the basic core teaching, time slots being allocated for the elective programs, which are then scheduled in the timetable. A large and open menu of options is allowed that balances the traditional science-based and specialist-based disciplines with those related to the doctor-patient relationship (communication, compassion, ethics), population-based and preventive medicine at both the biomedical and behavioural levels. In the special study modules more emphasis is placed on research and on-the-job learning. Options are meant to be opportunities for choice, not of what to leave out, but of what to add in to augment the core. Mastery of knowledge, skills and attitudes regarding prevention, cure and palliation, relevant to the practice of medicine, are covered in the core to ensure the maintenance of standards.

It is generally felt that, in the medical course, both breadth and depth of subject coverage are needed. Since the problem is that there is insufficient time to study everything in depth, the core of the new curriculum can provide the breadth while the elective activities can let students choose the topics (of particular interest to them) to study in depth.