Integrating Islamic Value In Medical Teaching Curriculum : IIUM Experience

Introduction Training and education is about molding human being. In the context of training and educating of future doctors, medical students are trained to become safe doctors as defined by the learning outcomes of the curriculum. The educator and trainer in whatever designation (teacher, professor, preacher or counselor) are responsible to enhance the mental development of the students or trainees by enhancing their analytical and methodical power, and not trying to make them learnt and memorize all the time. In educating future doctors from the Islamic perspective, it is desirable that students are inculcated with the correct mindset that is in consonant with the Islamic worldview and principles, such as "Doctor as an agent of healing and Allah is the Ultimate Healer" and "Work as ibadah". A correct mindset is an important driving force that motivates students to learn medicine in a proper way and thus shall be the foundation of Islamic medical professionalism, which sought to transform medical students to become caring and safe doctors desired by patients. According to this ideal, it is the fundamental duty of doctors to ensure that they have the necessary expertise as described by the profession, observing good ethical behavior (akhlaq), having good communication skills and exhibiting compassion in carrying out their professional duties. These are the characteristics of a safe doctor where most patients would feel safe and comfortable to receive their care that should be developed and nurtured during the training period.


Introduction
Training and education is about molding human being.In the context of training and educating of future doctors, medical students are trained to become safe doctors as defined by the learning outcomes of the curriculum.The educator and trainer in whatever designation (teacher, professor, preacher or counselor) are responsible to enhance the mental development of the students or trainees by enhancing their analytical and methodical power, and not trying to make them learnt and memorize all the time.In educating future doctors from the Islamic perspective, it is desirable that students are inculcated with the correct mindset that is in consonant with the Islamic worldview and principles, such as "Doctor as an agent of healing and Allah is the Ultimate Healer" and "Work as ibadah".A correct mindset is an important driving force that motivates students to learn medicine in a proper way and thus shall be the foundation of Islamic medical professionalism, which sought to transform medical students to become caring and safe doctors desired by patients.According to this ideal, it is the fundamental duty of doctors to ensure that they have the necessary expertise as described by the profession, observing good ethical behavior (akhlaq), having good communication skills and exhibiting compassion in carrying out their professional duties.These are the characteristics of a safe doctor where most patients would feel safe and comfortable to receive their care that should be developed and nurtured during the training period.
However, training doctors to attain the ideal characteristics of safe doctor according to the ideal of Islamic medical professionalism requires a proper curriculum, which has to be holistic, comprehensive and conforms to the Islamic worldview1.The main learning objectives of the curriculum would be that of transforming medical students to become good Muslim doctors.The training that students undergo should make them committed to practice their religious duties and obligations while ensuring that they achieve the desired level of competency as accorded by the profession, ethically sound in delivering their duties and able to communicate with compassion to the extent that their patients perceive them as able and safe doctors.Dedicated teachers are needed to implement the learning objectives of the curriculum, guiding and mentoring students to achieve the desired learning outcomes.Ideally, the teachers should portray excellent qualities as the living example of a good Muslim doctor for students to emulate.Development of such attributes during the period of training will necessarily affect doctor-patient relationship and quality of patient care provided leading to ultimate health and illness outcomes.

Islamization And Integration Of Knowledge In Medicine
In 1995, Professor Dr Omar Hassan Kasule proposed an Islamic Input Medical Curriculum or IIMC that was approved by the University Senate.This is later renamed as Islamic Input in Medical Program or IIMP after a curriculum review exercise in 20094.It is an innovative effort to Islamize the medical curriculum and consists of two separate but closely related components: Islamization and legal medicine.Islamization deals with putting medicine in an Islamic context in terms of epistemology, values and attitudes.It represents a noble effort of Islamization of medical sciences by bridging the dichotomy between traditional Islamic sciences and the medical sciences.Legal medicine deals with issues of application of the Law (syaria'h) from a medical perspective including the 'grey area' for which simple categorization as good and bad, legal and illegal is not easy.
The curriculum ensures that medical students are exposed to the Islamic perspectives of medicine and its practice in terms of its worldview, profes-Corresponds to: Ariff Osman, Department of Anesthesiology and Intensive Care, Kulliyah of Medicine, International Islamic University Malaysia, Kuantan, 25200, Pahang Darul Makmur, Malaysia.Bangladesh Journal of Medical Science Vol. 12 No. 02 April'13 sionalism, leadership and ethic.Students are prepared to internalize the moral and ethical dimensions of the profession, are introduced to basic Islamic concepts, are drawn to appreciate the human body and organs as the precious gift of the Creator reflecting His mercy and Bounty, are familiarized with fiqh issues (Islamic medical jurisprudence) and appreciate the Islamic medical heritage.Medical teachers with fundamental knowledge of Islam are entrusted to integrate the Islamic input in their teaching of medical sciences as well as to demonstrate good values that are in consonance with Islam in terms of their professionalism, leadership and ethic.

Islamic Input In Medical Program (Iimp)
Islamisation of knowledge will remain as rhetoric unless concerted and serious effort is taken to materialize it.The Islamic Input in Medical Program or IIMP is an effort of Islamization of knowledge of modern medicine.The Kulliyah of Medicine of International Islamic University Malaysia (IIUM) teaches medicine that is with embedded Islamic values and Islamic Law (syari'ah) in the teaching and practice of medicine.Throughout the 5-year undergraduate program, the curriculum provides venue for the islamisation process to take place.Teaching and learning medicine are based on the tauhidic paradigm and guided by the IIMP ideals.IIMP is based on 3 assumptions: a) that Islam has moral values that are universal and, being found in other religions and belief systems, can be taught to and be appreciated equally well by Muslims and non-Muslim students; b) a physician must understand Islamic Law relating to medicine, fiqh tibbi, in order to practice successfully in a Muslim community whose culture and social norms are shaped by the shariat and c) a successful physician must be equipped with personal, communication, leadership and management skills based on Islamic teachings and empirical social and managerial sciences.
In the pre-clinical phase IIMP presents the Islamic epistemological perspectives of basic medical sciences so that students, while learning these knowledge can appreciate the signs of the Creator, ayat al allah, from the book of empirical scientific observation, kitab al kawn, alongside appreciating the signs of the Creator from the book of revelation, kitaab al wahy.For example, in studying the heart, knowing that the heart rhythm arises from a specialized tissue, the sino-atrial node, which continues to produce the impulse until a person die should bring a student to appreciate his Creator; for a believer, this knowledge and appreciation should make him/her closer to Him.In learning anatomy from dissecting the cadaver, students should appreciate that anatomical landmarks, which are consistent in every human has important bearing in clinical examination.For example, the cricothyroid membrane, when externally compressed consistently occludes the esophagus preventing aspiration of gastric content into the lung.In the clinical phase, IIMP teaches students to help patients solve problems related to practical ibadat such as ablution, wudhu, prayer, solat, fasting, saum, pilgrimage, hajj & umrah and the lawful and prohibitions in activities of daily living such as halal medicine, food and nutrition, exercise and healthy life styles.
IIMP uses the theory of the purposes of the Law, maqasid al shariat, principles of the Law, qawa'id al shari'at, specific legal rulings from the Quran and sunnat, and comparing with European ethicolegal sources as basis for discussing medical ethico-legal issues such as autonomy, doctorpatient relationship, privacy and confidentiality, professionalism, animal and human research, resource allocation, end of life issues and medical malpractice 2 .Other issues such as assisted reproduction, genetic testing, cloning, cosmetic surgery, brain death, withdrawal and withholding of lifesupport measures, DNR, organ donation and transplantation are also discussed applying the same principles.
IIMP also focuses on developing students with important soft skills such as personal, communication, leadership and management skills based on Islamic teachings and empirical social and managerial sciences 3 .Students learn these skills through participation in the co-curricular activities and also a special module, made compulsory for all final year students.The "Leadership Game" provides experiential learning for students where activities that they experienced throughout the planning and execution of a chosen group program are recorded and compiled in a portfolio for assessment and evaluation.This module provides exposure and opportunity for learning important skills of organization, collaboration and working as a team especially for students who had never had such experi-ence before, as they have never participated in any co-curricular activities.For the experienced students, this module allows them to share their experience and guide their inexperienced peers, thus making learning enjoyable and strengthen the spirit of brotherhood, ukhuwah among them.The teaching of IIMP is integrated in three ways.First, the teacher of the medical specialty is also the teacher of IIMP.Second, the teaching material is integrated.For example when teaching cardiopulmonary resuscitation (CPR), the ethicolegal-fiqhi and Islamic conceptual issues are discussed at the same time, say for example the issue of when to stop CPR.Thirdly, the examination of IIMP is integrated in the general examination and not as a separate paper.

Achievements Of Iimp
The Kulliyah of Medicine, IIUM is the first to incorporate Islamic input in medical curriculum in the country.The philosophy of IIMP is based on the premise that teaching of medicine in a holistic manner is being achieved by having a series of relevant lectures for the students every week throughout the five-year course of the medical program.Medical teachers teach medicine that is integrated with Islamic worldview.However, with the passage of time and taking into account the current needs of medical education, the curriculum must also respond to these needs to stay relevant.The IIMP is an important component of learning and teaching medicine with regards to the proper personal and professional developments of the future doctors.Thus, every effort must be taken to integrate every aspect of teaching and learning of medicine so as to achieve its desired learning outcomes.However, similar integration into the area of research and publication is not yet fully established.
Implementing the blueprint of the curriculum is not an easy task and needs evaluation and improvements.The perception of the students as one of the major stakeholders is necessary to evaluate whether the learning objectives and outcomes are met.A survey to evaluate the perception of IIMC among the final year students was carried out in 2009.The results of this unpublished survey were utilized during the academic review of the curriculum in 2009 that is after more than a decade of existence.Similarly, the success story of the curriculum is difficult to measure.The closest we have as to indicate that the curriculum does produce well-balanced doctors was a survey carried out by the Institute of Health Management, Ministry of Health Malaysia in 2008.This unpublished study, entitled "Pre-employment training of physicians in Malaysia" targeted on the houseman surveyed on issues such as preparedness of medical graduates for the transition from medical school to hospital practice; motivation and job satisfaction and communication skills.It is noteworthy that our graduates attained the highest scores in all the items being surveyed.It is hypothesized that what made the difference was the curriculum that our graduates underwent as students.Thus, further studies are needed to confirm or refute this hypothesis.
Many other newer universities in the country have embarked on the islamisation of medicine effort taking the Kulliyah as the reference institution.This is a healthy trend for the Islamisation of human knowledge agenda.Although IIUM is the pioneer, it doesn't mean that it is the champion in this area.It needs to strategize and strengthen its commitment by engaging in research activities, writing of guidebooks and resource materials and establish a centre of excellence in Islamisation of medicine.Several other universities from Indonesia, Pakistan and Bangladesh also joined the bandwagon of islamisation of medicine.This should lead to meaningful cooperation and collaboration between these institutions so as to strengthen the islamisation of medicine agenda.

Future Prospects
The Kulliyah is committed to strengthen the curriculum further and desires to increase awareness among its academic staffs especially the younger ones by providing proper training in IIMP and encourages qualitative research in this area.Working together with the medical education unit and the student affairs division is a practical pathway to greater success in the future.New coordinators are appointed and "training the trainer" inhouse activities are to be carried out regularly.Publication of research activities in our online medical journal and writing of student guidebooks, teacher's manual is currently ongoing.This scholarly activity has a bright prospect that suits the current tagline of the university, which is "Innovate, Inspire, United and Make a difference" the other meaning of the acronym IIUM.
Strengthening the agenda of Islamisation of medicine through close co-operation with other likeminded institutions both locally and internationally is an important step to take.Seminars, conferences and learning workshops provide forum for awareness, exchange of ideas and enhancing commitment among members, so does research and publication activities, which should be promoted and established as well.
The next step after succeeding in the implementation of IIMP in the area of teaching and learning medicine, the Kulliyah is committed on the integration process in the fields of research and publication.Establishment of postgraduate programs in the various disciplines of medicine is an opportunity to islamise the research activities and contributes to new understanding of medical practice from the Islamic perspective5.This is the prelude to the establishment of centre of excellence in islamisation of medicine, which is the niche area of this Kulliyah.

Conclusion
Muslim scholars are responsible and should be in the forefront to lead a positive change in the ummah.The crisis of knowledge facing the ummah can be resolved by reforming the education systems and curricula of all disciplines to reflect Islamic epistemology based on the paradigms of tauhid.Islamisation of knowledge is the essence of the reform process.At the Kulliyah of Medicine IIUM, the IIMP can be regarded as an experiment of reformation of knowledge in the field of Medicine.It describes the way we train doctors according to the worldview of Islam, which is based on the tauhidic paradigm and realization of Islamic medical professionalism that emphasizes on acquiring the necessary expertise as safe doctors, embracing good ethical values and demonstrating good communication skills with compassion while attending to patients.
The experience gained over the past 15 years has been very enriching although we are aware of the many weaknesses that need rectification straight away.Production of guidebooks, manuals and textbooks on the islamisation of medicine is still a long way to go.Research in IIMP has only begun and training the trainers for effective implementation of IIMP and ensuring its sustainability is among the strategies for continuous improvement.