A. Name of the Department:- MEDICINE
B. Background of the department
School of medicine was initially established under former Adama Science and Technology University (ASTU) in Asella teaching referral hospital with aim of producing energetic, compassionate and competent medical doctors for the nation and global community. The school is formed by encompassing different clinical departments and biomedical department. The departments that formed School of medicine include:
a. Department of Internal Medicine
b) Department of Surgery
c) Department of Pediatrics and Child Health
d) Department of Gynecology and Obstetrics
e) Department of Biomedical sciences
f) Department of Radiology
g) Department of Ophthalmology
h) Department of Psychiatry
i) Department of Dermatology &Venereology
j) Department of Orthopedic surgery
k) Department of Dentistry &maxillofacial surgery
l) Department of Pathology
m) Department of Ear, Nose and Throat
n) Department of Emergency and critical care medicine
The school of medicine has graduated 5 batches of medical doctors under ASTU. Later the school began to receive its own students with establishment of Arsi university by 2014 G.C. the first batch of medicine graduated with the name of Arsi university in 2021. The school continues teaching medicine students using the former conventional curriculum till 2020 G.C at which time harmonized competency based integrated modular medicine curriculum began to be implemented.
The curriculum is designed and produced as an integrated, competency based, modular approach in which the basic sciences are taught simultaneously with clinical and community medicine. It is described in terms of learning outcomes, which define the knowledge, skills and attitudes (behaviors) so as to produce competent, compassionate, respectful caring and community oriented doctors for Ethiopia with internationally accepted standard of excellence.
The undergraduate medicine students will be admitted to medicine department on competitive basis after completing freshman courses after fulfilling admission criteria set by the school. Once admitted they will have premedicine courses for one semester after which time they are enrolled to two years of preclerkship years. At the end of second preclerkship year they are qualified to join clinical years after passing comprehensive Step 1 qualification examination. After two years of clerkship (clinical) attachments they are expected to pass Step 2 qualification examination to join internship. During internship they render clinical service under supervision of resident and specialist medical doctors. It takes 6 and half years to complete Medicine program and students are expected to take a total of 507 ECTC to graduate from medical school.
C. About Department
I. Mission of the medicine Program at Arsi University
- To produce competent, compassionate and committed doctors that would meet the present and future priority health needs of the Ethiopian population and fulfill international standards for medical education through our four fold mission to teach, to heal, to search, and to serve. This would be through programs of excellence in
- Education: by training the next generation of medicine students, residents, specialty fellows, and clinical practitioners through student-centered, collaborative environment that values compassionate care, integrity and inclusivity, academic excellence and scholarship, adaptability and social responsibility
- Clinical care: through state-of-the-art clinical programs which reflect the unique educational environment of the University, as well as the needs of the patients it serves;
- Research: through the development of new knowledge in the basic and clinical sciences, as well as social and population health.
- Community service: through sharing the School’s expertise and knowledge to enhance the broader community, including our affiliated institutions, other health care professionals, alumni and other colleagues, and citizens of the state.
II. Objectives medicine Program
- To prepare medical doctors equipped with solid knowledge of basic, clinical, behavioral, social and public health sciences
- To prepare medical doctors as clinicians who provide patient-centered care in the spirit of inter-professional collaboration and teamwork
- To prepare medical doctors who address health priority needs of Ethiopian population and its health system challenges
- To prepare medical doctors who promote and protect the health of individuals and populations
- To prepare medical doctors who act according to ethical and legal principles
- To prepare medical doctors who are leaders, problem-solvers, communicators and educators
- To prepare medical doctors who embrace critical thinking, evidence-based practice and research
- To inculcate in medical doctors the ability for lifelong learning
- To produce medical doctors meeting global standards
III. Graduate Profile
- Program profile
IV. Program Structure, Composition and Duration
- The duration of the medical education is six years with the following components: Pre-medicine, pre-clerkship I, pre-clerkship II, clerkship I, clerkship II and internship. Pre-clerkship I and II cover system-based modules (integrating biomedical, clinical, professional ethics and generic skills), social and population health modules and common courses. System-based modules instill solid knowledge of scientific basis of medicine and develop early clinical skills. The social and population health modules enable students to measure, analyze and promote population health.
- Progression from pre-clerkship to clerkship is determined by successfully passing a comprehensive internal and external exam. During clerkship, students develop clinical knowledge, skills and attitude through intensive patient-based teaching and guided practice in different clinical departments with opportunities to review pertinent basic biomedical sciences. They also acquire knowledge and skills of health systems, management and medical research. Then, students must pass a final qualification exam including comprehensive internal and external exam to progress to internship.
- Internship provides students with the opportunity to work under supervision in different clinical departments including a primary health care setting preparing them for autonomous practice. Before the end of each academic year in years 2 to 4, students have a month long community attachment to offer opportunities for application and deepening of knowledge and skills acquired in the respective years in the community setting. Based on the task analysis and national health policies and strategies, Emergency medicine was newly designed. Psychiatry, Emergency Medicine, Ophthalmology, Dermatology, ENT and Dentistry were added to internship rotations to increase the clinical exposure of students.
Summary of duration of stay and total ECTS to be taken
|Acadamic Year||Duration in weeks including vacations||Total ECTS|
V. Admission Requirement
- Arsi university school of medicine selects meritorious and passionate students based upon academic achievement and informed self-selection. Given the importance of having valid, defensible, comprehensive and fair student selection criteria, it is recommended that our school develop a separate defensible guideline that can be revised by School academic commission periodically. The Criteria for competition to join Medicine Department may include but not limited to:
- Academic achievement
- University entrance exam and transcript of grade 11 & 12.
- first semester CGPA and
- Medicine entrance examination
- Personality test & Interview result
- diversity (sex, disablity and geography) and
- Absence of major mental and physical disablities that could affect studing and practicing medicine.
NB. Separate admission guideline will be prepared by school academic counsel and get endersorsed by SAPTC. See annex I below
VI. Graduation Requirement
- A student should pass successfully in all modules obtaining a minimum grade of C
- A cumulative Grade Point Average (CGPA) of 2.00 must be obtained
- A Student should successfully pass step 2 qualifying examination
- Successful completion of internship attachment
VII. Degree Nomenclature
- Upon successful completion of the program, a graduate will be awarded with the degree of DOCTOR OF MEDICINE (MD) (in Amharic, “የሕክምና ዶክትሬት ዲግሪ”)
VIII. Assessment & evaluation methods
Assessment plays a central role in education process: it determines much of the work students undertake affects their approach to learning and is an indication of which aspects of the course are valued most highly. The purposes of assessment are to motivate students to learn, create learning opportunities, to give feedback to students and teachers, grading and quality assurance. There is a distinction between a formative assessment, which is mainly intended to help the student learn and a summative assessment, which is intended to identify how much has been learned. Formative assessment is most useful part way through the module and will involve giving students feedback which they can use to improve future performance. Faculty should conduct at least two formative assessments of each student during a given module or rotation. Summative assessment is used to make a pass/fail or, promotion decision; findings of formative assessment are not used to make pass/fail decisions, however. The following are the descriptions of the major assessment methods including when and where they would be used in the curriculum.
Direct observation of clinical skills (DOCS)
The purpose of DOCs or mini-clinical evaluation exercise is to assess clinical skills while a student interacts with patients in different settings. Typically, it takes 15-20 minutes and the assessor follows the student with a checklist and gives feedback at the end. The DOCs offer students immediate and ongoing feedback about their observed clinical skill and performance (interviewing skills, physical examination skills, and professionalism, clinical judgment, counseling skills, organization/efficiency and overall clinical competence). This method will be used in all years of the training and there will be at least two DOCs to be performed by a student in each module or clinical rotation. This assessment method enables one to follow the progress of the student and will be used for formative assessment.
Objective structured examination
Objective structured clinical examination (OSCE) is a performance-based exam. During the exam, students are observed and evaluated as they go through a series of 8 or more stations. It allows assessment of multiple competencies. It is Objective, because examiners use a checklist for evaluating the trainees; structured, because every student sees the same problem and performs the same tasks in the same time frame; Clinical, because the tasks are representative of those faced in real clinical situations. These increase the reliability and validity of the assessment. OSCE is a standardized means to assess history taking, physical examination skill, communication skills, ability to summarize and document findings, ability to make a differential diagnosis or plan treatment, clinical judgment based on patient ‘s note and procedural skills. OSCE may use manikins and simulators, standardized patients and real patients. Standardized patients are healthy persons trained to simulate a medical condition in a standardized way. Health science students, health facility staff and faculty may serve as standardized patients. Objective structured practical exam (OSPE) is a variant of OSCE to assess students’ knowledge and skill in a non-clinical setting. Both OSCE/OSPE will be part of the summative assessment and will be implemented during premedical, pre-clerkship I and II as well as clerkship I and II.
Structured long cases
Structured long case assessment presents the student with a complete and realistic clinical challenge thereby enabling the evaluator to see the complete picture of the student’s ability in addressing the challenges. The use of multiple cases improves reliability of the examination, which is a major weakness in the traditional long case. Additional improvements to the traditional long case are required to improve reliability. For example observing the student-patient interaction, using checklist and increasing the number of examiners . Feasibility should be considered here.
May include different item formats such as multiple-choice questions, matching, true-false, essay and short answer. Written assessment methods will help to evaluate knowledge and understanding of basic, clinical, public health and psychosocial sciences and professionalism and ethics. Important point to remember is to ensure written exams assess higher order knowledge in addition to recall and comprehension. Written assessments would be parts of both as formative and summative assessment in premedical, pre-clerkship and clerkship.
Standardized oral exam
The standardized oral examination is a type of performance assessment using realistic patient cases for questioning the examinee. One or two faculty serveas examiners and students can be tested on several different cases. Oral exam will be part of the summative assessment in qualification exams at the end of pre-clerkship and clerkship modules. In the case of pre-clerkship the examiner begins by presenting to the examinee a clinical problem in the form of a patient case scenario and asks the examinee questions that correlate, integrate the biomedical sciences with clinical context. In the case of clerkship, the questions probe the reasoning for requesting clinical findings, interpretation of findings, and treatment plans.
Logbook documentation serves as evidence of scope of patient care and community experience to meet requirements or specific learning outcomes. Maintaining logbook will encourage students to make use of all possible learning opportunities for clinical/procedural skills and community skills to fulfill minimum requirement. Regular review of logbook can be used to help the student track what procedures or experiences must be sought to meet requirements. The logbook document should be counter signed by faculty. The number reported in a logbook may not necessarily indicate competence. Logbook will be part of the formative assessment throughout the medical curriculum.
Portfolio is collection of papers and other forms of evidence that learning has taken place. It provides evidence for learning and progress towards learning objectives. Reflecting upon what has been learned is an important part of constructing portfolio. In addition to products of learning, the portfolio can include statement about what has been learnt, its application, remaining learning need, how they can be met. Portfolio helps to assess learning outcomes including those that are not easy to assess with other methods like personal growth, self-directed learning, reflective ability, self-assessment of personal growth and professionalism. Portfolio allows assessment of progress towards learning outcomes by using chronological work samples collected at different points in time. Portfolio will be part of the formative assessment throughout the duration of the medical training and can be used as a summative assessment during internship.
Global Rating is assessment of general categories of ability (e.g. patient care skill, medical knowledge, interpersonal and communication skills, professionalism, etc.) retrospectively based on general impression over a period of time and derived from multiple source of information. The purpose is to evaluate knowledge, skill and attitude over a period of time at the end of a rotation thereby helping the evaluation of the student’s effort across time. Global rating will be part of both formative and summative assessment of students throughout the duration of the medical curriculum3600 Evaluation which consists of measurement tools completed by multiple people in a student’s sphere of influence. Evaluators usually are faculty, other members of the health care team, peers, patients, families and community members. 3600 evaluations can be used to assess interpersonal and communication skills, teamwork ability, management skills, decision-making professional behaviors and some aspects of patient care. It will be used as part of the summative assessment in Community based training program (CBTP), team training program (TTP), and internship. In clerkship I and II it is more feasible to use it only as formative assessment
PBL /case study tutorials progressive assessment
PBL/ case study progressive assessment is a continuous assessment of students’ performance during PBL/case study tutorials with regards to content, process and professionalism. To improve reliability of the score, this assessment strategy will be guided by a checklist. The checklist may assess competencies in four areas: knowledge of basic, clinical, public health and psychosocial sciences and information gathering skills, reasoning skills, participation and communication skills, cooperation and teambuilding skills. This assessment method will be part of both formative and summative assessment during pre-clerkship I and II and clerkship I and II. PBL/case study tutorial assessment at the end of each session and midway during a module will be used as a formative assessment method while end of module assessment of students’ performance during PBL tutorials will be used as part of the summative assessment.
IX. Grading system
Letter grades shall be given based on the points earned out of 100. The letter grading system has a fixed scale as described in the table below
|Letter of Grade||Point scored||Description||Corresponding fixed Number grades|
|B+||[75, 80)||Very Good||3.50|
N.B: 1. The grading system for freshman and pre-medicine courses will be similar to the grading system stated in the university legislation due to the similarities of courses offered with other students.
2. All the grade given by credit hours for freshman courses is converted to corresponding ECTS value written in course catalogue for CGPA execution.
X. Quality Assurance mechanism
The medicine program shall undergo periodic self-evaluation once a year so as to assure the quality of education through the academic standard , quality assurance and relevance committee of the college. Based on the report of the self-evaluation and external evaluation made by Ethiopian education and training authority( ETA), necessary measures will be taken timely so as to maintain academic quality and standard.
Annex I : ADMISSION AND TRANSFER GUIDELINE FOR MEDICINE STUDENTS
Background of the Arsi university school of medicine
School of medicine of Arsi University was initially established under former Adama science and technology university (ASTU) in Asella teaching referral hospital with aim of producing energetic, compassionate and competent medical doctors for the nation and global community. The school has graduated 6 batches of medical doctors under ASTU.
Later the school began to receive its own students with establishment of Arsi university since 2014 G.C. The school continues teaching medicine students using the former curriculum till 2020 G.C at which time the first batch of medical doctors graduated with name of Arsi University.
The previous curriculum was having many gaps including the grading system, promotion criteria, lack of measurable core competencies, community attachment and duration of attachment different from other medical schools. These gaps were also similar in majority of other medical schools. That is why MOH in collaboration with MOSHE formed a task force to revise the curriculum and come up with harmonized competency based integrated modular medicine curriculum as of 2021 G.C.
Arsi university school of medicine would like to thank MOH, MOSHE and other stake holders for harmonizing this curriculum. Our school has formed a task force with name of Curriculum review and implementation committee to customize the harmonized CBIMMC to our university legislation.
Rationale to prepare this guideline
It is known that since 2019 G.C the Ministry of science and higher education (MoSHE) currently named Ministry of education, has designed and launched the new educational road map to be implemented in all universities. Prior to development of these new educational road map students were assigned to different disciplines from MoSHE. Specifically students with higher score of university entrance exam result were being assigned to medicine department from the outset thus no need to require additional guideline. With the newer educational roadmap every natural science students were forced to take freshman courses at least for first semester at which time they choose medicine, pharmacy and engineering departments based on their SCGPA, Entrance exam result and department entrance exam results. This was being done with MoSHE direction through its circular letter which is changing with time.
It is clearly written in the harmonized medicine curriculum that every school should have clear guideline for admission requirement for medicine department. Initially it was planned to incorporate the guideline in the curriculum. But this guideline are liable to change and revision due to different factors one of which is entrance exam result that can be variable every year. Thus, it is agreed by curriculum review and implementation committee and school academic counsel to prepare a separate guideline as revising guideline is easier than revising the curriculum in case required.
Article 1: Admission Requirements
Each medical school selects meritorious and passionate students based upon academic achievement and informed self-selection. Given the importance of having valid, defensible, comprehensive and fair student selection criteria, it is recommended that medical schools develop a defensible guideline. Formerly students with the higher score in the country were joining medicine with competition provided that they have selected the department from the outset after finishing their preparatory school.
Currently students used to select after completing the first semester of their freshman courses. Due to the nature of the discipline of medicine that requires intelligence and excellent academic status and the fact that majority of the students make it their first choice; there should be admission requirement guideline for screening purpose so as to obtain students of high academic caliber.
The criteria may include:
- Academic achievement
- Diversity (sex, disablity and geography) and
- Absence of major mental and physical disabilities that could affect studying and practicing medicine. This has to be substantiated by expert’s opinion
Article 2: Criteria for competition to join Medicine Department
As per Arsi university senate legislation Article 56(3) it says criteria for special admissions to individual programs shall be developed and recommended by CAC/DAC and endorsed by the admission and placement committee (SAPTC). In line with this article due to the fact mentioned above school of medicine through its academic counsel (SAC) has prepared the following prerequisite criteria to compete for enrollment to medicine department.
Article 3: Prerequisite to compete to join medicine department
The following prerequisite should be fulfilled to compete to join medicine.
Example: For the currently working scoring system from 700 points, 455 for males, and 420 for females and applicant coming from Developing regions, and those with minor disabilities.
Article 4: Weighted average of each exam types
Article 5: Special admission
Arsi university legislation Article 57(d) states that university shall allow special offer to some applicants. So school of medicine offer special admissions to students from other natural science, pharmacy and Engineering at the end of first year to encourage some students whose childhood dream was to be a doctor in such a way that: