Letters to the Editor
To the Editor:
The year 2009 was an important one for education reform in Taiwan. During that year, the Ministry of Education sponsored a pilot project at Taipei Medical University (TMU) to implement required courses that foster medical humanism for both premed and medical students.
As is the case with most education reform, this step was the outcome of earlier reform efforts and research.1 In the 1990s, leading medical educators in Taiwan promoted curriculum change to cultivate socially minded medical students and produce more competent physicians. This reform momentum accelerated in 1998 after the U.S. National Committee on Foreign Medical Education and Accreditation (NCFMEA) judged that Taiwan's medical education system was “not comparable” with the U.S. system. Progressive medical educators took this chance to implement curriculum changes that would counter the past rote education. In addition, the autonomous Taiwan Medical Accreditation Council (TMAC) was established in 1999 to evaluate and accredit medical schools. Its first mission was to promulgate liberal and humanistic education in the premed years. The most serious criticism from the NCFMEA was that medical students were selected mainly by their performance on the entrance examination. In response, in 2002, the TMAC listed personal interviews as part of the admission process in all medical universities in Taiwan and as one of medical education accreditation items.2
To assess the effect of this and the earlier reforms, in 2007 we designed a questionnaire to elicit students' attitudes toward professionalism and surveyed 256 medical students in all five years of training at TMU. To our dismay, we found that the fifth-year students, compared with those in the earlier years, gave lower valuation to constructs concerning interpersonal skill with patients and toward their duty to promote public health. The findings3 of this small survey are significant and echo findings from our previous national survey of medical students of four medical universities, all of which has alarmed leading medical educators in Taiwan.4
It was this alarm that spurred the creation of the pilot project to foster professionalism described at the start of this letter. We and our colleagues in medical education are hoping that prospective research of this effort will show that it is succeeding.
Chiung-hsuan Chiu, PhD
Assistant professor, School of Health Care Administration, Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
Linda Arrigo, PhD
Assistant professor, Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
Duujian Tsai, MD, PhD
Professor and director, Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan; firstname.lastname@example.org.
1Sullivan WM. Medicine under threat: Professionalism and professional identity. CMAJ. 2000;162:673–675.
2Huang KY. My Life Is So Different: Autobiography of Huang Kuang-Yan. Taipei, Taiwan: Linking Books; 2008.
3Chiu CH, Lu HY, Arrigo LG, Wei CJ, Tsai DJ. A professionalism survey of medical students in Taiwan. J Exp Clin Med. In press.
4Chiu CH, Tsai DJ. The medical education reform in Taiwan. Med Teach. In press.