Outpatient Training: An Obscure and Old Challenge in Medical Education


Habibeh Ahmadipour ORCID 1 , *

1 Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

How to Cite: Ahmadipour H. Outpatient Training: An Obscure and Old Challenge in Medical Education, Strides Dev Med Educ. Online ahead of Print ; 16(1):e100142. doi: 10.5812/sdme.100142.


Strides in Development of Medical Education: 16 (1); e100142
Published Online: December 24, 2019
Article Type: Editorial
Received: December 13, 2019
Accepted: December 15, 2019


Outpatient Care Medical Education Barriers Iran

Copyright © 2019, Strides in Development of Medical Education. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

1. To Fix a Misunderstanding

When it comes to outpatient and field training, all minds go to the Community Medicine Department Training but it is not right. Due to its nature, the training in the Community Medicine Department is not possible elsewhere except in the urban or rural health centers. According to the curriculum, during community medicine clerkship/internship, medical students should become familiar with the structure and processes of the health care system, concepts such as integrated care for vulnerable population, national programs for the control and prevention of diseases, measurement and analysis of health indicators, and assessment of social determinants of health, etc.

Given the low proportion of these courses in general medicine curriculum (1/21 of the clerkship and 1/17 of the internship) and also their approved educational content, the outpatient training, in its true sense, is not possible during these periods. Therefore, medical school should involve other departments (at least major departments) in the outpatient training.

2. To Specify the Outpatient Training Content

All contributing departments should specify their educational content for outpatient training, the content which could not be taught in the ward-based training programs. If this content does not exist clearly, students and professors get confused and the motivation for teaching and learning is reduced.

3. To Identify the Appropriate Place for Outpatient Training

As mentioned above, a field can be a hospital affiliated clinic, and urban, suburb or even rural health care center, etc. To determine which of these centers are suitable for the outpatient training, each contributing department is responsible to identify the appropriate location based on its outpatient educational goals.

4. To Specify Executive Responsibilities

After the content and location have been determined by the Training departments, the time has come for the contribution of the university deputies such as education, health, treatment and even management and resources development. Because if a department determines that its hospital-affiliated centers are not suitable for outpatient education, in terms of the number and diversity of the patients, each of these deputies can help the department to find a more suitable center. Finding, equipping and coordinating a training center for field training is beyond the responsibility of that departments and requires an agreement between all considered deputies with a clear description of their duties and responsibilities. If this contribution not done correctly, in addition to jeopardizing the implementation of new outpatient training program, routine service delivery processes also face problems.

However, it seems that the above points are the least things that must be considered for successful implementation of an ambulatory care training before the new introduced program “field training” is forgotten as previous similar programs.



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