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Integrated system-based medical education vs discipline-based medical education

Written by Nilesh Kumar Mitra · Thursday 21st February 2013

I am an Anatomy Professor who has taught anatomy to the medical school students in discipline based medical education system for first 10years of academic life. When I started teaching Anatomy in system-based medical education in the later half of my academic life I was surprised to find out that my students in system-based education can retain a lot of anatomy knowledge as they can visualize the application of the contents in the pathology, clinical science contents, PBL triggers and clinical skills sessions.

Surprisingly, medical schools in India still follow the discipline-based medical education. Mostly the students are forced to retain the factual knowledge of Anatomy in this system. When they are in Year 1,they study only Anatomy,Physiology and Biochemistry. Hence it is very difficult for the student to imagine the application of the knowledge of Anatomy learnt in lecture or dissection room.

For example, the students in discipline-based system learn the gross anatomy of the sternum and anterior thoracic wall. They need to memorize the importance of sternal angle without visualizing it as they are still not practising palpation of anterior thoracic wall for apex beat. I know that they learn it provided they are lucky to get a tutor who is a medical doctor, who obviously takes them to the task of palpating intercostal space through palpation of sternal angle in skeleton or over their own body surface marking.

But the lack of Clinical skills practice in traditional discipline based medical education in year 1 does not allow the student to apply their anatomy knowledge automatically.

Dr Nilesh Mitra