Community Based Education in a South African Context: Was Socrates Right?

Overseeing medical students working in small rural clinics challenges both the students and the lecturers. How does one evaluate a learning experience that does not involve memorising facts? Socrates (470-399 BC) maintained that the teacher's role was not to impart knowledge but rather to expose ignorance and encourage a process of self-discovery. According to Socrates, the outcome of this process was a new understanding of oneself, a sense of emotional balance and an increased consciousness of one's social responsibilities. This study evolved as I participated in the process of teaching students and became forcefully struck by their comments in their rotation reports. A qualitative analysis of 150 student reports was carried out and the major themes were highlighted. Those themes included: being overwhelmed by the difficulties and frustrations of an inadequate service, being challenged by cross cultural issues, comparing notes with traditional African medicine, reassessing compulsory community service and a changed vision about oneself and one's future career. A community-based experience in a rural clinic is definitely one way of preparing future doctors to meet the challenge of health care in South Africa.