Medical education and primary health care in tropical Africa: evidence for change.

Many aspects of Primary Health Care call for a complete revision of approach, emphasis and mental attitudes in medical education. This appears to be a pre-requisite for the promotion of total health involving all elements (i.e. favourable biological, social and physical environment) in the improvement of the general health status of the community. However, the training of medical students is still, in the main, hospital based, with a relatively insignificant clinical exposure in the community setting. Consequently, medical students have been ill-equipped by the training institutions to appreciate the necessary comprehensive health role they would be expected to perform, especially in relation to Primary Health Care, on their eventual return to the community as medical practitioners. An assessment of the attitude and response of a group of final year medical students to the traditional basic medical and clinical disciplines revealed important deficiencies which are discussed: Suggestions are proffered for wider adoption of a community based training programme.