Listening to FMUL
The First Year of the Curricular Reform at Lisbon University Medical Faculty (FMUL)
Showing unusual courage for Portuguese classical institutions, Lisbon University Medical Faculty has joined the current international trend to teach medicine in a more integrated manner. In the 2007-2008 academic year the students who entered the FMUL for the first time began their course of studies with a new curricular model. In this manner the Lisbon Medical School joins Harvard Medical School and several other US, European and Asian schools in putting into practice a new plan for medical teaching.
The new integrated curriculum model replaces the traditional teaching of the past, centred on an intensive calendar of predominantly theoretical classes, and dominated by a feudal system of institutes and departments, Unlike the traditional curriculum, in which teaching was divided up into different subjects, such as Anatomy, Physiology, Biology, Histology or Pharmacology, in the integrated curriculum the several different subject areas are interlinked in a model of organization that is more aimed at systems. For example, in the first year the students are alternately exposed to concepts of Biochemistry (cell molecules), Molecular Cell Biology (genes, the genome and genetic variability), Immunology (the molecular mechanisms of generating lymphocyte diversity) and Biology of Diversity (from genes to the organism).
The medicine practised today and that will be practised throughout the XXI century is without any doubt different to the medicine of the past. Preparing the new generations of doctors for change cannot only be achieved by adapting the contents of the former curricula to the new realities. Faced with the constant evolution of medical knowledge, the medical student must develop curiosity for novelty and a capacity for self-learning. For this reason, teaching at medical faculties should pay greatest attention to the concept of “teaching to learn”. In the new integrated curriculum the contact hours with the tradition didactic format have been reduced, and emphasis is placed on the preparation, presentation and discussion of the works carried out by the students. The aim is to stimulate the students’ capacities to research, synthesise and integrate multi-disciplinary approaches towards the solving of a specific problem. Another important aim in the new curriculum plan consists of promoting the link between basic knowledge with clinical practice. An example of this “transfer” teaching is the new subject area of Oncobiology, in there is the addressing of the molecular mechanisms of oncogenesis with aspects of diagnostics and oncological clinical therapeutics. Finally, and in tandem with the teaching of the nuclear basic sciences, the new integrated curriculum places great importance on the students’ being exposed, from the first day, to clinical practice and to fundamental issues of medical practice such as ethics, professionalism, social medicine, health policies and epidemiology.Implementing the new integrated medical curriculum has been an enormous challenge for all the teachers, having been used to working on isolated “islands” within the Faculty. Against the pessimistic forecasts by the most sceptical people, the response from the teaching staff has been very positive. We have still not managed to build bridges with motorways that might allow a direct and constant link, but on the anniversary of the first year of the reform we already have regular connections (by sea and air) among the several different islands. On the other hand, the students have become aware of the active role that they carry out in the new curriculum model. The students have learned to constructively criticize the teaching system, and the teachers have learned to meet together and work together, with each other and with the students. Even the administrative services have learned to have a constructive dialogue with the teachers and students. In short, the first year of the reform has been an excellent beginning, but it has been no more than a beginning. Ahead of us we have a long path of change to build. I offer all my colleagues, students and administrative staff my fullest thanks for your commitment to this adventure.
Pedagogical Coordinator of First Year Integrated MA in Medicine