ABSTRACT
The first course on Medical Sciences in Chile was inaugurated in 1833, being its director William C Blest, MD, an Irish physician graduated in Edinburgh University. Therefore, Dr. Blest can be considered the founder of Chilean formal medical education. When the University of Chile was established (in 1842), among its five initial Faculties was included Medicine, on the basis of the Medical Sciences course created ten years before. By then, the medical profession was not yet socially reputed and the initial years of the Faculty were difficult. During the 19th Century and until the second decade of the 20th century, this was the only medical school in the country. Its development was slow but sustained, reaching its apogee in the middle of the 20th Century, when it had outstanding clinical and basic sciences teachers and investigators. Clinical research, postgraduate teaching and medical specialization had a great development during that period. Nowadays, it is a complex Faculty that teaches eight health sciences courses leading to different professional titles, gives higher academic degrees in biomedicine and public health and certifies different medical specialties. It has a modern, well equipped library and a unique Museum of Medicine. Besides the traditional Departments in Medical Faculties, it has Departments of Medical Teaching, Bioethics and Medical Humanities. It provides continuing medical education programs and distance teaching has recently experienced a great development. The community is also favored with specific teaching programs. The academic promotion of its faculty members is based in a strict evaluation. During its existence, the Faculty has graduated a large number of physicians and other health care professionals. Our country should be grateful to the University of Chile Faculty of Medicine, in its 170th birthday, for its outstanding contribution to the development, welfare and happiness of Chilean society
Subject(s)
Humans , Schools, Medical/history , Education, Medical/historyABSTRACT
The Chilean Academy of Medicine is concerned about the significant increment in the number of Medical Schools in Chile, from six in 1981 to 16 in 2002. All these Schools were invited to participate in a seminar about medical training. Eleven Schools are private and 5 are public (3 private Schools are subsidized by the state). There are nine Medical Schools in Santiago and 7 in other regions. The students admission criteria varies from one school to another. One thousand one hundred twenty two students are admitted to these Schools each year. Clinical hospitals, urban and rural outpatient clinics are used as training fields. These pertain to the Ministry of Health, Universities, Armed Forces, Private Clinics and City Halls. The main recommendations of the seminar were: to promote an early contact of students with clinical problems and to analyze these problems from the perspective of basic sciences; to enhance semiological, clinical and physiopathological training; to increase the contact with outpatients; to favor health promotion and preventive activities; to educate professors in ethical and humanistic issues; to regulate the use of clinical campus and reinforce the formation of specialists in family medicine, internal medicine and pediatrics. The accreditation of Medical Schools and clinical training centers was recommended. The establishment of a national medical examination for Chilean and foreign graduates, was proposed. The Academy of Medicine is interested in assuring a good quality medical training and to avoid teaching activities in unqualified schools and hospitals
Subject(s)
Humans , Education, Medical, Undergraduate/trends , Schools, Medical/trends , Quality Control , Universities , Teaching Care Integration Services , Professional Review Organizations/trendsABSTRACT
With this issue, Revista Médica de Chile will have been published uninterruptedly, for 130 years. Formal medical education had an early development since Chile became independent from Spain (1817). The first Medical Sciences Course was organized in 1833 by the Irish physician William C Blest. The Santiago Medical Society was founded in 1869 and its journal -Revista Médica de Chile- in 1872. Its first director was Dr. German Schneider. Revista Medica is the oldest serial publication in South America and the second oldest in the Spanish speaking world. This is a remarkable fact for a comparatively young country. With the creation of the Medical Society and Revista Medica, a process of continuous medical education was started and they became a real Graduate School. The Journal has adopted the main changes in knowledge and technology. Some important milestones of its development, during the second half of the 20th century, were the definition of its objectives and structure, the incorporation of peer review of manuscripts (even with foreign reviewers) the adoption of international guidelines for publication, its incorporation into the main biomedical journal indexes, the modernization of its printing process, the making of a computer generated index of all papers published since 1872, its incorporation into a digital library in INTERNET and the active participation of its editors in the World Association of Medical Journal Editors. The success of the journal is influenced by the independence that the Medical Society has conferred to the editors (all outstanding University Professors), as well as to the characteristics of an educational campus "invisible and without tumult" (Ingelfinger)
Subject(s)
Humans , Education, Medical/trends , Periodical/trends , History, 19th Century , Societies, MedicalABSTRACT
This speech of the president of the Chilean Academy of Medicine, Dr Alejandro Goic, is a tribute to the memory of the Spanish physician, scholer, historian, writer and intellectual Dr. Pedro La'n Entralgo, who died in Madrid on June 4, 2001, at the age of 93. On that occasion, the Spanish newspaper "El Pais" defined him as the last humanist. The Spanish civil war started when La'n was 28 years old and he aligned with Franco's supporters. In 1940, when he founded the magazine "El Escorial", he was separated from the official party. He and other intellectuals declared themselves in an "interior exile". His autobiographical book, "Lightening the burden on the conscience" refers to his painful personal history. He obtained the History of Medicine chair, at the Complutense University, at the age of 34 and remained at that post until his retirement in 1978. His intellectual production is magnificent and calls to a mutual understanding, hope, friendship and love. Outstanding, among others, are his books "The wait and hope", "Theory and reality of the other", "Spain as a problem", "Medicine and history", "The clinical history", "Patient physician relationship", "Medical anthropology". He directed the collective work composed of seven volumes, called "Universal History of Medicine". He was a member of the Royal Academies for Language, History and Medicine. In Chile, he was named honorary member of the Faculty of Medicine of the University of Chile and of the Academies of Language, History and Medicine. He dictated a course of Medical Anthropology that had a profound impact on the thought of Chilean physicians. In 1949 he wrote that Chile was the most solid state of Latin America and that "Chile needs to leave his traditional calm, through a historical gesture, and create the river beds required by his magnificent spiritual and geographical gifts. There is a lack of a beautiful craziness". It was an invocation for an understanding with our neighboring countries "for ever and ever"
Subject(s)
Humans , Humanism , History of Medicine , Biobibliography , Anthropology, Cultural , SpainABSTRACT
The clinical setting is everything that contact us with the patient's reality, including physical, instrumental and laboratory exploration and we use it for diagnostic and treatment purposes. Disgnosis is the synthesis by which physicians conclude an elaborated analysis of subjective and objective data, obtained by physical exam and technology. This procedure involves data collection about the patient and his disease, the results of various tests and laboratory findings, the interpretation of the data and a diagnostic summary. Medical errors may be derived from insufficiency in any of these phases. It is evident that technology will never replace the intellectual data recollection, analysis and reasoning that is the physician's art. This contribution underlines some of the defects frequently observed in clinical practice that may cause medical errors
Subject(s)
Humans , Diagnostic Errors , Medical Errors , Physician-Patient RelationsABSTRACT
In the last two decades, important changes in medical training and care have occurred in Chile. The number of medical schools has been doubled, exceeding the national availability of professors and qualified training fields. The quality assessment and accreditation of medical training and care is insufficient in Chile. A National Autonomous Corporation of Certification of Medical Specialties, has certified more than 4,000 physicians in 44 specialties. The Chilean Association of Faculties of Medicine has accredited training centers during the last four decades. The National Commission of Undergraduate Training Accreditation, has developed a voluntary system for medical school accreditation. The Academy supports these strategies and considers that accreditation does not threaten institutions or individuals. It is rather a mechanism that identifies strengths and weaknesses of institutions and programs. This will finally result in better quality in medical training and patient care
Subject(s)
Humans , Quality Control , Professional Practice/trends , Accreditation , Quality of Health Care/trends , Certification , Education, Medical , Schools, MedicalABSTRACT
The underlying purpose of the Hippocratic oath and most medical ethics codes dictated during the twentieth century, is patient protection. Nowadays, however, clients of health services do not conform themselves with ethical declarations of the medical profession but demand that the rights that arise from those declarations, become legal instruments that force professionals, health authorities and governments to satisfy their health needs and respect their individual rights. Probably this is a consequence of the depersonalization of medical care, the weakening of ethical bases of physician- patient relationship and the emergence of new economical and social philosophies. Now, clients also have more expectations and a better knowledge about medicine than in yesteryears. Citizen organizations to defend health rights should not be seen as a threaten to medical profession and health institutions but as an opportunity to improve health care and respect towards people. They should not either harm the mutual confidence between the physician and his patient, nor the beneficial spirit of medical act, two fundamental components of medical acts
Subject(s)
Humans , Patient Advocacy , Ethics, Medical , Confidentiality , Quality of Health Care , Hippocratic Oath , Physician-Patient RelationsABSTRACT
The work of Dr. Claudio Costa Casaretto covers a broad field in the history of medicine in Chile. He contributed with the historical aspects in the centennial issue of Revista Médica de Chile in july, 1972. He published 85 papers in this journal in a lapse of 20 years. In his works, he investigated about medical personalities with the highest relevance for chilean medicine such as Dr. William Blest, graduated in Edinburgh and director of the first medicine course in Chile in 1833, the french obstetrician Dr. Lorenzo Sazie, first dean of the Faculty of Medicine of the University of Chile in 1843 and Dr. Eloisa Díaz, first physician graduated in Chile and South America in 1887. He published the translation from latin of Juan Ignacio Molina's verses "Elegies to smallpox", chilean writer and erudite of the XVIII century. He also undertook the origins of Universidad de San Felipe (1737), Universidad de Chile (1842) and Pontificia Universidad Católica de Chile (1889) and the main educational events occurred in the Faculty of Medicine of the University of Chile, during the past century. He also published about the public health situation and sanitary care during the XIX century, about the conflict between private and public teaching and other political events of the past century. The work of Dr. Costa as a whole, is a real history textbook of chilean medicine. Dr. Costa and Dr. Enrique Laval are the most important chilean medical historians of the XX century
Subject(s)
History of Medicine , Education, MedicalABSTRACT
According to a prospective study performed in 1993, Chile had 14,400 active physicians (excluding those over 70 years of age) and a physician/inhabitant ratio of 1:960. The estimated projection for 1998 was of 16,244 physicians and a ratio of 1:921. However, during the present decade, the number of medical schools in Chile has duplicated, increasing by 38.4 percent the number of available posts in medical schools. Also, 1,297 physicians graduated abroad, have been incorporated. Therefore, previous projections must be revisited. The present study shows that in 1998, Chile has 17,441 physicians (1:850), will have 20,610 (1:765) in 2003 and 24,449 in 2008. This last figure means a physician/inhabitant ratio of 1:679, similar to that of countries with a consolidated market economy. The foreseen medical population increase rate of 3.5 percent doubles the general population increase rate. To assure the quality of medical training, a medical school accreditation process is being held. This study highlights the need to review bilateral agreements subscribed with five countries, that recognize the physician degree without assessing the medical skills of foreign graduates
Subject(s)
Humans , Physicians/supply & distribution , Population Forecast , Chile , 60351 , Schools, Medical/statistics & numerical data , Schools, Medical/trendsABSTRACT
Predicting the future of medicine is daring. One can speculate about some of its future traits at the most. The spectacular progress in biological sciences has nurtured the hope that medicine will be able to dominate all ailments, improve the quality of life and longevity. Physicians are uncomfortable with the weak knowledge that they have about some diseases such as cancer, connective tissue diseases, degenerative diseases, mental and psychosocial conditions. They are also worried about the aggressive and mutilating surgical procedures that are required nowadays. One can foresee that molecular medicine and applied technology will advance at a great speed and will modify the therapy of several diseases and the social organization of health care. Scientific progress will also change our values and will pose new political and economical challenges. I believe that medical ethics and bioethics will become a growing concern for medical education and professional organizations. The so called biotechnology century will also be the bioethics century. The revision and elucidation of the fundamentals of medicine will differentiate, in the future, a medicine devoted to mankind with a solid ethical background from an impersonal health care that considers man as an object or maybe a merchandise. The second option will cast medical care through the abyss of decadence, to its end