medical students, 1968: who they are and what they think

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Brit.3. med. Educ., 1969, 3, 115-117 Medical Students, 1968: Who They Are and What They Think G A B R I E L E . R I F KA American University of Beirut School of Public Health, , Lebanon The role of medical students in the evolution of medical education has been recognized for long and their expressed views have often contributed to the revision of curricula, methods of teaching, and other related issues. The purpose of this study is to explore the medical student’s views and feelings about some important aspects of his education. The site of the study is the kmerican University of Beirut Medical School, which is a leading and long-standing medical school in the Middle East. Method The study subjects were 88 students in the last three years of undergraduate study (representing 73.337; of all students enrolled in the three classes), who were called to a meeting on June 6, 1968, to answer a questionnaire. The purpose of the meeting was not announced beforehand. The questionnaire elicited information on the student’s background, including age, nationality, birth order in the family, father’s occupation, and family annual income. 7 he student was also asked about the source of his financial support and linguistic proficiency in English during his period of study, and he was requested to indicate the names of a few senior members of faculties in the university. Other questions pertained to the func- tions of a sanitarian and of a public health nurse, utilization of the medical library, nunber of lectures he attends per year outside the university and number of cigarettes (if any) he smokes per day. Lastly, the student was asked to express his views on the teaching programme in public health and also whether his professors in the medical school were reasonably accessible and would en- courage him to have his own ideas. Results Social and Economic Background Sixty per cent of respondents were Lebanese; the remainder came from neighbouring countries including Jordan, Syrian Arab Republic, Iraq, the Arabian Peninsula, and Ethiopia. The mother tongue of the majority of students was Arabic. Ages ranged from 21 to 28 years; two students were married, and the group included only six female students (6.8%). Sixty-eight per cent were Christians, the others being Moslems. The majority of students described their fathers as non-professional, but 12.5yA said their fathers were medical doctors. The family size varied between three and 12 members, the median family, however, was five. Thirty-one students (35’3%) were the oldest children in the family, 26 (29.50/0) the youngest, and 27 (3o-71yO) middle children. Two were the only children in their families and two students did not respond. The family annual income fell, on the whole, in the middle-class category, taking into account Middle East standards. It varied from $2000 to $8000, business being the main source of income. Eighty- seven students (out of 88) mentioned that it was their own decision to study medicine, and 59 (67%) were expected to give financial support to their families after graduation. Attitudes to Faculty and Programme Professors Twenty-nine students (32.9%) felt their professors were reasonably accessible; six students (6.8%) thought their professors were not accessible, and 53 (60.2%) indicated that some professors were 115

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Page 1: Medical Students, 1968: Who They Are and What They Think

Brit.3. med. Educ., 1969, 3, 115-117

Medical Students, 1968: Who They Are and What They Think G A B R I E L E . R I F KA American University of Beirut School of Public Health,

, Lebanon

The role of medical students in the evolution of medical education has been recognized for long and their expressed views have often contributed to the revision of curricula, methods of teaching, and other related issues. The purpose of this study is to explore the medical student’s views and feelings about some important aspects of his education. The site of the study is the kmerican University of Beirut Medical School, which is a leading and long-standing medical school in the Middle East.

Method The study subjects were 88 students in the last three years of undergraduate study (representing 73.337; of all students enrolled in the three classes), who were called to a meeting on June 6, 1968, to answer a questionnaire. The purpose of the meeting was not announced beforehand. The questionnaire elicited information on the student’s background, including age, nationality, birth order in the family, father’s occupation, and family annual income. 7 he student was also asked about the source of his financial support and linguistic proficiency in English during his period of study, and he was requested to indicate the names of a few senior members of faculties in the university. Other questions pertained to the func- tions of a sanitarian and of a public health nurse, utilization of the medical library, nunber of lectures he attends per year outside the university and number of cigarettes (if any) he smokes per day. Lastly, the student was asked to express his views on the teaching programme in public health and also whether his professors in the medical school were reasonably accessible and would en- courage him to have his own ideas.

Results

Social and Economic Background Sixty per cent of respondents were Lebanese; the remainder came from neighbouring countries including Jordan, Syrian Arab Republic, Iraq, the Arabian Peninsula, and Ethiopia. The mother tongue of the majority of students was Arabic. Ages ranged from 21 to 28 years; two students were married, and the group included only six female students (6.8%). Sixty-eight per cent were Christians, the others being Moslems.

The majority of students described their fathers as non-professional, but 12.5yA said their fathers were medical doctors. The family size varied between three and 12 members, the median family, however, was five. Thirty-one students (35’3%) were the oldest children in the family, 26 (29.50/0) the youngest, and 27 (3o-71yO) middle children. Two were the only children in their families and two students did not respond. The family annual income fell, on the whole, in the middle-class category, taking into account Middle East standards. It varied from $2000 to $8000, business being the main source of income. Eighty- seven students (out of 88) mentioned that it was their own decision to study medicine, and 59 (67%) were expected to give financial support to their families after graduation.

Attitudes to Faculty and Programme

Professors Twenty-nine students (32.9%) felt their professors were reasonably accessible; six students (6.8%) thought their professors were not accessible, and 53 (60.2%) indicated that some professors were

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116 Gabriel E. Rifka

accessible and some were not. The students reacted differently to the question, ‘Have you been asked by your professors how their subjects of study should be presented 2’ Eleven (12.5%) answered in the affirmative, 31 (35.2%) in the negative, and 43 (489%) felt that some professors did and some did not. Three students did not answer the question.

Examinations and Future Plans Two students considered that the usual examina- tion system in current use at the university was excellent; 35 (39.8%) felt the system was good, and 49 (55.7%) thought that it was poor. NO language difficulties were reported by students. Fifty-nine students (67%) reported they would study medicine if given free choice again; 15 would not, and 14 were uncertain.

Fifty-seven students (64.8%) planned to study further after graduation irrespective of the country of study, and three students intended to practise directly after graduation. Sixty-four students (72.7%) expected to work eventually in their respective countries in the region and eight planned to emigrate to other countries. Four students were uncertain about the geographical area of work.

Medical Library Forty-three students (48.9%) believed that the medical library was an appropriate place of study, whereas 40 (45.4%) thought it was not. Five students did not express views one way or the other.

Teaching of Public Health When asked whether they were satisfied with their courses in public health, 33 students (37.5%) answered in the affirmative, but 54 (61.4%) ex- pressed their dissatisfaction and one student did not reply. Eighteen of the dissatisfied group felt no topic in public health was adequately covered during the courses, nine thought learning about public health in Lebanon and the neighbouring area should be reinforced, and eight recommended that more time should be allotted to field training.

Twenty-seven students (30.7%) expressed the view that, judging by the patients seen by them in hospital and out-patient department, preventable diseases amounted to not more than 107; of those diagnosed. Thirteen students thought the ratio was 30%~ and four up to 50%. Twenty-two students (25:h) did not respond.

The students were asked to outline two major functions of a public health nurse. The answers of 58 students (65.9%) were only partly correct, and those of 22 students incorrect. Eight students did not reply. As regards two major hc t ions of a sanitarian, 36 students (40.9%) answered partly correctly and 41 (46.6%) gave incorrect kswers. Eleven students did not respond.

Extra-curricular Activities On being asked to write the names of Ministers of Health at the time in their respective countries, 43% of students gave correct answers; however, 14% gave wrong names and 43% did not reply. Sixty-eight per cent of students knew the name of the director of the school of public health; 46% the name of the director of the school of nursing; and 83% the name of the Dean of the engineering school who has, however, been Dean for four years. Twenty-seven per cent of students were able to write the correct name of the medical librarian, and only one the name of the Dean of the school of agriculture who has been recently appointed.

As regards the doctor/population ratio in their own countries, 63 students (71.6:/,) gave reason- ably correct figures and 12 wrong information, whereas 13 did not answer. In the light of replies received, 43 students (48.9%) smoked and a similar number did not. Two students did not specify whether they smoked or not. Half of the smoking group smoked one to 10 cigarettes a day, one- third 11 to 20 cigarettes a day, the remaining over 20 cigarettes a day.

Discussion It is encouraging to note that, although the mother tongue of all the students involved in this study is not English, no language difficulties were reported during the teaching programme. Proper selection of candidates for the study of medicine has no doubt contributed to this finding. The small proportion (6.8%) of female students in the group reflects a trend commonly encountered in the Middle East where males constitute the main bulk of medical students. Likewise, the very small number (only two out of 88) of married students represents a comiion feature of the region, in contrast with the situation prevailing in a number of countries in Europe and North America, where the proportion of married students in medical schools is evidently higher. It is interesting to note

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Medical Students, 1968 117

that the vast majority of students decided on their own to study medicine apparently without an active involvement of their parents, although 12-5 yo of students are the sons of medical doctors.

The scope of knowledge of medical students about other faculties in the university can probably be broadened through ad hoc exchange of teaching personnel and through teamwork and close associa- tion, particularly in the field, with students from other faculties. The finding that less than 50% of students knew the names of Ministers of Health in their own countries does not necessarily indicate that the student has little interest in the health affairs of his country. Ministers of Health are likely to change frequently in this part of the world. However, one would expect that a medical student should follow up closely the health situation in his country by referring to local journals or by actively seeking pertinent information from his teachers, especially during the courses in public health.

In the light of comments made by students, further and more elaborate assessment studies should be conducted about the teaching of public health in the medical school. Pending this achieve- ment, more emphasis should probably be laid on public health problems in the Middle East, due attention being given to practical training in the field. The above should prove feasible by virtue of the abundant resourcefulness and rich potent- ialities of the school of public health in the same university. I am pleased to hear that the public health courses for medical students are already

under active revision by the faculties concerned. The remarks made by the students on the medi-

cal library deserve further study - at least to explore the reasons why 45’4% of the group think that the library is not appropriate for study. In this context it should also be recalled that only 27% of students were able to record the name of the medical librarian.

Conclusion The purpose of this study was to explore the feel- ings of a group of medical students about some aspects of medical education. Analysis of the data revealed that students vary widely in their attitudes and also in their scope of knowledge. Further research is indicated in specific areas including the teaching of public health, the utilization of the medical library, and the examination system in current use.

Acknowledgements The writer wishes to express his thanks to Dr Craig S. Lichtenwalner (director, school of public health and acting Dean, faculties of medical sciences) for his encouragement and support. He is also indebted to Dr Raif Nassif (director, school of medicine) for his guidance and valuable advice. Thanks are due to Dr Charles Churchill (professor of biostatistics) for his valuable assist- ance in designing the questionnaire and analysing the data, and to Mr Alfred Nassar (computer centre) for his effective help.