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

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