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National Taiwan University College of Medicine, The Design of Medical Humanities Courses for Clerkships

Wang, Wei-Dean MD; Lue, Bee-Horng MD

Special Theme Brief Article: International

For more information, visit NTUCM’s Web site at 〈〉 or contact Dr. Wang, Department of Social Medicine, National Taiwan University College of Medicine, 1 Jen-Ai Rd, Section 1, Taipei 100, Taiwan; e-mail: 〈〉.

Medical education in Taiwan is a seven-year program after high school. The curricula are basic college courses in the first two years, basic medical sciences in the third and the fourth years, clinical medical sciences in the fifth and the sixth years (clerkship), and rotating internship in the seventh year. In 1997, a curriculum reform was undertaken at National Taiwan University College of Medicine (NTUCM) in which medical humanities education was interwoven with learning of basic, clinical, and high-tech medicine. Various medical humanities courses have been integrated into the existing curriculum including lectures on medical history, ethics in medical research, and small-group discussions for second-year students on social medicine topics. Changes have also occurred during the clerkship years, including two new six-week courses: Family, Society, and Medicine, taken in the fifth year; and Life and Death, taken in the sixth year.

The Departments of Social Medicine, Family Medicine, and General Internal Medicine established and facilitated the Family, Society, and Medicine course. Students are divided into 12 small groups (ten to 12 students in each group). This course consists of lectures, small-group tutorials, medical procedure observations, patient interviews, hospice ward rotations, and community service projects. Lawyers, health policy makers, nursing home managers, and experts in a variety of fields including medical ethics are invited to give lectures. Students participate in group discussions, give oral reports, and conduct patient interviews through home visits. Experienced faculty members supervise the course and give student evaluation. These interviews are very good for students to develop patient-physician communication skills.

The traditional anatomy course was replaced by a newly designed two-stage anatomy course at NTUCM in 1997. The lectures and laboratory study are provided in the third year (the first stage) and the six-week cadaver dissection is conducted in the sixth year (the second stage). Students perform dissection after one year of clinical experience obtained from their clerkship in the fifth year. Faculty members from Surgical Department lead the cadaver dissection in small groups. The Life and Death course is offered in the first six weeks of the semester to parallel the cadaver dissection. It is designed to study human life and death from various viewpoints. Teachers invited for this course are experts in religion, anthropology, psychology, sociology, and other humanities related areas. Lectures about life and death viewpoints are more instructive and impressive when the Life and Death course is taken simultaneously with the dissection course. Students are asked to continue self-study on related issues in the following clinical rotations and hand in written reports about their learning experience and study achievement at the end of the semester.

Students’ reports and feedback suggest that courses taken during the clerkship years are received very favorably. After actual patient contact and study of health behavior, belief, medical care, and related issues in the Family, Society, and Medicine course during the fifth year, and the extensive study of life, death and human body in the sixth year, students not only become clinically oriented during their clerkship years, but also gain skills in humanities. Future plans include an intensive medical interview course to cultivate medical students with biopsychosocial capabilities.

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National Taiwan University, College of Medicine

Length of medical school program: Seven years. A proposed six-plus-two-year program is under serious debate; this curriculum would cover six years of medical school education plus two years of postgraduate training in general medical fields.

Level of education required for admission: Secondary.

Average number of students who matriculate each year: About 130.

Average number of students who graduate each year: About 125.

Cost of medical education per student: 440,000-450,000 TWD (12,825-12,116 USD).

Number of medical schools in Taiwan: 11: three national, one military, and seven private.

© 2003 Association of American Medical Colleges