The vision of the Kulliyah of Medicine at UIA was explained clearly by its first dean Prof Tahir Azhar when he
wrote: ‘When the Kulliyah of medicine for this university was proposed it was very clear from the beginning that it
was to be more than just another medical faculty to provide another training facility for the manpower needs of the country.
It has to be much more than that. Indeed from the outset it has to be consonant with the mission and vision of the university.
This would mean that the missing dimensions in the training and education of doctors would have to be filled in. The curriculum,
the teaching staff and the ambience will have to reflect the universal message of Islam. It should aspire to the hub of a
medical training center which would grow up to be the pride of the entire ummah. This is a very heavy undertaking indeed but
this is what the university has taken upon itself. An undertaking no more than what had been left by those before whose path
is nothing but to seek the pleasure of the Creator Who Has revealed His way for all of mankind’ (1). This vision is
in conformity with the university’s triple-I vision of Islamization, Internationalization, and Integration. The kulliyah’s
curriculum has therefore since its inception in 1997 emphasized integration in all its aspects: practical with the theoretical,
clinical with the basic sciences, and values with practice. The rest of this paper briefly describes the Islamic Input Curriculum
ay the kulliyah and gives some examples of its application in practice.
CORRECTING THE MISCONCEPTION OF ISLAMIC MEDICINE
There has been much confusion on the meaning and contents of Islamic medicine. Some people have understood it wrongly
to refer to traditional or alternative medicine practiced by Muslims. There are a few individuals who mistakenly think that
UIA is teaching some form of Muslim traditional or alternative medicine. The Islamic Input Curriculum (IUC) at UIA is based
on the form assumption that Islamic Medicine is not specific medical procedures or therapeutic agents used in a particular
place or a particular time by any group of Muslims. Islamic Medicine is defined as medicine whose basic paradigms, concepts,
values, and procedures conform to or to do not contradict the Qur’an and Sunnah.
It is universal, all-embracing, flexible, and allows for growth and development of various methods of investigating
and treating diseases within the frame-work described above. Thus modern scientific medicine can be accepted as a valid expression
of Islamic medicine if its ethics and values do not contradict those of Islam (2). The content and methods of teaching of
the medical course at UIA are the same as those at other Malaysian universities. The difference is in the IUC that students
at UIA take in addition to the regular medical curriculum. The Islamic Input into the curriculum provides an Islamic ethical
context for the learning and practice of Medicine.
THE CONCEPT OF AN ISLAMIC INTRODUCTION TO MEDICINE
Islamic introduction to any discipline of study establishes basic Islamic principles and paradigms that determine
and regulate the methodology, content, and teaching of a particular discipline. Students of the discipline will study the
introduction first before embarking on studying the discipline. Students will in this way have an Islamic orientation to the
discipline that will enable them deal with the discipline in a critical way. They will be able to recognise aspects of the
discipline that agree with the Islamic frame-work and separate them from those that do not. This sets them on the road to
new creative thinking that helps them make original contributions to the discipline from the Islamic perspective. The Introduction
to the discipline can therefore be looked at as a tool to transform a student from an uncritical consumer of knowledge to
one who is critically selective. A parallel can be drawn with the Ibn Khaldun’s Introduction to History, muqaddimat,
which was the first book of his universal History, kitaab al ‘Ibar. Ibn Khaldun’s work is rightfully called the
philosophy of history because it presents generalizing and methodological concepts that make sense out of the narration of
historical events. We can, in other words, say that the muqaddimat enables a student to understand the study of History. Ibn
Khaldun presented a rational/logical, analytical, and encyclopaedic approach to History. He was original in his thinking and
developed new terminology to convey his ideas. He explained how the physical environment affects the growth of human society
from the most primitive to the most sophisticated urban centers. He explained the determinants of leadership and the political
system. He explained the relation between group feeling, ‘asabiyyat, on one hand and the rise and fall of political
dynasties on the other. He explained the rise and fall of civilizations and the factors that regulate economic and social
conditions (3). The conclusions presented in the muqaddimat was based on Ibn Khaldun’s wide experience in practical
politics as well as his extensive travels in the then known Muslim world. Ibn Khaldun was a Muslim scholar and many of his
ideas were influenced by Islamic precepts.
THE ISLAMIC INPUT CURRICULUM AS AN INTRODUCTION TO MEDICINE
The Kulliyah of Medicine at UIA, is currently experimenting with an approach to Islamization in medicine similar
to that pioneered by Ibn Khaldun. It has a 5-year program of Islamic input into the Integrated Medical Curriculum that will
be published in 5 volumes under the title ‘Muqaddimat al Tibb: Introduction to the Study and Practice of Medicine for
Medical Students and Medical Practitioners’. The programs runs parallel to the medical curriculum. Relevant Islamic
concepts on medical conditions are introduced before the students study those conditions. The purpose of medical treatment
can be used to illustrate this approach. The western (Euro-American) world-view is that the purpose of medicine is to prevent
premature death, prolong life, and may be at some stage in the future discover the cause of cell aging and cell death and
thus be able to eliminate death altogether. Medical students at Kuantan are taught that the timing of death, ajal, is in the
hands of Allah and that no human, physician or not, can delay or advance it. People will die when their term arrives. The
purpose of medicine is therefore not to prevent death but to maintain the human in the best quality of life for the remainder
of their life on earth. Since the moment of death is never known to any human with any certainty, the physician will strive
his utmost until the last minute to ensure the highest possible quality of life. The two approaches, western and Islamic,
will lead to differences in the attitudes and behaviors of Muslim and non-Muslim physicians although they have the same quantum
of medical knowledge, skill, and technology.
FIVE MAIN OBJECTIVES OF THE ISLAMIC INPUT CURRICULUM
Concepts and paradigms: The first objective is the introduction of Islamic paradigms and concepts related to medicine
(Mafahiim Islamiyat fi al Tibb). The Muslim physicians must have some general concepts deriving from Islamic teachings that
can guide their work and research. These concepts can be grouped in five major categories: (a) The Islamic creed, aqidat Islamiyyat. (b) General concepts of knowledge, ilm & marifat. (c) The universe, kaun (d) The human, insan (e) Concepts relating
to transitions in the human condition, manazil al hayat: life, hayat; death, mawt; health,
sihat; disease, maradh); and medical treatment, tatbiib.
Medicine and revelation: The second objective is strengthening faith, iman, through study of Allah’s sign
in the human body. Medicine and medical knowledge have been described as the altar of faith, al tibb mihrab al iman. Study
of medicine leads to the conclusion that there must be a powerful and deliberate creator because such a sophisticated organism
could not arise by chance. Contemplation of the structure and functioning of the human body lead a normal person to appreciation
of the power of the Creator and to believe in Him. The following are ways in which this can be achieved: (a) Appreciating
the perfection, optimality, and sophistication of human biology starting from the sub-cellular to more sophisticated structures
like tissues and organs, (b) Appreciating the order, harmony, and purposiveness of human growth and development (c) Appreciating
human senses and organ systems as a gift from Allah (d) Appreciating the tauhidi integrating paradigm as reflected in the
well coordinated body physiology and homeostasis as well as the interaction of the human organism with the eco-system.
Medicine and the Law: The third objective is appreciating and understanding the legal, fiqh, aspects of health
and disease, al fiqh al tibbi. There is a close interaction between injunctions of Islamic Law, shari’at, and medical
practice. Muslim physicians must be aware of the general concepts so that they can give preliminary advice to the patients.
Diseases and their treatment interfere with the patient’s duties to Allah and also to other humans by limiting legal
rights and obligations. Often times difficult and fine choices must be made. A well-trained physician should be able to understand
the various options available and to explain them well to enable the patient make an informed decision. Fiqhi aspects of medicine
can be categorized in groups: (a) Medical and health issues of iman, salat, saum,
zakat, hajj, dhikr, tilawat al Qur’an (b) Fiqh issues in normal physiological processes: female issues (breast-feeding,
menstruation, pregnancy), excretion of waste (urination, defecation, flatus, toilet hygiene), nutrition (eating and drinking),
mental/psychological processes (sleep, memory, fatigue, moods), and sexual relations (c) Fiqhi
issues in disease conditions: (understanding the impact of disease on ‘ibadat obligations and the impact of disease
on human and social obligations) (d) Understanding medical aspects of applying shari’at: medical forensic evidence and
Social and ethical issues: The fourth objective is understanding the social and ethical issues in medical practice
and research, al qadhaya al ijtima’iyat wa al akhlaqiyat fi al tibb. Medicine is not taught or practiced in a social
or ethical vacuum. Good physicians must understand how social problems and issues impact on health, disease and medical treatment.
They also must appreciate how medical practice can create or solve social and ethical problems. The physician is the first
recourse to patient and their families in trying to make an informed decision when confronted by an ethical issue. The physician
while not be expected to make a legal ruling, fatwa, must know and understand the issues involved from Islamic and medical
perspectives and guide the patients to the most appropriate choices. The socio-ethical issues involved here can be divided
into 3 categories: (a) Societal institutions and how they affect disease occurrence
and disease management (b) social issues: Understanding medicine from the context of a social system, eradication of social
root causes of disease. (b) The physician and professional ethics: The amanat
of being professionally competent, etiquettes with patients and colleagues, medicine as service and not exploitation. (c)
Ethical issues in medicine and research: ethical issues due to technological advances in medicine, ethics of research and
violation of human and animal rights.
Historical and future perspectives: The fifth objective is to understand medicine in the ummah from historic and
futuristic perspectives, tarikh wa mustaqbal al tibb. The medical student is motivated and inspired by appreciating the medical
heritage of the Muslim civilization. Knowledge of the evolution of medical knowledge and practice since the first century
of hijra and achievements of Muslims in medicine have been ignored by western scholars and have been poorly documented by
Muslims. This knowledge is an indispensable component of the Islamic intellectual heritage. Medical knowledge in the Qur'an,
tibb Qur’ani, and the hadith, tibb nabawi, are known by very few Muslim physicians. Islamization of medical sciences
is a challenge that does not aim at producing different knowledge but at producing medical and scientific knowledge within
an ethical and moral context.
SOME DISTINGUISHING ASPECTS of the ISLAMIC INPUT CURRICULUM
Tauhidi holistic comprehensive approach: The curriculum is designed from a holisitic tauhidi paradigm that does
not look at medicine as a science and art isolated from the rest of society and human endeavors. When medical issues are discussed,
reference is made to relevant social and spiritual aspects. A basic paradigm of this manual is that medicine and medical treatment
are comprehensive involving physical, psychological, social and moral aspects. It therefore tries to be inclusive and discuss
all factors that directly or indirectly affect human well-being or ill health. This paradigm is a practical consequence of
the integrative tauhidi paradigm that is the basis of the Islamic civilization.
Integration and universality: The curriculum aims at universality and integration. Medicine is not a collection
of sub-specialties but an integrated whole. Medicine in integrated with other disciplines in a multi-disciplinary approach
to solving human problems. Disease and its treatment at seen from the context
of the whole eco-system. Lack of integration with the eco-system leads to new problems being created while solving old ones.
Well-rounded physician: The medical curriculum for which this manual is prepared aims at producing a physician
who is not only skilled in scientific medicine but also understands the spiritual and social aspects of disease. Such a physician looks at the patient as a whole person living in a social and spiritual milieu and
not just as a collection of symptoms and signs. The physician’s approach to medical problems is not only scientific
and technical but extends to other aspects of the patient’s life that affect
Methodological analysis: The manual has followed a consistent methodology in analysis of medical phenomena in the
light of the Qur’an and sunnat. Biological phenomena are presented as a miracle of the human body. The student is led
to appreciate the majesty of Allah’s creation by pointing out the following recurring patterns in all organ systems:
parity, symmetry, reserve functional capacity, functional adaptation, harmony and coordination. Fiqh and ethical issues are
analyzed based on original sources in the text, nass, of Qur’an and hadith as well as two Purposes of the Law, maqasid
al sharia, and Principals of the Law, al qawaid al fiqhiyyat al kulliyat, that are directly derivable from the primary textual
sources. In analyzing ethical issues arising out of modern developments in biotechnology, the manual has gone beyond the technical
and narrowly legalistic framework to consideration of social roots and consequences of disease. Abortion, for example, is
not analyzed only as a case of feticide but in its wider implication of facilitating sexual promiscuity by providing a way
out of an undesired and unplanned pregnancy.
METHODS OF TEACHING THE ISLAMIC INPUT CURRICULUM
The interactive discussion approach is used and the traditional lecture format is discouraged. The aim is to raise curiosity, interest, consciousness, and not to indoctrinate. Students should come out
of the course knowing what are the real issues and why they are important. They should be able to intelligently discuss the
available solutions alternatives and choose the best.
Regular sessions are envisioned. The Islamic input is regular throughout the 5-year course of study. It is estimated
that about 25% of the curriculum can be taught as special sessions on the Islamic input. The rest will be taught as part of
the regular medical lessons by the lecturers concerned. The lecturer will mention the Islamic aspects of whatever topic they
The Islamic input closely follows the relevant topics that are being taught in the general medical course. This enables the student to integrate information from more than one source in order to
achieve a comprehensive understanding without being confused. It is envisioned that the Islamic input will take a cumulative
total of 125 hours in the 5-year medical course. Each unit is covered in 1-2 class-room sessions each lasting 1 hour. The
student needs 15 minutes for each session to study the material before class. In the class the instructor leads discussions
for 30-45 minutes and summarize the main points in the remaining 15 minutes. The manual consists of more material than is
needed for the purposes of the curriculum so that students interested in more detailed aspects can read on their own.
Non-specialist Instructors can teach the curriculum: The material is presented at an introductory non-specialised
level. Any Muslim lecturer with basic knowledge of Islam can teach the material using the manual and teaching guidelines that
are provided. A workshop is held for instructors at the start of each block to prepare them. Integration with the general
medical curriculum: It is proposed that the teacher of each medical subject should also teach its Islamic input to be able
to integrate the material well. Guest speakers may be brought in for specific
topics that require more specialist handling.
Questions on the Islamic input are included in the written and oral tests and examinations that are given to students.
The questions are not put in a separate section but are fully integrated with the rest of the medical questions. These questions
however can not be more than 5% of the total grade points for the examination in order to preserve the professional integrity
of the examination as a test of medical knowledge and competence. The assessment will not look for retention of specific facts.
It will assess general understanding of the concepts and methodological approaches to be used in practical situations outside
the class-room when the future physician encounters actual practical problems and conceptual challenges.
EXAMPLES OF APPLYING THE CURRICULUM IN TEACHING BED-SIDE ETIQUETTE
Obligation to visit the patient, wujuub iyadat al mariidh: The ward rounds fulfill one of the social obligations
of visiting the sick (KS 505). Visiting the sick has a lot of excellence, fadhl
iyadat al mariidh, (KS 505). Care givers get a lot of reward from Allah for fulfilling this social obligation in addition
to the rewards for their medical work The caregiver should interact with the patient as a fellow human. The human relation
has priority over the professional patient-physician relation. Some bedside visits should therefore be purely social with
no medical procedures or medical discussions.
Etiquette of visiting a patient, adab ‘iyadat al mariidh: The prophet regularly visited his companions who
fell sick (KS 505, MB #1956). His behavior at the bedside of the patient is good guidance for both the physician and the other
visitors to the patient. The books of sirah have preserved for us memories of such visits such as what the prophet said during
the visit (KS 505). The following are recommended actions during a visit to the patient: supplication, dua, for the patient
(KS 505, MB #1961), reading Qur'an for the patient (KS 505), and asking the patient for supplication, dua. The Qur'an is a
cure, al Qur'an dawa (KS p. 338). Dua is a cure, al dua dawau (KS p. 338). The Prophet gave us guidance on what can be said
and what should not be said in the presence of the patient (KS 505). The following are enjoined: asking about the patient’s
feelings, sua'al anhu, doing good/pleasing things for the patient, ihsaan, making the patient happy, tatyiib nafs al maiidh,
and encouraging the patient to be patient, tashjiu al mariidh (KS 505). The patient should be discouraged from wishing for
death wishing death, tamanni al mawt (KS 524).
Mannerisms of the caregiver: Caregivers must have a cheerful disposition, imbisaat (MB #2045). They must deal with
patients with leniency, rifq (MB # 2025). They must strive to do good, ma'aruf (MB #2024). They must also have only good thoughts
about their patients, husn al dhann. They must avoid evil or obscene words (MB
#2026). It is important for the caregiver to have full interaction with the patient but must still observe the rules of lowering
the gaze, ghadh al basar, except when medical necessity dictates otherwise. Caregivers must not be arrogant and show off (MB
#2116). They must adopt an attitude of humbleness, tawadhu'u (MB #2117) all the time.
Emotional involvement: It is very wrong for caregivers to adopt a detached emotionally-neutral disposition thinking
that is the way of being professional. Caregivers must be loving and empathetic, tawadud & tarahum (MB #2018). They must
show mercifulness, rahmat (MB #2020). The emotional involvement must however not go to the extreme of being so engrossed that
rational professional judgment is impaired.
Covering of awrat: Both the caregiver and patient must cover awrat as much as possible. However, the rules of covering
are relaxed because of the necessity, dharurat, of medical examination and treatment. The benefit, maslahat, of medical care
takes precedence over preventing the harm inherent in uncovering awrat. When it is necessary to uncover awrat, no more than
what is absolutely necessary should be uncovered. To avoid any doubts, patients of the opposite gender should be examined
and treated in the presence of others of the same gender. The caregivers should be sensitive to the psychological stress of
patients, including children, when their awrat is uncovered. They should seek permission from the patient before they uncover
their awrat. Caregivers who have never been patients may not realize the depth of the embarrassment of being naked infront
of others. An epileptic woman who was embarrassed at the uncovering of her awrat during an attack came to the prophet. He
prayed for her and Allah answered the prayer (MB #1954).
Medical procedures: Caregivers must be fully aware of their legal liabilities and responsibilities, mas'uliyat
al tabiib (Sunan Abu Daud Kitaab al diyaat baab 24, Ibn Majah Kitaab al Tibb baab 16). The rules of seeking permission, isti'
dhaan, must be followed whenever caregivers approach a patient. The patient must
be forewarned about the approach of the caregiver and should not be surprised. The privacy of the patient must be respected
and he or she should be examined after getting permission. Medical care must be professional, competent, and considerate.
Medical decisions should consider the balance of benefits and risks. The general position of the Law is to give priority to
minimizing risk over maximizing benefit, dar'u al mafsadat muqaddamu ala jalbi al maslahat. Any procedures carried out must
be explained very well to the patient in advance.
Supporting care: The caregivers must listen to the felt needs and problems of the patients. They should ask about
both medical and non-medical problems. Supportive care such as nursing care, nutrition, cleanliness, and ensuring physical
comfort are as important as the medical procedures themselves. In terminal cases it is only the supporting care that can be
Managing fever: Fever is a generalized often non-specific patho-physiological response. It is a cause of much discomfort.
Caregivers should detect it early and treat it effectively. The prophet described fever as a blow of hot wind from hell-fire.
He recommended using cold water to cool the body during fever (MB #1972). Any additional methods of reducing body temperature
should be used.
Managing pain: The caregiver should comfort the patient in pain. He can explain that there is reward, ajr, for
being patient when suffering (MB #1953). The patient should persevere and not wish for death, tamanni al mawt, because of
extreme pain (MB #1958, 1959, 1960). The patient should be reassured that there is eventually a cure for every ailment, dawa
li kulli dai (MB #1962) so that there is no loss of hope.
Control of infections: The prophet forbade a sick person visiting the healthy (KS 504) to prevent spread of infection.
Precautions against spread of contagion were also recommended (MB #1969). Caregivers are obliged to make sure they have all
their infectious diseases treated so that they are not a risk to their patients.
The experiment at UIA is still in its infancy and we can not at the moment judge its success of failure. We will
have to wait for the products to graduate and go in the field. We will then be able to assess whether their ethical and social
conduct are improved as a result of the program.
Tahir Azhar in the Introduction to the Islamic Input Manual at UIA
Kasule, Omar Hasan: Islamic Medicine: Concepts and Misunderstandings. The Journal of the Islamic Medical Association
of South Africa.
Volume 3, No. 1 1-38, April 1997
Ubn Khaldun, The Muqaddimah: An Introduction to History (translated by Franz Rosenthal, edited and abridged by
NJ Dawood). Bolingen Series, Princeton. 1967
YEAR 1: FUNDAMENTALS