Real decisions of international medical students on choosing elective courses on general, internal, and evidence-based medicine at Kyiv Medical University

Supplementing and improving education content as scientific and subject disciplines emerge is a main principle of curriculum development. Students' participation in this process is essential for implementing the standard for quality assurance in the European Higher Education Area. Medical students may benefit from gaining more competence in current issues of general, internal, and evidence-based medicine (EBM). The relevance of such elective courses (ECs) for international medical students has not been studied yet according to the literature review. The study object was a methodology for designing a curriculum in the system of higher medical education using a student-centered approach. The study subject was student-related factors influencing curriculum development in terms of making decisions on choosing ECs by international medical students at a clinical department of a medical university. The study aimed to describe features of students' decisions and determine student-dependent factors regarding the choice of ECs on current issues of general, internal medicine, and EBM by international medical students of Kyiv Medical University (KMU). This explorative, descriptive, comparative cross-sectional pilot study utilized a self-administered web questionnaire, which was answered in April 2024 by 46 international 6th- and 5th-year medical students of KMU coming from eight Asian and African countries (India, Pakistan, Sri Lanka, Iran, Türkiye, Nigeria, Ghana, and Tanzania) and registered in the KMU's Google Workspace. All participants were divided into three groups according to region: South Asia, West Asia, and West and East Africa. The literature review was performed using information analysis methods. The relevance of all proposed topics for ECs on the issues of EBM, rheumatology, and geriatrics was justified by their choice by all study participants with a frequency of 33,33% to 72,22% in different subgroups and by the average number of topics selected of 1,71 to 2,11 per person. Decisions to choose a course on practicing EBM in internal medicine were more often made by sixth-year students (72,22%) and those coming from South and West Asian countries (73,33% and 80,00%, responsively) than by 5th-year students (46,43%) and Africans (42,31%), whose greatest interest was in aspects of rheumatology. Neither gender factor nor current academic performance in internal medicine influenced students' decisions regarding the number and topics of ECs. Our study revealed a lack of student initiative concerning individual offering topics for ECs, facts of non-choice of an EBM course in some regional subgroups, like a relatively low frequency of choice of ECs in geriatrics (33,33 and 35,71% among 6th- and 5th-year students, respectively), which confirmed the necessity of the guiding role of teachers in implementing a more student-centered approach in curriculum development and the role of student-dependent factor in this process such as their country of origin.