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TEACHING BIOETHICS & MEDICAL HUMANITIESfor MEDICAL STUDENTS in Indonesia
Case of Gadjah Mada
Soenarto Sastrowijoto
CENTER FOR BIOETHICS & MEDICAL HUMANITIES
Faculty of Medicine Gadjah Mada UniversityYogyakarta
December 2005
2
INTRODUCTION
International Standard in Basic Medical Education (WFME, 2003) 1)
Competence – based curriculum (Knowledge, skills, attitude/behaviors/ ethics
Development of Science & Technology : New technology and New techniques – economics issues – ethical problems (Fig.1)
Medical practice – Clinical decision making : scientific, ethics, legal and humanities based.
3
The limit number of Human resources for Bioethics teaching policy issues !
Share experiences among countries in teaching bioethics for medical students
What kind of policy should be developed related to HR capacity building (in Bioethics and Humanities)
Education / Teaching / Training on Bioethics and Humanities to improving HR competencies (cognitive, psychomotor, affective) in Bioethics and Humanities
INTRODUCTION
4
Medical Education
• Medical Practice
MD
Clinical Decision Making
• Education Standards • Medical Education Standards
• Medical Care Standards
1. Scientific (EBM)
2. Ethics (Moral principles)
3. Legal (Act, Regulation)
4. Humane
“Stake holders”
• Quality Assurance (Jaminan mutu)
• Social Accountibility
5
New Biomedical Sciences
New Technology (Recombinant – DNA Technology)
Methods of Medical SCIENCES
Methods of Medical Sciences - TECHNIQUES
Scholar Physicians
Medical Technology INDUSTRY
Economics of Medical Care
ETHICALISSUES
Drugs Devises Physical Setting
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INDONESIAN EXPERIENCE• National Core Curriculum, Teaching Ethics
I - Various (before 1993) – Medical Care/ ServiceII - Humanities (1993) – Sensitive to Socio Economic, Culture, Anthropology, Religion, etcIII - Bioethics & Medical Humanities (1997) – Combined
• Teaching Strategy - Conventional – senior lecturers – role Model - Structured lectures
- Innovative/hybride/PBL
• Hidden Curriculum in Bioethics
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UGM EXPERIENCE• Before 1993 - Nat. Core. Curric. I - Senior lecturer
1993 - Nat. Core. Curric. II - Humanities (12 Credit) Team teaching
1993 - Bioethics & Medical Humanities Structured – Team teaching – lectures
Semester 1 - Ethics & Law I (one credit)2 - Social Medicine I (two credits)3 - Behavioral medicine I (one credit)4 - Medicine Philosophy (two credits)5 - Behavioral Medicine II (one credit)7 - Behavioral Medicine III (one
credit)Teaching Strategy : Conventional lecturing
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• 2002 - UGM started PBL and Student Centered Curriculum Bioethics and Medical Humanities is in Block VIat the end of year I (Fig. 2)
- The Topic Tree (Fig. 3) Block VI consisted of 3 Modules : Bioethics, Medical Behavior, and Medical Law.Each of modul – some learning units for SGD
• WHO Searo - Material for Bioethics teaching (WHO – SEARO)- Field studies (India, Thai, Indonesia, etc)- Results - accepted, sincronized with the
local issues. - case studies (learning unit) of Block VI
should be renewal continuously
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Week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
E1: Exam for BSc in Medicine (BSc.Med or S.Ked)E2: Exam for MD or Doctor (Com prehensive Exam )E3: Exam for GP Licence (by each country's com m ittees)
(16 Aug-2 Oct '04)
Block III
Biomedical Science II
7 weeks
Block II
Biomedical Science I
(6 Dec '04-22 Jan '05)
5 weeks
Blo
ck II
(1 May-17 Jun '06)
Biomedical Science III
7 weeks
(7 Feb-26 Mar '05)
Block V
Public Health and
Entrepreneurship
Mak
e U
p T
est
Sem
este
r H
olid
ays
Mak
e U
p T
est Sem ester
Holidays
(30 J ul-18 Aug '07)(25 Jun-28 Jul '07)
Mak
e U
p T
est
Sense Organ
3 weeks
Year 1
2 w
eeks
: (8
-20
No
v '0
4)
2 w
ee
ks
: (2
2 N
ov
-4 D
ec
'0
4)
2004/2005
Block I
Study Skills and
Information Tech.
7 weeks
(4 Oct-6 Nov '04) Idu
l Fit
ri H
olid
ays
(13 Mar-29 Apr '06)(21 Nov '05-7 Jan '06)
Absorption
7 weeks6 weeks
(19 Sept-29 Oct '05)
Block IX
Neoplasm, Degenerativ e
7 weeks
2006/2007
(21 Aug-16 Sept '06)
Year 2
(12 Mar-28 Apr '07)Sem
este
r H
olid
aysBlock XV
Nephrology , Urology
Infection
Mak
e U
p T
est
Sem
este
r H
olid
ays
4 weeks
(18 Sept-14 Okt '06)
and Regenerativ e Process
(30 Apr-16 Jun '07)
(28 J an-16 Feb '08)
Block XVII
Psychiatry
7 weeks
Reproductive Health
7 weeks
Block XVI Block XVIII
Neurology, Behavior andEndocrine and
10 weeks 8 weeks 4 weeks Ho
liday
s Obsgyn
(18 Feb-26 Apr '08) (5 Mei-28 Jun '08)
(15 Jun-25 Jul '09)
Year 4
Blo
ck X
X
2 w
ee
ks
: (2
2 O
ct-
3 N
ov
'0
7)
Internal Medicine
and Trumatology
6 weeks
(5 Nov-15 Dec '07)
International Health and Man. of
New Emerging Diseases
6 weeks2008/2009
(15 Sept-22 Nov '08) (1-27 Dec '08) (29 Dec '08-24 Jan '09) (26 Jan-21 Feb '09) (2-28 Mar '09) (30 Mar-11 Apr '09) (13-25 Apr '09) (27 Apr-9 May '09)
K3ME2
10 weeks 4 weeks 4 weeks 4 weeks 4 weeks 2 weeks 2 weeks
MF An
Ho
liday
s PH
2 weeks 2 weeks 2 weeks
(11-23 May '09) (1-13 J un '09)
CURRICULUM IN BASIC MEDICAL EDUCATION 2002 (5 YEARS)GADJ AH MADA UNIVERSITY FOR BATCH III (2004-2009)
Year 5
Paediatric H
olid
ays Surgery
Ho
liday
s Opt Psychiatry
Mak
e U
p T
est
Block X
Musculo Skeletal Sy stem
and Locomotion
7 weeks
(23 Jan-11 Mar '06)
Block XI
Digestion and
5 weeks
(26 Jun-29 Jul '06)
2005/2006
Block VIII
Immunology and
Metabolism
7 weeks
(22 Jan-10 Mar '07)
2 w
ee
ks
: (3
1 O
ct-
12
No
v '
05
)
Blo
ck V
III (
14-1
9 N
ov
'05)
3 weeks
(30 Ok t-18 Nov '06)
Medical Science Hemopoitic & Lymph.D is. Hem opoitic & Lym ph.Dis.
Hem ostasis & Shock
Idu
l Fit
ri H
olid
ays
2 w
ee
ks
: (1
6-2
8 O
ct
'06
) Block XIV
Hemostasis & Shock
4 weeks
and Technology
Sem ester Holidays
5 weeks
Ho
liday
s Paediatric
(7 Jul-2 Aug '08)
Block XIX
2007/2008
(4 Aug-6 Sept '08)
Sense Organ
3 weeks
(20 Aug-8 Sept '07)
Elective
4 weeks
(10 Sept-6 Okt '07)
5 weeks
Neurology
Ho
liday
s
Block XIX Block XX
Idu
l Fit
ri H
olid
ays
2 w
ee
ks
: (8
-20
Oc
t '0
7)
Block XXI
Emergency Medicine
Block XXII
and Body Fluid
Mak
e U
p T
est
7 weeks
(20 Nov '06-6 Jan '07)
Mak
e U
p T
est
ENT RadDV
6 weeks
(17 Dec '07-26 Jan '08)
E1
Sem ester Holidays
3 weeks
Year 3
Block IV
Block VII
Lif e-Cy cle and
Gerontology
4 weeks
(22 Aug-17 Sept '05) Idu
l Fit
ri H
olid
ays
Block XIVBlock XIII
6 weeks
(28 Mar-14 May '05) (16 May-2 Jul '05)
Block VI
Medical Humanities
and Bioethics
7 weeks
(11-30 Jul '05)
Block VII
Life-Cycle and
Gerontology
3 weeks
(1-20 Aug '05)
Semester
Holidays
3 weeks
Block XII
Circulation and
Respiration
7 weeks
Block XIII
Medical Science
and T echnology
3 weeks
(31 J ul-19 Aug '06)
Fig. 2
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• By time, teaching Ethics for undergraduate medical students developed appropriately.
• Development of Contents (ethics, bioethics & medical humanieties, (attitude behavior, ethics, law, civics & religion) ; teaching strategies, conventional to innovative (student – centered and PBL) ; faculty member capability (degree programme, Master & Doctoral, training, workshop, scientific meeting)
• Workshop and trainings WHO and UNESCO, or others strengthening Medical Health Institution – Educations.
• In Indonesia the “National Networking for Bioethics and medical Humanities” was established in 2000, with their National Scientific Conference each two years, also strengthening, Teaching Bioethics.
DISCUSSION
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CONCLUSION
• The effort of the Educational institution in ballancing of knowledge, skills and attitude/ behavior / ethics teaching should be continuously renewed.
• Sharing experience in teaching bioethics and medical humanities could be regularly carried out through networking / partnership/collaboration activities, among institutions/ countries
• National policy should be developed ! Related to Bioethics and Humanities experts, for services, research and education
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