Document Type: Letter to Editor


University of California, San Diago, USA


My interest in the department of medical education started in the year 1955 when about 900 high school graduates in Shiraz, participated in the “Konkoor”, an Iranian University entrance exam. Of these 900 graduates, 42 passed and gained admissions into Shiraz University Medical School and six years later, 32 graduated and received a medical degree from Shiraz University Medical School. I was one of them. The medical school curriculum was based on an American Medical School Curriculum. The courses and textbooks were all in English, taught by visiting American professors in various medical specialties. The natural trend for such trained Iranian medical graduates was to participate in the ECFMG qualifying exam, an assessment of their readiness to enter further graduate training in the U.S. Of the 32 graduates, 24 passed the ECFMG and started their 5 year (1961-1965) specialty training in U.S. hospitals. As one of the graduates of the Class of 1961, I was in close contact with my medical school classmates and followed their moves and professional activities with interest. In 1969, eight years following graduation, 17 of the 32 graduates were residing and working in the United States, while the remaining 15 had stayed in Iran. In 1971, during my sabbatical leave, at Johns Hopkins University, we engaged in the study of medical schools graduates in Iran. We were astonished to find 1625 Iranian medical graduates had permanently immigrated to and were working in the United States. The reasons for this large-scale immigration were multifold. As the medical school curriculum in Iran was modeled on those in the Western countries, it was natural that the Iranian medical graduates gravitated to these countries. The graduates that remained in Iran were sometimes faced with a 2 year mandatory military service. They were confronted with rural settings, which were a far cry from their medical training, having to treat patients with minimal equipment and medication. This lack of opportunity was partially responsible in their ploy to emigrate to the West. The establishment of the department of medical education along with the department of community medicine at Shiraz University provided an ideal opportunity to modify the medical school curriculum and the methods of instruction, and to tailor these to the needs of the Iranian population. The success and reputation of both these departments had a significant role in modifying not only the curriculum in Shiraz, but also those of medical schools in the entire Eastern Mediterranean region. It is indeed very pleasant news to find the present publication where medical schools in the region and further afield can share their ideas about the successes and pitfalls of medical education