ABSTRACT
Introduction: As of 2001, the Philippines ranks 7th among the world’s 22 countries with a heavy tuberculosis (TB) burden. As the country accelerates its campaign to control the global epidemic, the Philippine Tuberculosis Initiatives for the Private Sector (PhilTIPS) joined the efforts to combat it through the Directly Observed Treatment Short-course (DOTS) strategy and brought it to the level of medical schools. PhilTIPS commissioned this work to develop an evidence-based medical curriculum with strong and conscious integration of TB-DOTS. Materials and Methods: In the needs assessment, curricula, sample tests, and syllabi were reviewed. Deans and curriculum committee chairs were also asked to answer a questionnaire dealing with how TB, TB control and DOTS were taught. Based on the needs assessment, the TB control-DOTS core curriculum was developed. Ten months after its implementation, a monitoring evaluation was conducted through questionnaires, review of records and key informant interviews. Discussion: Representative samples of 18 out of 32 schools participated in the needs assessment and monitoring phase. Data revealed that the biomedical and clinical aspects of TB are emphasised in all schools. But only 7 out of 18 (38.89%) actually dealt with DOTS. A competency-based, integrated, and interactive TB-DOTS curriculum was then developed. The competencies around which the curriculum was designed were: (1) a thorough understanding of TB as a biomedical and social phenomenon; (2) the management of TB patients; and (3) an adherence to DOTS in managing TB patients. The curriculum was reviewed by local and international panelists, and implemented in 2003 to 2004. Monitoring evaluation 10 months later revealed that this curriculum was minimally to moderately integrated by medical schools. The study exhorts all medical schools to empower their graduates with competence in TB-DOTS.
Medical schools play an important role not only in the building of medical expertise but also in the socialisation of future physicians. Societies expect these institutions to train students to competently and holistically handle common health problems. As tuberculosis (TB) has been consistently listed as one of the Philippines’ top 6 causes of mortality and morbidity over the last 2 decades, equipping medical graduates with the competence to manage TB is not just imperative but also urgent.
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