Residência em Medicina de Família e Comunidade para a formação de recursos humanos: o que pensam gestores municipais? / Family and Community Medicine Residency Programs for training the health workforce: what do municipal health managers think?

Resumo Treinamento especializado, provimento e fixação de profissionais na Atenção Primária à Saúde são desafios prementes no Brasil. A recente expansão dos Programas de Residência em Medicina de Família e Comunidade coexiste com lacunas na literatura sobre o efeito deste processo. O objetivo do trabalho é explorar a perspectiva do gestor municipal de saúde acerca das estratégias para o fortalecimento das residências e do papel destas na formação profissional e na qualificação da atenção. Trata-se de um estudo de análise quantitativa e qualitativa, com aplicação de questionário a gestores de municípios cenários destes programas. As respostas de 48 sujeitos foram submetidas a estatística descritiva e análise de conteúdo. Os resultados revelam um esforço em incorporar o Médico de Família e Comunidade na rede de atenção à saúde, uma percepção do potencial das residências no incremento da qualidade da atenção e da formação profissional e fragilidades nas ações para melhoria da estrutura e organização dos serviços com residentes. Vislumbra-se assim o potencial das residências para a superação de problemas históricos da Atenção Primária à Saúde brasileira, se atrelada a ações de fortalecimento do serviço, dos recursos humanos e do próprio programa.

Abstract The training, recruitment and retention of primary care professionals is a constant challenge in Brazil. The recent expansion of family and community medicine residency programs in the country coexists with gaps in the literature on the effects of this process. This article explores municipal health managers' understanding of these programs and the role they play in professional training and improving the quality of health care. We conducted a quantitative and qualitative analysis of the responses to questionnaires answered by 48 health managers working in municipal health services affiliated to residency programs. A descriptive statistical analysis of the quantitative data was performed and the qualitative data were analyzed using thematic analysis. The findings show that efforts were made to incorporate family and community doctors into the health care network and that managers recognized the potential residency program have to improve the quality of care and enhance professional training. Weaknesses were found in actions to improve infrastructure and facilities and the organization of the services affiliated to the programs. This study highlights the potential of residency programs for addressing longstanding problems in primary health care in Brazil when combined with actions to strengthen services, human resources and the programs.

Interlocuções entre a Declaração de Astana, o Direito à Saúde e a formação em Medicina de Família e Comunidade no Rio de Janeiro, Brasil / Dialogues between the Astana Declaration, the Right to Health and Family and Community Medicine training in Rio de Janeiro, Brazil

Resumo Este artigo discute e promove inquietações à luz da repercussão dos 40 anos da Declaração de Alma-Ata e também da Declaração de Astana, discutindo os possíveis impactos na formação em Medicina de Família e Comunidade, segundo o olhar de 2 Programas de Residência de 3 instituições públicas: a Universidade do Estado do Rio de Janeiro, a Universidade Federal do Rio de Janeiro e a Fundação Oswaldo Cruz. Estes estão inseridos em um contexto histórico e social, entre o mundo do trabalho, as políticas públicas, os organismos internacionais, a população e os sujeitos envolvidos na construção, manutenção e consolidação da Atenção Primária no Brasil. Assim, em um breve resgate histórico, contextualizamos qual Atenção Primária era cenário de prática e para onde, possivelmente, estaríamos nos deslocando. Conclui que a garantia do Direito à Saúde, estaria ameaçada pelo conceito de Cobertura Universal, preconizado pela Declaração de Astana; o que provoca importantes discussões: garantia de ofertas de serviços providos pelo estado, defesa da equidade e integralidade das ações. Reafirmação sobre o risco de gerar desigualdade ao se criar múltiplas ofertas de serviços para diferentes segmentos da população, reiteração sobre a importância do acesso às Unidades de Saúde, valorização da territorialização.

Abstract This paper discusses and fosters concerns in light of the repercussions of both the 40th anniversary of the Alma-Ata Declaration and the Astana Declaration, discussing the possible influence on Family and Community Medicine training, as per the lenses of two Residency Programs of three public institutions, namely, State University of Rio de Janeiro, Federal University of Rio de Janeiro, and the Oswaldo Cruz Foundation. These are inserted in a historical and social context, between the world of work, public policies, international organizations, the population and subjects involved in the construction, maintenance, and consolidation of the Brazilian PHC. Thus, in a brief historical revival, we contextualized which Primary Care was a practice setting and where we might be headed. We concluded that the willingness to ensure the Right to Health would be threatened by the concept of Universal Coverage, advocated by the Astana Declaration, which leads to essential discussions: ensuring state-provided services, advocating for equity and integrality of actions, reaffirming the risk of generating inequality by creating multiple service offerings for different segments of the population, reiterating the relevance of access to health, and valuation of territorialization.

La Medicina Familiar y Comunitaria en Uruguay de 1997 a 2019: ¿cuántos kilómetros faltarán para llegar al pueblo aquel? / Family and Community Medicine in Uruguay from 1997 to 2019: how many kilometers will it take to reach that town?

Resumen La residencia de medicina familiar y comunitaria comenzó en Uruguay en el año 1997. A través de un proceso autogestionado, las primeras generaciones se moldearon en una formación que integraba en ellos el conocimiento y la experiencia hospitalarios junto con la praxis territorial en un servicio de salud de base comunitaria con población de referencia. El reconocimiento académico de la especialidad y la instalación de los ámbitos institucionales para su gestión fueron conquistas paralelas a ese proceso en la primera década. La segunda década estuvo marcada por la expansión territorial de la estructura docente-asistencial, la descentralización de la universidad y la participación activa de la medicina familiar y comunitaria en la reforma de la salud y la agenda de derechos. La tercera década de la especialidad se presenta en su inicio como crisis dada por la caída sostenida en la aspiración a la residencia. Desde una aproximación inicial a las explicaciones, se reflexiona sobre la posibilidad de estar frente a una crisis más profunda y la necesidad de encontrar las claves de una medicina del siglo XXI que permita alcanzar los principios de Alma Ata, siempre vigentes.

Abstract The Family and Community Medicine Residency started in Uruguay in 1997. Through a self-managed process, the first generations were molded into training that integrated hospital knowledge and experience with territorial praxis in a community-based health service with a population of reference. The academic recognition of the specialty and the installation of the institutional areas for its management were achievements parallel to that process in the first decade. The second decade was marked by the territorial teaching-assistance expansion in the country, university decentralization and the active participation of Family and Community Medicine in the Health Reform, and the country's rights agenda. The third decade of the specialty begins with a crisis triggered by the sustained decline in the aspiration for residency. An initial approach to explanations reflects on the possibility of facing a more profound crisis and the need to find the keys to a 21st century Medicine that allows us to achieve the principles of Alma-Ata that are still current.

Reflexões e propostas para a estruturação de programas de Mestrado em Medicina de Família e Comunidade no Brasil / Reflections and proposals for the establishment of Family and Community Medicine Master's Programs in Brazil

Resumo Embora a atenção primária à saúde (APS) e a medicina de família e comunidade (MFC) tenham aumentado seu espaço e relevância no cenário assistencial e nos cursos de graduação médica, não há cursos de pós-graduação "stricto sensu" em MFC no Brasil. Neste artigo, analisamos alguns aspectos do campo da saúde pública brasileira e da própria estruturação da pós-graduação "stricto sensu" nacional que podem ajudar a explicar este panorama. Como uma contribuição para o debate neste tema, também reunimos informações de experiências internacionais em pós-graduação e pesquisa em MFC e elaboramos uma proposta de currículo para futuros cursos nacionais de mestrado em MFC. Ao final discutimos algumas estratégias fundamentais para o surgimento de cursos de pós-graduação "stricto sensu" nesta área no Brasil, destacando o potencial desses cursos para a avaliação e a qualificação dos serviços de atenção primária, em especial a Estratégia Saúde da Família, e para a formação de profissionais especializados em APS necessários para a consolidação do Sistema Único de Saúde como sistema acessível, abrangente e equitativo para a população brasileira.

Abstract While Primary Health Care (PHC) and Family and Community Medicine (FCM) have expanded their space and relevance in health care and undergraduate medical courses, Brazil has no stricto sensu FCM postgraduate programs. In this paper, we analyze some aspects of the Brazilian public health field and the national stricto sensu postgraduate system that can help to explain this scenario. As a contribution to the debate on this topic, we also gathered information from international postgraduate and research experiences in FCM and devised a curriculum proposal for future national FCM master's courses. In the end, we discussed some key strategies for the emergence of stricto sensu postgraduate courses in this discipline in Brazil, highlighting the potential of these programs for evaluation and qualification of primary care services, especially the Family Health Strategy, and the training of PHC specialists required for the consolidation of the Unified Health System (SUS) as an accessible, comprehensive and equitable health system for the Brazilian population.

Adecuaciones de las asignaturas de formación general del plan de estudios de medicina cubano para la República Popular de Angola / Adaptation of general training subjects from the Cuban Medicine syllabus for the Republic of Angola

INTRODUCCIÓN: el aporte a la salud de la misión médica cubana en la República Popular de Angola ha contribuido al mejoramiento del estado de salud de la población, fundamentada en la Medicina Comunitaria. Debido a ello se solicitó por parte de la Secretaría de Estado del Ministerio de Educación Superior de este país, la implementación del plan de estudios cubano para la carrera de Medicina adecuado a las condiciones angolanas en sentido general, donde se incluyó las asignaturas de formación general: idioma Inglés, Educación Física e Informática Médica en estrecha vinculación con la Medicina Comunitaria I y II. OBJETIVO: adecuar las asignaturas de formación general del plan de Estudios de la carrera de Medicina de Cuba a las condiciones de la República Popular de Angola. MÉTODOS: se realizó una investigación de desarrollo tecnológico basado en el marco contextual y regulatorio del entorno angolano, a través del análisis documental, entrevistas a autoridades y grupos focales con criterios de expertos en estos temas. RESULTADOS: fueron analizadas las asignaturas de formación general en sus ejes transversales y verticales, así como, se realizó el diseño de las disciplinas de Informática Médica, Educación Física e Idioma Inglés e integradas al Plan de estudio de Medicina. CONCLUSIÓN: la proyección comunitaria está presente a lo largo de toda la carrera de Medicina e integra las disciplinas de formación general, lo cual permite que los futuros profesionales consoliden los conocimientos y las habilidades para el desarrollo de la misma.

INTRODUCTION: The Cuban medical mission to the Republic of Angola has contributed to the improvement of that population's health, based on community medicine. Therefore, the Secretariat of State of the Ministry of Higher Education of this country requested the implementation of the Cuban Medicine major syllabus adapted the overall Angolan conditions. The general training subjects included were English Language, Physical Education and Medical Informatics, in close relation with Community Medicine I and II. OBJECTIVE: To adapt the general training subjects of the Cuban Medicine major syllabus to the conditions of the Republic of Angola. METHODS: A research about technological development was carried out, based on the contextual and regulatory features of the Angolan environment, by means of documental analysis, interviews to the authorities and focal groups with criteria by experts in these topics. RESULTS: The general training subjects were analyzed in their traverse and vertical axes, and the design of the disciplines Medical Informatics, Physical Education and English Language was carried out and integrated to the Medicine syllabus CONCLUSION: Community projection is present throughout the whole Medicine major and integrates the general training disciplines, which allows for the future professional to consolidate his/her knowledge and the abilities for the development of their carreer.

Implantação do Programa de Residência em Medicina de Família e Comunidade da Secretaria Municipal de Saúde do Rio de Janeiro, Brasil / Implementation of the Residency Program in Family and Community Medicine of the Rio de Janeiro Municipal Health Department, Brazil

Resumo A reforma da Atenção Primária à Saúde na cidade do Rio de Janeiro gerou diversas necessidades de melhoria da rede, em uma delas está a qualificação profissional de médicos para atuar neste nível. Desta forma, foi estruturado o Programa de Residência em Medicina de Família e Comunidade pela própria Secretaria Municipal de Saúde. Este artigo tem como objetivo descrever a experiência da implantação desse Programa no contexto da reforma da Atenção Primária à Saúde. Além disso, demonstrar a estruturação do Programa para atingir os objetivos propostos pela reforma e como isso se reflete na rede e sugere investimentos em estudos que possam sinalizar os impactos gerados pelo Programa.

Abstract The reform of Primary Healthcare in the city of Rio de Janeiro created various needs for improvement of the network, one of which was professional training/qualification of doctors to practice at this level of care. To respond to this the Municipal Health Department took the initiative of structuring the Residency Program in Family and Community Medicine. This paper aims to describe the experience of implementation of this program in the context of the reform of primary healthcare. It also reports on the process of structuring of the program to meet the objectives proposed by the reform, and how this is reflected in the network, and suggests investments in studies that can indicate impacts generated by the Program.

Breve historia de la formación de recursos humanos / Brief history of the formation of human resources

Se realizó una investigación de carácter histórico cuyo objetivo fue relatar el desarrollo del proceso de formación y superación de los colaboradores cubanos en la misión y del Nuevo Programa de Formación de los médicos integrales comunitarios en Portuguesa, estado llanero de la República Bolivariana de Venezuela en el marco de Misión Médica cubana. Se utilizaron métodos como el análisis y síntesis de la literatura consultada, histórico-lógico y genético así como la entrevista y la revisión de documentos e informes estadísticos. Se relata cómo y cuándo comenzó la docencia para los colaboradores cubanos, destacándose, en el posgrado, la formación de especialistas de MGI, EGI tanto cubanos como venezolanos así como la formación de másteres. En el pregrado se destacó la formación de médicos para el fortalecimiento de la salud pública en Venezuela, el nacimiento del Programa Nacional de Formación en Medicina Integral Comunitaria, en 2011 se graduó la primera cohorte con 311 nuevos profesionales que brindan servicio en el sistema público de esa nación.

A historical research study was conducted to present the development of the process of formation and upgrading of Cuban cooperators in the Cuban Medical Mission and of the New Program for the Formation of Community-based Integral Physicians in Portuguesa state of the Bolivarian Republic of Venezuela. The methods used in the study were analysis and summarizing of consulted literature, historical-logical and genetic analysis as well as interviews and reviews of documents and statistical reports. The study set forth how and when teaching activity started for the Cuban cooperators, making emphasis on the post-graduate education, the formation of General Integral Medicine specialists both Cubans and Venezuelans and the formation of Masters . In the undergraduate education, the study underlined the formation of physicians for the strengthening of the public health in Venezuela and the inception of the national program of community-based integral medicine formation from which the first cohort of 311 new professionals graduated in 2011, who render service in the public health system of that nation.

Teaching community medicine to medical undergraduates—learning by doing: Our experience of rural posting at All India Institute of Medical Sciences, New Delhi, India.

Background. The goal of medical education is to ensure that the medical graduate has acquired broad public health competencies needed to solve the health problems of the community. We present the current teaching of community medicine to medical students of the All India Institute of Medical Sciences (AIIMS), New Delhi during their 5-week posting at the rural centre at Ballabgarh, Haryana. Methods. The teaching activities consist of field visits to different levels of health facilities and meeting with health workers, epidemiological exercises, a community-based exercise, posting in inpatient and outpatient departments of a secondary hospital, and domiciliary visits to families of patients. These are spread over 80 sessions of about 200 hours. There is very little didactic teaching and the assessment is broad-based. The evaluation of the posting was based on comparison of blinded pre- and post-posting assessments as well as anonymous feedback of the posting by the students. Results. There was a significant increase in the mean scores of all components of the posting—epidemiology (5.1 to 8.4), health systems (6.8 to 9.3) and clinical (8.0 to 10.8). The posting did not result in a better understanding of a public health approach as compared to a clinical approach. The feedback provided by students was generally positive for all activities with 94% of them rating it as good or very good. Conclusion. The teaching of community medicine can be made more practical and interesting without compromising on learning. However, despite such a programme, getting medical students to develop a public health approach is a daunting task.

Formación médica en la Escuela de Medicina de Orotta, Asmara, Eritrea / Medical education at the Orotta School of Medicine, Asmara, Eritrea

La Escuela de Medicina de Orotta en Asmara, Eritrea fundada en el 2004 por docentes cubanos es una muestra más de la solidaridad cubana. Objetivo: describir los elementos fundamentales de la organización académica en la Escuela de Medicina de Orotta para que puedan servir en otros países pobres. Métodos: se revisaron los documentos rectores disponibles en los archivos de la Escuela de Medicina de Orotta desde su fundación hasta febrero del 2012: el catálogo, los registros de secretaría general, biblioteca y del responsable de la colaboración docente cubana así como la evaluación de pre acreditación docente realizada por expertos de la OMS, y datos obtenidos según criterios objetivos bibliométricos. Resultados: se presenta el plan de estudios, inspirado en el cubano, teniendo como pilar la Medicina Comunitaria. Se describen características particulares del plan y su puesta en práctica, así como las condiciones mejoradas de la Escuela de Medicina de Orotta en cuanto a becas, biblioteca e informatización, que la hacen un lugar de excelencia certificado por observadores extranjeros. Los resultados de la Escuela de Medicina de Orotta, fundada gracias a la solidaridad de Cuba, demuestran la factibilidad de implementación en las condiciones de un país pobre que ha seguido un programa inspirado en el cubano para la formación de médicos logrando resultados satisfactorios en la calidad y cantidad de sus graduados, lo que ha sido reconocido por expertos nacionales, extranjeros y reflejado en la prensa. Conclusiones: con la ayuda solidaria de Cuba y la aplicación de sus planes de estudio, es posible la creación de escuelas de medicina en países pobres, con buenos resultados...

The Orotta School of Medicine in Asmara, Eritrea, founded in 2004 by Cuban professors is another sample of Cuban solidarity. Objective: the goal of this paper is to describe the principles of the academic organization of the Orotta School of Medicine for possible use in other poor countries. Methods: the main available documents (2004-2012) from the archives of the Orotta School of Medicine were revised: the school catalog, records of the Offices of the Registrar, the Cuban Dean and library (using bibliometric criteria), as well as the accreditation assessment of WHO. Results: we present the curriculum, which is inspired in the Cuban one and has Community Medicine as backbone. Specific characteristics of the curriculum and its implementation are described and the improved facilities of the Orotta School of Medicine regarding boarding, library and connectivity. All these features make the Orotta School of Medicine a reference school, certified by foreing observers.The results of the Orotta School of Medicine, founded thanks to the Cuban solidarity show the feasibility of implementing a curriculum inspired in the Cuban one adapted to the conditions of a poor country, for the production of high quality medical doctors, what has been recognized by forieng scholars and appeared in press reports. Conclusions: it is possible the foundation of med schools in poor countries with the Cuban solidarity and the implementation of the Cuban curriculum adapted to local conditions...

La migración de médicos en Venezuela / The emigration of physicians in Venezuela

OBJETIVO: Determinar los factores que podrían incidir en la intención de migrar a otros países por parte de profesionales de la salud venezolanos. MÉTODOS: Estudio exploratorio que aplicó respectivamente entrevista semi-estructurada y encuesta a una población conformada por cuatro profesionales de la salud y 36 estudiantes de medicina. Los datos de la entrevista fueron analizados por categorización deductiva e inductiva y los de la encuesta mediante análisis univariado y bivariado. RESULTADOS: Se observó una intención de emigrar general de 13,8 por ciento en los estudiantes, con diferencias entre los dos grupos incluidos en el estudio. Se halló un alto efecto motivador para migrar en las razones laborales (16,6 por ciento), particularmente la posibilidad de conciliar la vida personal y la laboral, obtener mejor remuneración, acceder a formación continua, trabajar en un mejor sistema de salud y disponer de recursos básicos para la práctica profesional. Se determinó que las razones profesionales ejercen un efecto motivador moderado (13,8 por ciento), mientras que las personales y contextuales no influyen de manera importante (menos de 3 por ciento). Aun cuando durante las entrevistas a los médicos graduados hubo choques de intereses políticos y económicos, solo 5,5 por ciento de los estudiantes encuestados consideraron la situación política o económica como factor expulsor en la fuga de profesionales. CONCLUSIONES: Se recomienda fortalecer la gestión y el desarrollo profesional del personal médico, conciliando sus expectativas con el marco legal y las necesidades del sistema de salud. Haría falta establecer un sistema de registro formal de la migración de profesionales y ampliar el estudio de los factores causales al nivel nacional, dado que un mejor conocimiento de estos fenómenos migratorios contribuiría a generar y sustentar propuestas que garanticen la autosuficiencia de recursos humanos de salud.

OBJECTIVE: Ascertain the factors that could affect the intention of Venezuelan health professionals to emigrate to other countries. METHODS: Exploratory study that applied a semistructured interview and survey, respectively, to a population consisting of four health professionals and 36 medical students. The interview data were analyzed by deductive and inductive categorization and the survey data by means of univariate and bivariate analysis. RESULTS: It was observed that 13.8 percent of the students generally intended to emigrate, with differences between the two study groups. It was found that work-related issues had a high motivating effect (16.6 percent), particularly the possibility of balancing work with personal life, better pay, access to continuing education, working in a better health system, and having the basic resources necessary for professional practice. It was determined that professional reasons had a moderate motivating effect (13.8 percent), whereas personal and contextual reasons had little influence (less than 3 percent). Although the interviews of physicians who had obtained their medical degree revealed clashes involving political and economic interests, only 5.5 percent of the students surveyed considered the political or economic situation a determinant in the emigration of professionals. CONCLUSIONS: It is recommended that the management and professional development of medical personnel be strengthened, reconciling their expectations with the legal framework and needs of the health system. A formal system for tracking the emigration of professionals and broadening the study of the causative factors at the national level should be set up, since better knowledge about the phenomena linked with emigration would help generate and support proposals to guarantee self-sufficiency with respect to human resources for health.

Motivación en educandos del Programa Nacional en Medicina Integral Comunitaria / Motivation of the students involved in the National Program of Integral Community Medicine

Se realizó un estudio descriptivo y transversal en el contexto del Programa Nacional de Formación en Medicina Integral Comunitaria. Se efectuó entre enero y marzo de 2010 en los 5 núcleos docentes definidos para el municipio Torres del estado Lara, en la República Bolivariana de Venezuela. El universo de trabajo estuvo constituido por 68 educandos que se encontraban entre el 3er y el 5to año académico, fueron excluidos 5 estudiantes que no se encontraban cuando se empleó el instrumento y 1 por no querer participar en el trabajo. Quedó una población de estudio de 62 alumnos. Se aplicó un cuestionario a los estudiantes y una guía de observación al proceso docente educativo. Se encontró que la mayoría tenían una motivación intrínseca (83,9 por ciento) y la mayor proporción de alumnos reveló un grado de motivación intermedio hacia la carrera de medicina (48,4 por ciento), seguido por el grado de motivación alto (43,5 por ciento). El 71 por ciento de los estudiantes presentaba una percepción buena del proceso docente educativo y a medida que iban alcanzando años académicos superiores, el grado de motivación fue incrementándose. Al mismo tiempo en el contexto donde existía una situación educativa buena, el grado de motivación alto fue predominante. Se concluye que el grado de motivación alto de los estudiantes se encuentra relacionado en mayor proporción con la motivación intrínseca, una buena percepción estudiantil del programa de estudio y el desarrollo de situaciones educativas en concordancia con lo propuesto en el diseño del Programa Nacional de Formación en Medicina Integral Comunitaria

A descriptive, cross-sectional study was performed within the National Program of Formation in Integral Community Medicine from January to March, 2010 in the five teaching groups located in Torres municipality, Lara state, Bolivarian Republic of Venezuela. The initial universe of study was made up of 68 students who were studying in the 3rd, 4th and 5th academic years; 5 of them were excluded because they were not present at the time of implementing the instrument and one who did not want to be involved in this study. A questionnaire and an observational guide for the educational and teaching process were administered. It was found that most of the students were intrinsically motivated (83.9 percent) and the highest portion of them disclosed intermediate level of motivation toward the medical studies (48.4 percent) followed by high motivation (43.5 percent). Seventy one percent of the students showed good perception of the teaching and education process in addition to increased motivation as they move to higher academic levels. At the same time, the level of motivation was predominantly high in the settings where the educational situation was good. It was concluded that the high level of motivation of the students is greatly related to the intrinsic motivation, to good perception on the curricula and the development of educational situations in line with the proposals of the design of the National Program of Formation in Integral Community Medicine

El control a la actividad docente como trabajo docente metodológico en elPrograma Nacional de Formación de Medicina Integral Comunitaria / Control of the teaching activity as methodological work in the National

Se realizó un estudio que respondió a un proyecto investigación en el campo de la educación médica, en el área de pregrado, con el objetivo de describir el control a la actividad docente como tipo de trabajo docente metodológico del Programa Nacional de Formación en Medicina Integral Comunitaria, en el Área de Salud Integral Comunitaria Pedro Fontes, del Distrito Capital de la República Bolivariana de Venezuela, durante el curso 2008-2009. Se utilizó un sistema de métodos integrado por métodos teóricos, empíricos y procedimientos estadísticos con un enfoque cuanticualitativo. Se encuestó el universo de 24 profesores y se entrevistó a 4 informantes clave. Se realizó, además, la revisión de documentos de interés para la recogida de información, tales como: planes de trabajo docente metodológico, actas de la visita de control y actas de la reunión metodológica. La información obtenida fue triangulada, lo que permitió llegar a los resultados que se presentan y que evidencian insuficiencias en la planificación y ejecución de los controles a las actividades docentes, además de insuficiencias en su dirección con violaciones de lo establecido en la Circular MIC 08 del 2008 para su planificación, ejecución y control

We carried out a research answering to an investigative project in the field of medical education, in the pre-grade area, with the objective of describing the control of the teaching activity as a teaching methodological work of the National Program of Communitarian Integral Medical Formation, in the Communitarian Integral Health Area Pedro Fontes, of the Capital District of the Bolivarian Republic of Venezuela, during the school year 2008-2009. We used a methodological system integrated by theoretical, empirical methods and statistic procedures with a quanti -qualitative approach. A universe of 24 professors was surveyed and 4 key informants were interviewed. We also reviewed documents of interest for information gathering, like: plans of methodological teaching work, acts of control visits and acts of the methodological meetings. Collected information was processed, leading to the results we present and evidencing insufficiencies in the planning and execution of controls to the teaching activities, and also deficiencies in their direction with violations of the established in the Circular MIC 08/2008 for their planning, execution and control

Factores relacionados con el rendimiento académico en la asignatura Morfofisiología Humana IV, del Programa Nacional de Formación de Medicina Integral Comunitaria / Factors related with the academic performance in the matter Human Morpho-physiology IV, of the National Program of Formation of Community Integral Medicine

Se realizó un estudio de investigación, con el objetivo de caracterizar el rendimiento académico del grupo de estudiantes del Programa Nacional de Formación en Medicina Integral Comunitaria, durante el desarrollo de la asignatura Morfofisiología Humana IV, en el municipio Leonardo Infante, Estado Guárico. Se trabajó con el universo de 32 estudiantes, que recibieron la asignatura en la primera cohorte del programa y con los 12 profesores que la impartieron, a los que se les aplicó sendas encuestas. Para la recogida de la información se realizó, además, una entrevista estructurada a informantes clave, y se obtuvo información de los registros de Secretaría Docente del Estado, lo que permitió presentar y discutir los resultados. Con todo ello, se logró identificar factores relacionados con el rendimiento académico en la asignatura objeto de estudio, agrupados de acuerdo a la clasificación asumida, y que al concluir el estudio resultaron estar relacionados con lo socioeconómico, lo académico previo al ingreso a la carrera, y lo académico durante el proceso enseñanza aprendizaje en la asignatura Morfofisiología Humana IV, con la repercusión propia de ser la cuarta asignatura que se imparte de una disciplina. Estos últimos, los propios del proceso docente, fueron los identificados como los que mayor relevancia

We carried out an investigation study with the objective of characterizing the academic performance of the group of students of the National Program of Formation of Community Integral Medicine, during the teaching of the matter Human Morpho-Physiology IV, in the municipality Leonardo Infante, State of Guarico. We worked with the universe of 32 students studying the matter in the first group of the program and with the twelve teachers that taught the matter; surveys were applied to both of the groups. To collect the information we also made a structured interview to key informants, and obtained information from the records of the Educational Secretary of the State, allowing us to present and discuss the results. With everything, it was possible to identify factors related with the academic performance in the matter studied, grouped according to the assumed classification. When the study was concluded they turned out to be related with the socioeconomic aspects, the academic aspects before entering the career, and the academic aspects during the teaching-learning process in the matter Human Morpho-Physiology IV, with the characteristic of being the fourth part of a matter that is imparted. These last ones, proper of the teaching process, were identified as the one with bigger relevance

Algunos factores relacionados con el rendimiento académico en el examen estatal de los residentes cubanos de Medicina General Integral / Some factors related ti the academic performance in the final board exam of the Cuban resident physicians in the General Family Medicine

Se realizó un estudio investigativo en el campo de la educación de posgrado, con el objetivo de caracterizar algunos factores relacionados con el rendimiento académico de los residentes cubanos de la especialidad Medicina General Integral en el examen estatal, atendiendo a su autopreparación y condicionantes locales del proceso de formación posgraduada en el Estado Miranda, Venezuela, durante el curso 2005-2006 para lo cual se emplearon métodos teóricos y empíricos de investigación. Se diseñó una encuesta y una entrevista a expertos. La encuesta fue dirigida a la totalidad de los médicos cubanos residentes que se presentaron a examen estatal en ese periodo, que sumaron un total de 28, con el propósito de indagar sobre: calificación obtenida en examen estatal, autopreparación, bibliografía, así como también elementos referidos a: organización y estructuración del proceso enseñanza-aprendizaje. Fueron identificados como factores, la deficiente autopreparación del residente, insuficiente tiempo de preparación para el examen, insuficiente bibliografía, la falta de interconsultas y rotaciones hospitalarias. Los expertos relacionaron la deficiente preparación de los residentes con la insuficiente bibliografía, la sobrecarga asistencial y el medio social quienes a sus juicios limitaron en el tiempo de preparación para el examen.

A research study was conducted in the field of graduate education to characterize some of the factors related to the academic performance of Cuban general family medicine residents in the final board exam, taking into account their self-preparation and the local conditions of the graduate formative process in the Miranda state, Venezuela in the 2005-2006 academic years. To this end, theoretical and empirical methods were used together with the design of an expert-tailored interview and survey. The survey was administered to the 28 Cuban residents who attended the board exam in that period in order to find out the marks in the exam, their self-preparation, the consulted literature and the organization and structuring of the teaching-learning process. The identified factors were poor self-preparation of the residents, not enough time to prepare themselves for the exam, lacking literature, and lack of interconsultations and clinical rotations in hospitals. The experts associated the poor preparation of the residents for the exam with lacking literature, the work overload and the social setting conditions, and according to their criteria, these elements restricted the time spent in preparing for the exam.

Caracterización de la preparación pedagógica de los profesores de Morfofisiología Humana II / Characterization of educational training of II Human

Se realizó una investigación con el objetivo de caracterizar la preparación pedagógica de los profesores de Morfofisiología Humana II del Programa Nacional de Formación de Medicina Integral Comunitaria en el Estado Cojedes, Venezuela, a través de encuestas a los estudiantes y profesores. Se seleccionó el 20 por ciento de los profesores y un 30 por ciento de estudiantes de los 18 núcleos docentes del estado, se aplicaron encuestas con preguntas cerradas y mixtas, se realizaron entrevistas a 5 informantes clave y se revisaron documentos y bibliografías que permitieron delimitar el problema científico, justificar el estudio y fundamentarlo teóricamente; el diseño metodológico se estructuró basado en la triangulación de métodos teóricos, empíricos y procedimientos estadísticos que permitieron obtener la información necesaria sobre la caracterización de la preparación pedagógica de los profesores de Morfofisiología Humana II en el estado, los que presentaron insuficiente preparación pedagógica. Tuvieron mayor dificultad en la aplicación de las categorías didácticas objetivos, métodos y evaluación además necesitaron aplicar más los conocimientos pedagógicos en la forma de organización Práctica Docente

The aim of present research was to characterize the educational training of II Human Morphophysiology professor in the National Program of Training of Community Integral Medicine in the Cojedes state through surveys applied to students and professors. The 20 percent of professors and the 30 percent of students were selected from the 18 state teaching nuclei applying surveys including closed and mixed questions; interviews to 5 key informers and the documents and references were reviewed allowing us to define the scientific problem, to justify the study and its theoretical principle; the methodological design was structured on the base of the theoretical and empirical methods triangulation and the statistical procedures allowing to achieve the needed information on the characterization of the educational training of the II Human Morphophysiology in this state, who had a poor educational training with difficulty in application of objective didactic categories, methods and evaluation and also it is necessary to apply more the educational knowledges in a Teaching Practice organization way

La aplicación del sistema de evaluación en la asignatura de morfofisiología humana III, desde la perspectiva del profesor / The application of assessment system in human III morphophysiology as subject from the professor perspective

La aplicación del sistema de evaluación en la asignatura de Morfofisiología Humana III, curso 2005-2006 del Programa Nacional de formación del Médico Integral Comunitario (PNFMIC), Micro región 3, Yaracuy, tuvo como objetivo caracterizar durante el proceso de enseñanza aprendizaje el momento evaluativo desde la óptica de los profesores que impartieron esta asignatura y describir la aplicación de la puesta en práctica del sistema de evaluación de la asignatura Morfofisiología Humana III en las condiciones reales de la docencia. Se utilizó como instrumento en esta investigación un cuestionario aplicado a un universo de 27 profesores, de tres núcleos docentes y dos entrevistas semiestructuradas y a profundidad a informante. La primera de ellas estuvo dirigida a los jefes de colectivos docentes, que se encuentran incorporados a la maestría de Educación Médica Superior y en la segunda se consideraron aquellos especialistas de Medicina General Integral con experiencia docente anterior de pregrado. La caracterización realizada, así como la identificación de las principales dificultades en la aplicación del sistema de evaluación objeto de estudio, son datos de gran valor para el perfeccionamiento del proceso docente, así como en la realización de futuras investigaciones de intervención.

The aim of the assessment application of the National Training Program of Community Integral Physician in the subject of III Human Morphophysiology (course 2005-2006), Micro-region 3), Yaracuy, was to characterize during the teaching-learning process, the evaluative moment from the point of view of the professors giving this subject and to describe the application of assessment system of the above mentioned subject under the real teaching conditions. At present research we used as tool a questionnaire applied in 27 professors from three teaching nuclei and two semi-structured interviews and in depth to the informant. The first one was addressed to the teaching groups chiefs involved in Higher Medical Education mastery and in the second one are included those Integral General Medicine specialists with a pregraduate previous teaching experience. The characterization carried out, as well as the identification of the major difficulties in application of study assessment system, is valuable data for the teaching process improvement and for the carrying out of future interventional researches.

Análise dos Programas de Residência para formação do médico de família no Estado do Ceará / An analysis of residency programs to train family doctors in the state of Ceará, Brazil

Introdução - A história das políticas de saude no Brasil sempre esteve atrelada a necessidade de melhorar, quantitativa e qualitativamente, os recursos humanos responsaveis pelo desenvolvimento das açoes de saude. A criaçao do Sistema Unico de Saude (SUS) demandou um perfil de recursos humanos compatfvel com as exigencias desse novo modelo. Para garantir a implementaçao e consolidaçao do SUS, em consonancia com seus princfpios, fez-se necessaria a organizaçao da Atençao Primaria em Saude como porta de entrada aos serviços de saude. Para tanto, foi criado, pelo Ministerio da Saude, em 1994, a Estrategia Saude da Familia (SF). A partir da implantaçao da SF verificou-se a necessidade de formaçao dos profissionais de saude, em especial, do medico de familia, para exercer suas atividades neste campo de atuaçao. Assim, a Residencia Medica, caracterizada como a interface entre as instituiçoes de ensino formadoras do profissional medico e os serviços de saude, tem buscado formar 0 medico de familia, por meio de programas criados por diversas instituiçoes. Objetivos - Caracterizar os Programas de Residencia existentes no Estado do Ceara, para formaçao do medico de familia. Metodos ˆPesquisa com abordagem qualitativa, de carater descritivo, a partir da analise de fontes secundarias e documentais e da coleta de dados primarios, mediante a realizaçao de entrevistas em profundidade com informantes-chave, iniciada após previa aprovaçao do Comite de Etica em Pesquisa e assinatura do termo de consentimento livre e esclarecido pelos entrevistados. as sujeitos sao residentes das Residencias em Medicina de Famflia e Comunidade. A analise do material seguiu os ensinamentos da Analise de Conteudo de Bardin Resultados - as currfculos dos Programas de Residencia faram desenhados para utilizar metodologias ativas de aprendizagem, a fim de aproximar a teoria da pratica e desenvolver competencias para formar medicos de familia. Na percepçao dos entrevistados estes Programas contribuem para a formaçao dos medicos de familia par serem orientados e baseados na comunidade e enfatizarem 0 trabalho em equipe. Conclusao - A Residencia em Medicina de Familia e Comunidade e a modalidade de ensino de excelencia para formar 0 medico de familia, por treina-Io em serviço junto a comunidade e preencher as lacunas de conhecimentos da graduaçao.

Extensão comunitária: um caminho para a formação médica / Communitarian extension: a path for medical formation

O artigo objetiva relatar a experiência do projeto Parceiro Sanitário desenvolvida pela Universidade doPlanalto Catarinense (UNIPLAC), Lages SC, tendo por base uma extensão comunitária. Tal processo envolve aconstrução coletiva do enfrentamento de questões relacionadas à saúde da população, estimulando a formaçãode parcerias institucionais, favorecendo o controle social através da participação da população no planejamentoe execução de ações relacionadas à saúde e a medicina comunitária.