Driving curricula transformation

“Curriculum shapes the kind of health professionals we become. It determines what we are taught to notice, what we are taught to value, and how we understand our responsibilities to patients, communities and the health system,” said Sayuran Pillay, fifth-year MBCHB student, and founding convenor and co-chair of the Student Curriculum Lekgotla (SCL).

“Students are formed by the curriculum every day, and they often see both its strengths and its gaps very clearly,” he added, arguing for the importance of student voices in curricula decision making. In so doing, he echoes a growing global shift.

In hosting its inaugural symposium, the University of Cape Town (UCT) and the SCL marked a significant milestone by bringing together 70 delegates, students and staff from universities that included the Witwatersrand, KwaZulu-Natal and Stellenbosch in person, and others online, in shared conversation and debate around health professions education. In so doing, it created a rare inter-university space for students to engage critically and constructively on the future of health sciences education in South Africa.

In this way, it sparked the start of broader efforts towards growing institutional SCL nodes and sustained national student collaboration with health education leadership.

Central to UCT’s vision

“This movement reflects several values central to UCT’s vision of student leadership, national engagement, transformation, innovation in education, and inter-institutional collaboration,” said Pillay, who expressed gratitude to the dean of the Faculty of Health Sciences, Professor Lionel Green-Thompson, for his ongoing support; and to Dr Dina-Ruth Lulua, Dr Morne Visser and Dr Jaisubash Jayakumar who helped launch and shape SCL.

The symposium gave the UCT student cohort a platform to report on problems with current curricula, present scholarly pieces around issues and potential interventions, and facilitate dialogue and co-creation sessions. A defining feature of the symposium was its deliberate positioning of student experience as a legitimate source of scholarly and institutional inquiry.

“It was also incredibly energising to see students from across the country choosing UCT as the convening space for these conversations.”

“Hosting this was significant because it showed that UCT can be a serious home for student–staff partnerships in curriculum change. It demonstrated what becomes possible when a faculty and deanery are willing to support students – not only as consultees, but as partners who can help shape educational thinking. It also positioned UCT as a convening space for a broader national conversation,” Pillay said.

“It was also incredibly energising to see students from across the country choosing UCT as the convening space for these conversations. There were some powerful moments throughout the day.”

Topics ranged from over-biomedicalisation and the hidden curriculum, to institutional culture, language, clinical skills, assessment, interprofessional learning, decoloniality and socially-accountable education. There was also an address by Professor Harsha Kathard, whose work on disability, communication, health professions education and social justice aligns with the SCL’s approach.

An innovative approach

Founded in 2023, the SCL aims to bridge gaps in curricula through an enduring partnership between student and educator, rather than a once-off or exclusively student-driven approach. Consciously riding on the collaborative name, lekgotla, with its Southern African tradition of collective conversation and consensus building, it strives to approach the curriculum as a dynamic construct which moves with times, needs and communities, rather than a fixed product, rooted in a non-representative past.

By working in partnership with the faculty and deanery, rather than as a traditional student society, SCL has created an innovative space for students to work alongside curricula processes, while building agency, rather than simply being consulted or informed.

“The idea was to recognise that there were excellence and leadership among students, but that it needed a structured platform, capacity-building and a more constructive relationship with staff if it was going to influence curriculum work meaningfully,” Pillay explained.

“At UCT, we have been fortunate to receive strong support from faculty members and the deanery. Staff have been receptive and constructive, offering guidance while allowing students to shape and take ownership of the process. This has been central to the SCL’s momentum. Many students have seen through this work what is possible when faculty members say yes, create space and help students think carefully about how to use that space responsibly.”

Global recognition

It is a collaborative, constructive approach that has attracted global recognition. In 2025, it garnered the Patil Teaching Innovation Award, a prestigious health-professions’ education award for outstanding ingenuity in teaching methods, assessment and curriculum planning. This was awarded at the International Association for Health Professions Education (AMEE) International Conference in Barcelona, Spain, where the SCL fended off 72 international submissions with its innovative student–staff partnership model rooted in the lekgotla engagement tradition.

This award acknowledged UCT as an innovative frontrunner in the move towards the co-construction of curricula, sewing seeds for health education globally.

Related work by Pillay and Dr Khwezi Zwane was also presented at the inaugural AMEE Conference in Kigali, Rwanda, in 2025. The SCL is contributing to wider student engagement work through AMEE and the emerging Youth Forum of the Consortium of Medical Schools in Africa.

“For me, student–staff partnership is a way of moving beyond frustration into shared responsibility, where students are supported to contribute with insight, care and seriousness,” said Pillay.

Transforming a curriculum rooted in past inequalities

Health professions education has its roots in a long and complex history, and despite all that has been done to realign curricula to date, it still reflects roots of power, exclusion and knowledge-making. SCL goals are to move curricula across health disciplines towards a health professions education that is academically rigorous, socially responsive and contextually grounded.

“UCT, as an institution, emerged within colonial and apartheid contexts that determined whose knowledge would be legitimised, whose voices would be centred, and what forms of professional identity would be produced. And while significant structural reforms have taken place, particularly in widening access, the epistemic and pedagogical foundations of the curriculum continue to reflect these histories,” said Pillay.

“I would also like student engagement itself to be embedded in curriculum governance as a normal and expected part of how health sciences education is developed, rather than an occasional consultation exercise.”

As a result, there is a disconnect, he argues, between students whose goal is to respond to the needs of the communities they serve and an education structure not originally designed for this purpose. This leads to gaps between training and practice, knowledge and context, and participation and authority.

“Across universities, there is a lack of consistency in how students are involved in curriculum work, and gaps around Africanisation. I would like to see curricula that more intentionally engages African health systems, histories of local medicine, disability justice, language and communication access, ethical leadership, community-based knowledge, planetary health, and the lived realities of patients and communities.

“I would also like student engagement itself to be embedded in curriculum governance as a normal and expected part of how health sciences education is developed, rather than an occasional consultation exercise.”

Driving change for future generations

As senior students, there are members of the SCL, at UCT and beyond, who are advocating for changes to curricula from which they will never benefit. They are laying the road for those who will come after them.

“Much of this work is service-oriented, and many of the changes we advocate for may not benefit us directly. That means the students who stay involved tend to be deeply committed, reflective and willing to work for those who come after them,” said Pillay.

While a rewarding journey, it is not without bumps in the road. Student–staff collaboration means navigating power dynamics, levels of experience, institutional expectations and capacity constraints, something with which UCT’s Designing for Social Justice Partnership short course was helpful.

The next step is to strengthen the SCL as a national, and ultimately continental, student network for curriculum change.

“We want students across Africa and beyond to have meaningful ways of shaping the education that shapes them, while working in partnership with staff, communities and institutions,” Pillay concluded.