Curriculum or syllabus: which are we reforming?

Although the concept of 'curriculum' is complex, a common understanding of the term by those involved in medical education is essential, given the current climate of medical curriculum development and reform. It has not previously been established that such a common frame of reference exists. We polled a sample of medical educators with a range of teaching experience and responsibility in an attempt to discover what they understood by 'curriculum' (and whether or not the concept could be articulated). A sample of medical students was similarly polled. In total, 85% of staff and 34.9% of the students responded. The responses obtained were subjected to a content analysis. The answers received were polythematic in 87.5% of cases, dominant themes including 'curriculum as a syllabus', 'curriculum as a meta-syllabus', and 'curriculum as a means to an end'. Our data show that the nature of curriculum is complex and does not lend itself to dictionary-style definitions. Moreover, the majority of those polled view 'curriculum' in two-dimensional terms, tending to equate it to 'syllabus'. This may have significant implications for curriculum reform.