Explaining how two patients with the same diagnosis may not have the same treatment because of financial considerations, I looked around to see delegates from the US, UK and Canada nod their heads in agreement. The large Hong Kong delegation looked perplexed; it was only after learning about their public health system that I understood why.
Sixteen years after its establishment in the Ateneo de Zamboanga University School of Medicine, the Problem-Based Learning (PBL) curriculum is only now emerging as a groundbreaking medical education innovation. The Frontiers in Medical and Health Sciences in Education Conference we attended in Hong Kong was the first time I joined an international conference, and my first time to present to an international audience. The trip itself was a miracle; we kept praying our abstracts would be chosen for presentation as we believed we had something important to share with other schools. The organizers thought so too, and when we received confirmation for presentation, we went into a flurry of preparing the slides and script.
Hongkong is a beautiful place. At this time of the year, the air is crisply cold and fresh. There was hardly any litter in the streets, while motorists and pedestrians strictly abided rules which made for loose traffic. In my whole stay there, I saw just one beggar in the subway halls; no one lived under bridges or in broken-down shanties. No one appeared sick in the streets, even in the windy cold. Everywhere I looked, there were shops full of fungus, tree roots, animal parts and strangely-colored solutions.
It was ancient Chinese culture enmeshed with a global city’s rigid discipline, coming together in vibrant and productive expansion.
From the moment I arrived at the conference venue, there was so much to read and learn and store away for future use. Our conference kits came with a compilation of all submitted abstracts. I began reading about ethical reasoning, bereavement, and the patient-physician interaction, but only the ADZU-SOM abstracts were about community medicine. It wasn’t surprising; most medical schools around the world still follow the traditional curriculum of theory-intensive learning.
When the first speaker, Dr. Richard Drake, an anatomist from the USA who has authored several books, began discussing curricular reforms and innovative approaches in reinforcing anatomical knowledge, I realized he was just talking about PBL. How the ADZU-SOM has been teaching its students for 16 years now is considered ground-breaking curriculum for them. Professors and deans from medical schools all over Asia, Europe and the Americas seemed to agree with Dr. Drake during his Q&A segment. They began discussing medical practice accountability and community health, all of which are components of my medical school’s curriculum.
There we were, sitting quietly in our seats, wanting to tell everyone that yes, PBL curricula work; yes, community-based medicine can make immense changes in communities just as the ADZU-SOM graduates have done in the past decade.
The succeeding student presentations cited experiences of the University of Hong Kong students including their outreach programs. They conducted lectures and proper hand washing demonstrations for five hours in remote communities and felt their lives change.
It was at that moment that I thanked God for the wonderful opportunity to present our school to this audience, and resolved to tell the students of the profound experiences we have in the community. I wanted to tell them that five hours does not get you enough time to know people and their families well. It does not allow you to see patients as people and not just another case of pneumonia. They have feelings, family and financial difficulties that need addressing in order to prevent disease, not just existing conditions.
Looking out at the crowd after my presentation of Value Formation as an Impact of Community Learning Experience, it dawned on me that no matter what the public health system of a country, community medicine and PBL works in forming conscientious, resourceful, responsive and accountable physicians. The Hong Kong students found it astonishing that our government could not afford to give free medicines; in any hospital a Hong Kong resident consulted, the medicines cost them nothing. Still, the inability of the Philippine government to provide free drugs did not prevent the ADZU-SOM from serving the communities in Region IX. I wanted to explain why, regardless of the system, a medical school has to keep service to humanity at the forefront of its curriculum.
There was so much my classmates and I had to share, but so short a time at the stage. I could only hope that what little did offer would enable them to reflect more on their medical curricula.
-Caroline C Fabian
3rd Year, Medical Student
