1. Higher Medical
Education System in
Afghanistan
DR. MOHAMMAD NAEEM (MD. PGD)
CONSULTANT PATHOLOGIST IN FMIC

2. History of Healthcare system in Afghanistan
 In 1932 during the reign of King Nader Shah, the first and only
Medical College was founded for Afghanistan, in Kabul.
 The first students of the college were 10 high school graduates.
 Entrance exam was not required.
 Turkish Professors had the honor to train the first group of Afghan
physicians.
. All students were male, since no female attended school at that
time.

3. Cont.……
Basic sciences were included in the first year of curriculum.
Students were sent to India (Bombay) to learn anatomical
dissection during their second year.
The clinical training started in third year during morning at the
state hospital in Jade Maiwand.
The sixth year was a clinical rotation in the above hospital.
First group of students graduated in 1938.
In 1938 “Ali Abad University Hospital” was built and inaugurated.

4. Curriculum of Medical School:
First year basic sciences: PCB ( Physics, chemistry, and biology)
which was common classes for colleges of Medicine and Science. In
1961 PCB was changed to MPCB. Mathematics was added.
First and second year : Anatomy, physiology, biochemistry,
microbiology, biophysics, and histology.
Third year: Internal medicine, surgery, general pathology.
Fourth year: General medicine, surgery, preventive medicine,
infectious diseases, pharmacology, obstetrics, and organ pathology.

5. Cont.…..
Fifth year: Pediatrics, gynecology, dermatology, neuropsychiatry,
ENT, and ophthalmology.
Starting with the third year students received clinical training at the
“Ali Abad and women’s University Hospitals”.
This included four and half months in Internal Medicine and four
and a half months in Surgery.
During this time, and during their fourth and fifth years the
students worked in the hospitals in the morning and in the afternoon
they followed lectures at the medical school.

6. Cont.…..
In their sixth year students had only clinical rotations in hospitals
through out Kabul, in different disciplines and no theoretical
lectures.
Upon completion of their rotation they had to take a clinical test in
each field.
Upon successful completion of the tests M.D degree was awarded
to each graduate.

7. Cont.…..
In mid 1950s when the number of students increased, concours
(entrance exam) was introduced.
In 1963 in Afghanistan the second medical school in Jalal Abad was
founded.
Number of graduates from Kabul and Jalal Abad medical schools
increased from ten to 120 per year.
From each graduating school 10 percent remained as staff with the
universities.

8. Cont.…..
The remaining 90% graduated physicians became employees of the
MPH, and other government institutions.
Medical Schools were part of the universities.
The Chancellors of these universities were directly responsible to
the Minister of Education.

9. During and after 1970s:
Kabul Medical School is divided into three branches (sections):
Adult Medicine
Pediatrics
Stomatology

10. Cont.…..
Number of students in each class increased from low one hundred
to hundreds.
Total number of students reached in thousands.
School of medicine was named Kabul Medical Institute (KMI).
KMI was transferred to MoPH.

11. In the last few years five additional medical
schools were opened in the provinces
Balkh (Mazar-I-Sharif) 1986
Herat 1988
Kandahar 1992
Gulbahar (Albiruni Univ.) was brought from Faiz Abad
Afghan University (Peshawar) was brought to Khost province and
later named SZU.
Total number of students exceeding ten thousand.

12. Cont.…..
The Kabul Medical School evolved to several colleges.
Number of graduates exceeded the needs.
Quality of education deteriorated.
The curriculum suffered a major setback.
No one is sure of the present curriculum.
A complete renovation is needed.

13. Medical Students of the Kabul Medical
Institute
oA combined team of Afghan Medical Association (AMAA) and Loma
Linda University (LLU) traveled to Afghanistan on April 11 – 17, 2002
oThey conducted a study to find useful information with regards to
KMI medical students.
oQuestions were asked in writing and student responses were
collected.

14. Purpose of the study:
The aim of this study was to ask the students about the quality of
their medical education, availability of teaching materials and their
knowledge of English.
284 student of KMI grade 3 and 4 participated in the study.

15. Conclusion:
1. The students of KMI are able to speak and understand English, Pashto
and Dari (58%).
2. They do not believe that they have adequate available literature in
Dari or Pashto (80%).
3. However the knowledge of English is limited (58%) and they are in
need of help to learn more English even if it causes a delay in their
graduation.

16. Cont.…..
 Some of them have background training in computers (15%) but the
majority had no training in computers. They are willing to learn how to
search for and acquire medical knowledge via the internet and computers.
 Majority are willing to apply for a position with the teaching faculty
after graduation (70%).
They do not have enough teaching staff in KMI and there is a need for
teaching faculty abroad to come and teach them.(97%).

17. Cont.…..
The Majority of students think that the current number of medical
schools and medical students far exceed the number needed for
Afghanistan. There is a need for drastic action to decrease the number of
medical schools and students. Some students who fail the examinations
could become allied health professionals (60%).
 All the students think that the current level of acquiring a medical
education is below the standard and there is need for improvement
(100%).

18. KMI not included till 2021

19. Recommendations:
Fortunately the majority opinion of the students favor a
change for the betterment of the education system. They want
to see a drastic reduction in the number of medical schools
and students. They are willing to learn English and accept
English for teaching. The Ministry of Higher education,
International NGOs and administration of KMI should take
steps to improve the current status by heeding the
recommendation of the students demand for change.

20. Cont.…..
For the long term future plan and development of Afghanistan's
healthcare system rehabilitation of medical education must be a
priority.
This goal can be achieved by the facilitation of academic links with
developed world institutions.
Further development of new education methods such as PBL is also
important

21. Accreditation
Accreditation is a method for assuring quality. Accreditation is the
independent, third-party evaluation of a conformity assessment
body against recognized standards, conveying formal demonstration
of its impartiality and competence to carry out specific conformity
assessment tasks (such as certification, inspection and testing)

22. Advantages of Accreditation

1. For the university, it provides a reliable basis for inter- and intra-
institutional cooperative practices, including admissions and transfer
of credit.
2. For the faculty and administrators, it promotes ongoing self-
evaluation and continuous improvement and provides an effective
system for accountability.
3. For the school or program, accreditation enhances its national
reputation and represents peer recognition.

23. Cont.…..
4. For foundations and other private funding sources, it represents a
highly desirable indicator of a program's quality and viability.
5. For prospective students and their parents, It provides assurance
that the school or program has been evaluated and has met accepted
standards.
6. For prospective employers, it provides assurance that the
curriculum covers essential skills and knowledge needed for today's
jobs.

24. References:
1. http://www.afghanmed.org/archives-past-history-healthcare/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122775/
3. https://amc.gov.af/102/accreditation
4. https://ilac.org/about-ilac/
5. https://accreditation.ca/news/the-5-top-benefits-of-accreditation/
6. https://ceph.org/constituents/students/benefits-of-accreditation/
7. https://wenr.wes.org/2016/09/education-afghanistan
8. https://mohe.gov.af/
9. https://www.4icu.org/top-universities-asia/