Improving South African medical curricula related to traditional health systems

C Lawrence, J Bollinger, K A Stewart, Mosa Moshabela


Background. Increased co-ordination and co-operation between traditional and biomedical health systems in South Africa (SA) is a national priority. To improve care, practitioners in both systems must learn to recognise the value of their parallel counterparts, and such lessons should begin in medical school. However, there is little research regarding the way in which SA’s medical students are taught to interact with the traditional medicine (TM) system.

Objectives. To explore how SA medical students perceive their curriculum as it relates to the traditional health system and to describe their suggestions for improvement. Methods. We conducted individual in-depth interviews and focus group discussions with 43 final-year medical students across 3 SA medical schools. We applied thematic analysis to improve our understanding of student-reported experiences with TM in their medical school curricula.

Results. All 3 medical schools rely heavily on hidden curricula to educate students on the SA traditional health system. These hidden curricula are largely negative and learnt primarily from witnessing faculty-client interactions involving TM use. Students across the institutions agree that this problematic deficit in formal teaching contributes to their incompetence in treating patients who use TM. Their suggestions for improvement focused largely around 3 themes: (i) understanding the fundamentals of the traditional health system; (ii) empathising with patient use of TM; and (iii) promoting broader structural integration of the two health systems.

Conclusion. Medical students in SA recognise the value of increased exposure to and education surrounding the traditional health system. Future curricular interventions should focus on increasing formal teaching of TM, directly addressing the hidden curriculum related to the topic, and instituting policies and initiatives that improve integration of the SA biomedical and traditional healing paradigms on a structural level.

Authors' affiliations

C Lawrence, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; nd Public Health, University of KwaZulu-Natal, Durban, South Africa; Mount Sinai Hospital, New York City, USA

J Bollinger, Duke University, Durham, USA

K A Stewart, Duke University, Durham, USA

Mosa Moshabela, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; Africa Health Research Institute, University of Kwa-Zulu Natal, Durban, South Africa

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Cite this article

African Journal of Health Professions Education 2021;13(2):146-149. DOI:10.7196/AJHPE.2021.v13i2.1246

Article History

Date submitted: 2021-07-21
Date published: 2021-07-21

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