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

Abstract

ABSTRACT

Since its establishment, Institute of Medicine (IOM) has been pursuing Community Oriented Medical
Education (COME) in training medical graduates in the country. The community orientation of the MBBS
program of IOM is achieved through community based learning divided into different experiences like field
based community diagnosis, concurrent field with families with sick members, district hospital management
through posting in the district hospitals. The aim of this article is to review the organization of the COME
at IOM, identify the strengths and weaknesses of this approach and suggest measures for improvement. A
review of the educational activities related to community based learning experiences was done, and focus
group 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 been
any consensus regarding the effectiveness and desirability of this approach. The review revealed that the
program at IOM has partially incorporated the concepts of COME in its teaching learning activities. Students
and 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 are
certain areas, particularly in orientation of the students, supervision and logistic support that need
improvement. In conclusion, COME though not formally evaluated so far, seems to have made a strong
influence on the education of physicians in Nepal. It needs continuous support and strengthening in order to
produce doctors with social relevance in future as well.

Key Words: Medical Education, Community Oriented, Evaluation, Nepal.