Strategies for sustaining curricular changes in medical schools: a proctological view

Major changes were introduced to medical curricula globally over the last two decades. They were driven either by external pressure from governing bodies or self-reflective processes. Though much has been written about the planning, initiation and implementation of such changes, fewer experiences of the strategies to achieve sustainability have been shared in the medical literature despite their long and successful sustainability.

 

The necessity was identified and motivation was generated for medical curricular reforms in Sri Lanka by pioneering group of academics who reflected upon the existing process. Major changes have been sustained for more than a decade successfully. The Faculty of Medicine University of Indonesia in its short history of curricular reforms, in accordance to the government’s proposals has adopted similar measures for their sustainability.

 

Though we involved in neither the change nor the sustainability processes in those countries thoroughly, we had the opportunity for upward observation. We attempted to compare the successful measures of sustainability in the two countries and correlate our conclusions with the experiences and recommendations published by others.

 

Leading the process cleverly, formulating a suitable management structure, decentralising the decision making power, managing resources effectively, collaborating with different parties in the institution, keeping balance between top-down and bottom-up approach, enhancing motivation of cohort, maintaining flexibility and adaptability throughout the process, establishing functioning system of on-going evaluation early, networking with external professional bodies, continuing training programme regularly and frequently, and sharing the ownership seem to be generically effective as strategies for sustainability of changes in medical curricula.