Implementing Change in Medical Education in Developing Countries

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Abstract
Medical schools in developing countries are constantly faced with the problem of adapting an inherited style of education to suit local needs and constraints. Often these needs have changed considerably since the curriculum was first established. Yet the difficulty of bringing about curricular changes, especially in conventional medical schools, is well known. This paper attempts to guide innovators in developing countries, but many of the suggestions are appropriate to all innovators. The issue of international standards is closely scrutinised, and their hypothetical nature revealed. The detrimental effect of national licensing examinations on curricular innovation is discussed. The futility of ad hoc changes and the need for a carefully thought out philosophy of change which leads logically to new ways of educating future professionals are stressed. Guidelines for maintaining an innovation and for evaluating its short- and long-term outcomes are developed.

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