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By Dr Shams Najib-MPCB neither stands for Motor Protection Circuit Breaker nor for Multi-Purpose Collaborative Body, but it stands for Math, Physics, Chemistry, and Biology (MPCB). This is a two-semester course at the beginning of Afghanistan’s Medical Schools. MPCB has failed to achieve sufficient rigor to prepare students for tackling the sciences fundamental to medicine at advance level now required. Afghanistan expects a higher standard from students who are pursuing medicine in an era in which recent researches and medical technology have revolutionized biomedical science and health care in rest of the world including our neighboring countries.
In Afghanistan, prior to admission to the medical schools, completing premedical courses are not required. All students are absorbed directly from high schools via Kankor to the medical schools. The only established indicator is the Kankor exam, which I believe is not a standard tool for gauging and evaluating doctors-to-be. The current curriculum is mainly focused on Mathematics, Physics, Chemistry, and Biology. Those interdisciplinary courses are essential, though not adequate. The current first year (MPCB/PCB) syllabus calls for substantial reforms.
Thus, a greater efficiency and a tighter focus on science that is relevant to medicine should be emphasized during the first year of the medical school. The two-semester course should be replaced by Premedical Competencies. A focus on integration of principles over several other courses should also be incorporated. Changes in both the duration and in the contents of the current MPCB is critical. The Premedical Competencies ought to foster scholastic rigor, analytic thinking, quantitative assessment, and analysis of complex systems in human biology. Following is a suggested framework to the proposed changes.
DURATION: The current two-semester MPCB should be replaced by Premedical competencies for three consecutive semesters; one complete year.
CURRICULUM: The curriculum for premedical competencies might be comprised of Human Biology, Biologically relevant Chemistry, and Physics, Math, Biostatistics, Social Science and English language.
Biology: All newly enrolled students must complete three semester of biology. The current level of biology is way below the regional and international standard. The three-semester biology curriculum should be devoted to molecular biology (genetics) and cell biology and should emphasize human biology. For example, signal transduction, basic pharmacologic principles, homeostasis and feedback, an introduction to endocrinology (hormone receptors), neuronal signaling, and immunology.
Chemistry: The exacting contents of chemistry should be replaced. All fresh medical students must complete a three-semester inorganic chemistry, organic chemistry, and biochemistry. The chemistry courses should provide the foundation for the study of biologically relevant chemistry and physics,
Physics: The status quo of physics taught in Afghan medical faculties are below the accepted standards. A two-semester course in the area of bio-physics should be delivered. The medical students should be taught in biologically relevant areas of mechanics, kinetics, thermodynamics, the properties of matter (quantum theory) and way theory, electricity and magnetism, and optics.
Mathematics and Algebra: All applicants must complete a 3-semester mathematics sequence along with biostatistics. Computational skills are critical for contemporary scientific research and literacy. Along with derivatives and integration, quantifiable understanding of dynamic physiological process and system should be included. In order to meet the global standards, more relevant algebraic and trigonometric quantitative skills must be incorporated to the current syllabus of the mathematic course.
Biostatistics: Statistics are currently taught in medical faculties, but to some extent, the contents of the subject are not pertinent. The current statistics course should be replaced with biostatistics. The medical students should be adequately prepared for the quantitative reasoning. The one semester that is currently devoted to statistics, the three-semester or one-year effort should be more relevant to biology and medicine than the formerly required, traditional, one semester statistics.
Social Science: The study of social and behavioral sciences is an essential foundation for the study and practice of medicine. The 1-year “Premedical Competencies” curriculum should also be comprised of subjects such as psychology, sociology, anthropology and ethics at least for one semester each.
English Language: it is obvious that without any doubt, English has now achieved the global status. In today’s world, all the most influential medical journals, and magazine are published in English, and it has also become the language of International Conferences and the language of medical researches. English is the cut-off language for medical purposes and it should be a compulsory subject along with other required courses. It is highly recommended that teaching English should not only be confined to the “Premedical Competencies”, but should go in parallel with other disciplines until graduation from the medical faculty.
The writer is an Afghan physician with Masters in Public Health from University of Minnesota.
