Past History of Healthcare in Afghanistan

Ibrahim Seraj, M.D.
August 4, 2002

History:

  1. In 1932 during the reign of King Nader Shah, the first and only Medical College was founded for Afghanistan, in Kabul.
  2. In 1931 a physician assistant program had already begun in Kabul, which lasted for three terms.
  3. The first students of the college were 10 high school graduates.
  4. Entrance exam was not required.
  5. Turkish Professors had the honor to train the first group of Afghan physicians.
  1. During this time the students attended for six years.
  2. All students were male, since no female attended school at that time.
  3. Following year an additional 8 students were admitted to this college.
  1. Basic sciences were included in the first year of curriculum.
  2. Students were sent to India (Bombay) to learn anatomical dissection during their second year.
  3. The clinical training started in third year during morning at the state hospital in Jade Maiwand.
  4. Didactic lessons continued in the afternoons.
  5. The sixth year was a clinical rotation in the above hospital.
  6. For many years this was the only college in Afghanistan, at the Kabul University.
  7. First group of students graduated in 1938.
  8. In 1938 “Ali Abad University Hospital” was built and inaugurated.
  9. Years later colleges of Science, Law, and others were added to Kabul University.
  10. Upon termination of the contract with Turkey a relationship with French health authorities were established.
  11. An affiliation between Kabul Medical School and Paris Medical School started.
  12. At this point 12 French professors arrived to teach basic as well as clinical sciences.
  13. At this point the school duration extended to seven years of study.

Curriculum of Medical School:

  1. 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.
  2. First and second year Medical School: Anatomy, physiology, biochemistry, microbiology, biophysics, and histology. Anatomical dissection was performed in Kabul, therefore there was no need to send students to India.
  3. Third year: Internal medicine, surgery, general pathology.
  4. Fourth year: General medicine, surgery, preventive medicine, infectious diseases, pharmacology, obstetrics, and organ pathology.
  5. Fifth year: Pediatrics, gynecology, dermatology, neuropsychiatry, ENT, and ophthalmology.
  6. Starting with the third year students received clinical training at the “Ali Abad and women’s University Hospitals”.
  7. This included four and half months in Internal Medicine and four and a half months in Surgery.
  8. 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.
  9. In their sixth year students had only clinical rotations in hospitals through out Kabul, in different disciplines and no theoretical lectures.
  10. Upon completion of their rotation they had to take a clinical test in each field.
  11. Upon successful completion of the tests M.D degree was awarded to each graduate.

Jalalabad Medical School

  1. In 1963 in Afghanistan the second medical school in Jalal Abad was founded.
  2. The efforts of Dr. Gordon Hadley resulted in establishing affiliation between LLU and Jalal Abad Medical School.
  3. Curriculum of this university followed the same as that of Kabul Medical School.

General Information:

  1. In mid 1950s when the number of students increased, concours (entrance exam) was introduced.
  2. Number of graduates from Kabul and Jalal Abad medical schools increased from ten to 120 per year.
  3. From each graduating school year 10 percent remained as staff with the universities.
  4. The remaining graduated physicians became employees of the MPH, and other government institutions.
  5. Medical Schools were part of the universities.
  6. The Chancellors of these universities were directly responsible to the Minister of Education.

During and after the communist regime:

Kabul Medical School is divided into three branches (sections):

  1. Medicine
  2. Pediatrics, and
  3. Stomatology
  1. Number of students in each class increased from low one hundred to hundreds.
  2. Total number of students reached in thousands.
  3. School of medicine was named Kabul Medical Institute (KMI).
  4. KMI was transferred to MPH.
  5. In the last few years five additional medical schools were opened in the provinces
  6. Balkh (Mazar-I-Sharif) 1986
  7. Herat 19..
  8. Kandahar 1992
  9. Gulbahar (Albiruni Univ.) was brought from Faiz Abad
  10. Afghan University (Peshawar) 1999
  11. Total number of students exceeding ten thousand.
  12. Kabul Medical School in recent years again detached from the MPH and became attached by by-passing the University directly to the Minister of Higher Education.

Conclusion:

  1. The Kabul Medical School evolved to several colleges.
  2. Number of graduates exceeded the needs.
  3. Quality of education deteriorated.
  4. The curriculum suffered a major setback.
  5. No one is sure of the present curriculum.
  6. A complete re-haul is needed.
  7. LLU and the Afghan Medical Association in America is in the process of re-establishing relations with KMI and the MPH – a welcomed opportunity.


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