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Analysis of the elective curriculum in undergraduate medical education in Croatia


Livia Puljak, Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia. Tel: 00 385 21 557807; Fax: 00 385 21 557811; E-mail:,


Medical Education 2010: 44: 387–395

Context  Elective courses are a significant part of undergraduate medical education throughout the world, but the value provided by these courses and the reasons for choosing particular elective courses have not been studied extensively.

Objectives  The aim of this study was to investigate medical and dental students’ experiences of elective courses in undergraduate medical education in Croatia and to gather students’ recommendations for the improvement of elective courses.

Methods  Medical and dental students studying under the Bologna curriculum were given a questionnaire in which they were asked for their opinions of elective courses and their suggestions as to how they might be improved. Data on elective courses were obtained from medical schools’ administrative offices.

Results  The survey response rate was 92% (834/903). Medical students gave elective courses an average grade of 3.44 out of 5, whereas dental students gave a lower average of 3.15. Students’ suggestions for change included introducing more practical work and recognising international student exchanges and attendance at conferences as elective options. A third of students indicated that teachers should be given additional training in leading elective courses. Analysis of the curriculum showed that elective courses in Croatian medical schools are very heterogeneous in terms of their content and the number of credits and assessment methods they involve, and are very conservative in that only structured courses are offered. Students cannot design their own courses or take more elective courses than represent 10% of their total number of credits.

Conclusions  Student opinion should be consulted when medical schools venture into the elective curriculum so that students can feel that they are really benefiting from these subjects. Students would welcome new and personally designed strands. Elective courses are a significant part of medical education and therefore their quality and purpose need to be assessed regularly in order to ensure that they meet students’ needs.