Prescribing skills for undergraduate
Nepal Journal of Epidemiology 2013;3 (3): 260-261
Copyright © 2013 CEA&INEA
Published online by NepJOL-INASP
www.nepjol.info/index.php/NJE
Prescribing skills for undergraduate medical students: Time to redress the
neglect?
Shankar PR
1
1
Professor, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
Chief Editor
Dr. Indrajit Banerjee
Technical Editor
Dr. Nishida Chandrasekharan
Formatting Editor
Dr. Indrajit Banerjee
Editorial
Medical schools have a major challenge of preparing
undergraduate students to choose and prescribe safe and
cost-effective treatments. Problem-based learning in
pharmacology based on national essential medicine lists
and standard treatment guidelines has been recommended
as a key intervention to improve prescribing
1
. Recognizing
the fact that traditional pharmacology teaching
concentrates on memorizing information about medicines a
number of initiatives have been introduced to improve
teaching-learning of rational therapeutics.
Recognizing the vital importance of the subject, the World
Health Organization (WHO) has developed four publications
dealing with teaching rational use of medicines (RUM).
These are ‘Guide to good prescribing’
(http://whqlibdoc.who.int/hq/1994/who_dap_94.11.pdf),
‘Ethical criteria for medicinal drug promotion’
(http://apps.who.int/medicinedocs/documents/whozip08e/
whozip08e.pdf), ‘How to investigate drug use in health
facilities’ http://apps.who.int/medicinedocs/en/d/Js2289e/)
and a book for teachers titled ‘Teacher’s guide to good
prescribing’(http://apps.who.int/medicinedocs/en/m/abstr
act/Js2292e/). ‘Guide to good prescribing’ was used to
conduct rational pharmacotherapy training for fourth year
medical students in a medical school in Turkey
2
. Case-based
teaching was used to impart rational pharmacotherapy skills
to students in India
3
and developing and using a personal
formulary was found to be effective in schools following
both a traditional and a problem-based curriculum
4
.
In a medical school in Lalitpur, Nepal students learn about
various aspects of RUM during small group pharmacology
learning sessions
5
. Personal (P) drug selection using
objective criteria and unbiased sources of medicine
information is an important exercise in pharmacology. At
present in Nepal the exercise is being conducted at Manipal
College of Medical Sciences, Institute of Medicine and KIST
Medical College
6
. The P-drug selection process uses a logical
deductive process, using accurate and objective
information, to adopt strict criteria (efficacy, safety,
convenience and cost, on selecting drugs and writing a
complete prescription
7
. In a medical school in Brazil
students liked the methodology and the opportunity to
reflect on various factors involved in the prescribing process
but could not use it much in practice due to lack of
stimulation and not being allowed to do so by older
residents and senior doctors
7
.
In the United Kingdom initiatives to improve prescribing
have recently been carried out
8
. Prescribe, a repository of e-
learning materials to support education in clinical
pharmacology and prescribing has been created, and
the Prescribing Skills Assessment, a national online
assessment designed to allow medical students to
Corresponding Author:
Dr. P Ravi Shankar MD
Xavier University School of Medicine
Aruba, Kingdom of the Netherlands
E-mail: ravi.dr.shankar@gmail.com