Como se relacionam o escopo de práticas profissionais, a formação e a titulação de médicos de Família e Comunidade? / How are factors as scope of professional practices, education and title of Family and Community doctors related? / ¿Cómo se relacionan el alcance de prácticas profesionales, la formación y la titulación de médicos de Familia y Comunidad?

O objetivo desta pesquisa foi analisar o escopo de prática dos médicos atuantes na Estratégia Saúde da Família (ESF) em Fortaleza-Ceará e suas relações com a formação e titulação em Medicina de Família e Comunidade (MFC). Foi realizado um estudo transversal de abril a novembro de 2018, aplicando-se formulário semiestruturado para 263 médicos, contendo 38 atribuições entre ações, atividades e procedimentos da Medicina. Destacou-se uma maior abrangência dos escopos entre médicos com formação no exterior e com formação específica em MFC, sendo a dupla qualificação da residência médica com a titulação fator de maior impacto. Os médicos declaram saber fazer um número de atividades, ações e procedimentos superior ao que de fato realizam.(AU)

The objective of this research was to analyze the scope of practice of doctors who work in the Family Health Strategy in the Brazilian city of Fortaleza, state of Ceará, and its relations with Family and Community Medicine education and title. A transversal study was conducted from April to November 2018 applying a semistructured form to 263 doctors with 38 attributions among medical actions, activities, and procedures. The scopes had a greater coverage among doctors with overseas education and specific Family and Community Medicine education. The double qualification of medical residency and title was the factor with the greatest impact. Doctors declared knowing how to work with a higher number of activities, actions, and procedures than the one they indeed knew how to do.(AU)

El objetivo de esta encuesta fue evaluar el alcance de la práctica de los médicos que actúan en la Estrategia Salud de la Familia en Fortaleza (Estado de Ceará) y sus relaciones con la formación y titulación en Medicina de Familia y Comunidad (MFC). Se realizó un estudio transversal de abril a noviembre de 2018, aplicándose un formulario semiestructurado a 263 médicos, conteniendo 38 atribuciones entre acciones, actividades y procedimientos de la medicina. Se subrayó una mayor amplitud de los alcances entre médicos con formación en el exterior y con formación específica en MFC, siendo la doble calificación de la residencia médica con la titulación el factor de mayor impacto. Los médicos declaran que saben hacer una serie de actividades, acciones y procedimientos superior al que de hecho realizan.(AU)

The Doctor of Medicine (Paediatrics) Programme at The University of the West Indies, Mona at 45 years, 1972-2017 / El programa de Doctor en Medicina (Pediatría) de la Universidad de West Indies, Mona tras 45 Años, 1972-2017

ABSTRACT The Doctor of Medicine (DM) in Paediatrics Programme began in 1972 in Jamaica and was the first four-year clinical residency programme to be offered at The University of the West Indies (UWI). The DM Paediatrics programme trains residents for four-years and equips them after completion to practice as consultant paediatricians. Over the forty-five years of offering this programme, 237 students have been enrolled and 159 students have successfully completed the course. Over ninety per cent of the graduates are Caribbean nationals. Graduates from the DM Paediatrics programme at Mona are currently serving in Jamaica and other Caribbean countries, the United States of America (USA), Canada, Australia and the United Kingdom. Approximately, 24% have pursued subspecialty training and 60% work in a hospital-based setting while 30% work in private practice and 27% in academia and research. There are some of these that combine hospital ward work with academia and research. The DM (Paediatrics) Programme at the UWI, Mona, has achieved its mandate of providing paediatricians for Jamaica and the Caribbean and is committed to continue to train paediatricians to meet existing paediatric healthcare needs in Jamaica and the Caribbean.

RESUMEN El Programa de Doctor en Medicina (DM) en Pediatría comenzó en 1972 en Jamaica y fue el primer programa de residencia clínica de cuatro años que se ofreció en la Universidad de West Indies (UWI). El programa DM de Pediatría entrena a los residentes durante cuatro años y los faculta después de su terminación para practicar como pediatras consultores. En los 45 años de este programa, 237 estudiantes han sido matriculados y 159 estudiantes han completado con éxito el curso. Más del 90 por ciento de los graduados son nacionales del Caribe. Los egresados del programa DM de Pediatría de Mona prestan actualmente sus servicios en Jamaica y otros países del Caribe, los Estados Unidos de América (EE. UU.), Canadá, Australia y el Reino Unido. Aproximadamente, el 24% han continuado su formación en subespecialidades; el 60% trabaja en el medio hospitalario, mientras que el 30% trabaja en la práctica privada; y el 27% en la academia y la investigación. Algunos de ellos combinan el trabajo en las salas de hospitales con la academia y la investigación. El programa DM (Pediatría) de UWI, Mona, ha logrado su mandato de proveer pediatras para Jamaica y el Caribe, y se compromete a seguir capacitando a pediatras para que satisfagan las necesidades de salud pediátrica existentes en Jamaica y el Caribe.

Initial results of a doctorate in medical sciences program at a regional university / Resultados iniciales de un programa de doctorado en ciencias médicas de una universidad

The number of doctoral programs in the biomedical field has risen in recent decades, but with a concentration in Santiago and little expansion into the provinces. The aim of this article is to describe the initial results obtained by the Doctorate in Medical Sciences program of the Universidad de La Frontera, Chile. Observational study, conducted in the Department of Surgery at the Universidad de La Frontera, Chile. All cohorts in the program from 2008 to 2015 were included. The outcome variables were: Graduation rate and scientific productivity of the graduates (WoS and SciELO publications). Other variables of interest were: academic faculty productivity (WoS and SciELO publications), and characteristics of students who entered the program (age, sex, origin, profession, previous graduate training and number of years of formal university education). Descriptive statistics were applied. During the evaluation period, of a total of 17 qualified, 8 doctorates have been granted (1.6 per year), a graduation rate of 47.1 %. The research productivity for 2010-2015 was 14.1 publications per graduate (8.4 WoS and 5.7 SciELO) and 43.8 publications per academic (41.2 WoS and 2.6 SciELO). In the period, 55 professionals applied and 27 were accepted (49.1 % rate acceptance). Initial results of the Doctorate in Medical Sciences program of the Universidad de La Frontera, Chile are presented.

El número de programas de doctorado en el área biomédica ha crecido en las últimas décadas, aunque la mayoría se concentra en Santiago, con un escaso desarrollo en regiones. El objetivo de este artículo es describir los resultados iniciales obtenidos por el programa de Doctorado en Ciencias Médicas de la Universidad de La Frontera. Estudio observacional, descriptivo; realizado en el Departamento de Cirugía de la Universidad de La Frontera. Se incluyeron la totalidad de las cohortes que han ingresado al programa, desde 2008 a 2015. Las variables de los resultados fueron: Tasa de graduación y productividad de los graduados (publicaciones WoS y SciELO). Otras variables de interés fueron: productividad del Claustro (publicaciones WoS y SciELO); y características de los alumnos que ingresaron al programa (edad, sexo, origen, profesión, formación de postgrado previa y número de años de formación universitaria formal). Se aplicó estadística descriptiva. Durante el período evaluado, de un total de 17 habilitados, se graduaron 8 doctores (1,6 por año), tasa de graduación de 47,1 %. La productividad para el período 2010-2015 fue de 14,1 publicaciones por graduado (8,4 WoS y 5,7 SciELO); y 43,8 publicaciones por miembro del Claustro (41,2 WoS y 2,6 SciELO). En el período analizado postularon 55 profesionales, siendo aceptados un total de 27 (49,1 % de aceptación). Se presentan los resultados iniciales del programa de Doctorado en Ciencias Médicas de la Universidad de La Frontera.

Association between participation and compliance with Continuing Medical Education and care production by physicians: a cross-sectional study / Associação entre participação e cumprimento de um programa de Educação Médica Continuada e produção assistencial dos médicos: estudo transversal

Objective Physician participation in Continuing Medical Education programs may be influenced by a number of factors. To evaluate the factors associated with compliance with the Continuing Medical Education requirements at a private hospital, we investigated whether physicians’ activity, measured by volumes of admissions and procedures, was associated with obtaining 40 Continuing Medical Education credits (40 hours of activities) in a 12-month cycle. Methods In an exclusive and non-mandatory Continuing Medical Education program, we collected physicians’ numbers of hospital admissions and numbers of surgical procedures performed. We also analyzed data on physicians’ time since graduation, age, and gender. Results A total of 3,809 credentialed, free-standing, private practice physicians were evaluated. Univariate analysis showed that the Continuing Medical Education requirements were more likely to be achieved by male physicians (odds ratio 1.251; p=0.009) and who had a higher number of hospital admissions (odds ratio 1.022; p<0.001). Multivariate analysis showed that age and number of hospital admissions were associated with achievement of the Continuing Medical Education requirements. Each hospital admission increased the chance of achieving the requirements by 0.4%. Among physicians who performed surgical procedures, multivariate analysis showed that male physicians were 1.3 time more likely to achieve the Continuing Medical Education requirements than female physicians. Each surgical procedure performed increased the chance of achieving the requirements by 1.4%. Conclusion The numbers of admissions and number of surgical procedures performed by physicians at our hospital were associated with the likelihood of meeting the Continuing Medical Education requirements. These findings help to shed new light on our Continuing Medical Education program. .

Objetivo A participação de médicos em programas de Educação Médica Continuada pode ser influenciada por inúmeros fatores. Para avaliar os fatores associados ao cumprimento dos requisitos para Educação Médica Continuada em um hospital privado, investigamos se a atividade médica, medida por volume de internações e procedimentos, esteve relacionada à obtenção de 40 créditos (40 horas-aula) em um ciclo do programa de 12 meses. Métodos Em um programa exclusivo e não obrigatório de Educação Médica Continuada, coletamos o número de admissões e de procedimentos realizados por médico. Analisamos dados como tempo de formado, idade e sexo. Resultados Foram analisados dados de 3.809 médicos credenciados e autônomos. A análise univariada mostrou que os requisitos de Educação Médica Continuada eram mais preenchidos por médicos do sexo masculino (odds ratio de 1,251; p=0,009) e que eles apresentavam números de internações mais significativos (odds ratio de 1,022; p<0,001). A análise multivariada mostrou que idade e número de admissões estiveram associados ao cumprimento das metas estabelecidas. Cada admissão aumentou a chance de atingir a meta em 0,4%. Entre os que realizaram procedimentos cirúrgicos, a análise multivariada mostrou que médicos do sexo masculino eram 1,3 vez mais propensos a atingir a meta estabelecida que seus pares do sexo feminino. Cada procedimento cirúrgico realizado elevou a chance de atingir a meta em 1,4%. Conclusão O número de admissões e de procedimentos cirúrgicos realizados por médicos em nosso hospital foi associado à probabilidade de alcançar a meta de Educação Médica Continuada. Estes achados lançaram uma nova luz sobre o nosso programa de Educação Médica Continuada. .

Adesão ao Programa de Educação Permanente para médicos de família de um Estado da Região Sudeste do Brasil / Adherence to the Ongoing Education Program for family doctors in a southeastern Brazilian state

A Educação Permanente em Saúde é uma estratégia de transformação das práticas em saúde, sendo a adesão do profissional um dos desafios para sua efetivação. Nessa perspectiva, o objetivo deste trabalho foi investigar, a partir da percepção dos supervisores, os fatores relacionados à adesão dos médicos às atividades do Programa de Educação Permanente (PEP) para médicos de família de um Estado da região Sudeste. Trata-se de um estudo transversal, quantitativo, com utilização de questionários on-line. Os dados foram analisados por meio do teste qui-quadrado com correção de continuidade para se verificar a associação entre a estrutura, tópicos, atividades do PEP, dificuldades dos supervisores no trabalho no PEP e dos médicos na APS e a baixa e boa adesão ao Programa. A ótima participação dos médicos se relacionou à adequação do espaço físico (p = 0,001) e à abordagem multidisciplinar (p = 0,035) e dos aspectos epidemiológicos (p = 0,043). Já a baixa adesão se associou à inadequação da estrutura física, à dificuldade de compreensão da metodologia, ao menor tempo de atuação do supervisor, às múltiplas jornadas de trabalho dos médicos, entre outras. A boa adesão ao PEP é uma possibilidade de reconstrução coletiva da realidade laboral cotidiana e da prática médica na Atenção Primária em Saúde.

Ongoing Health Education is a strategy for transformation of health practices, though the adherence of professionals is one of the challenges facing its implementation. Thus, the objective of this study was to investigate the factors associated with adherence of family doctors to the Ongoing Education Program in a southeastern Brazilian state from the perception of supervisors. It is a cross-sectional and quantitative study with the use of online questionnaires. Data were analyzed using the chi-square test with ongoing correction to determine the association between structure, topics, activities and difficulties of the supervisors working in Ongoing Health Education, difficulties of the physicians in Primary Health Care (PHC) and poor and good adherence to the program. Excellent medical participation was statistically related to the adequacy of physical space (p = 0.001), a multidisciplinary approach (p = 0.035) and epidemiological aspects (p = 0.043). Low adherence was associated with the inadequacy of the physical structure, difficulty understanding the methodology, less time in a supervisory position, multiple workdays, among others. A good adherence to Ongoing Health Education is a possibility for collective reconstruction of the everyday work of physicians in Primary Health Care.

Proyecto institucional para la educación médica continua en investigación clínica / Continuing medical education: A clinical research institutional project

En la Argentina, educar en investigación clínica consiste principalmente en cursos teóricos. En países desarrollados existen programas que generan el entorno propicio para un aprendizaje práctico y continuo. En el 2006, en el Servicio de Clínica Médica del Hospital Italiano de Buenos Aires se creó el Área de Investigación en Medicina Interna para formar profesionales capaces de participar en todas las etapas de la investigación clínica. El propósito de este estudio es describir el área y su impacto en la educación en investigación en medicina interna durante el período 2006-2008. El proyecto cuenta con un programa de capacitación en investigación clínica para residentes y otro de perfeccionamiento para becarios. Además de becas, asesoramiento en proyectos, ateneos sobre investigación clínica y registros de enfermedades prevalentes en medicina interna. Participan el 33% (6/18) de los clínicos de internación, se encuentran en formación 3 becarios y 7 monitores de investigación. 25 residentes pasaron por el programa de capacitación, completaron una propuesta de investigación 19 (76%). Se hicieron 59 presentaciones en congresos. Se encuentran en proceso de publicación 6 artículos originales y 2 en revisión por comités editoriales. De un cuestionario de evaluación del área, el 76% (35/46) considera que ha adquirido nuevas habilidades, y 93% (44/47) refiere que las utiliza en la práctica diaria. El 100% (47/47) considera que ha recibido orientación adecuada. El 97% (45/46) considera que sus ideas han sido respetadas. La implementación del área de investigación logró aumentar la capacitación y producción científica en investigación clínica independiente.

In Argentina, education in clinical investigation is based on courses with theoric content. In developed countries programs with ongoing and practical content exist, generating the proper context to learn. In 2006, the Hospital Italiano de Buenos Aires (HIBA) created an area to train physicians, Research Area in Internal Medicine, and enable them to participate in every step of the clinical investigation process. The objective of this study is to describe this teaching area and its impact on the investigation in Internal Medicine in the HIBA, in the period 2006-2008. This area counts with fellow positions and provides training in Clinical Investigation for rotating residents. It has different activities including lectures, project counseling and 3 ongoing Institutional Registers for prevalent medical problems, 33% (6/18) of Intern staff are currently participating, with 3 fellows and 7 monitors for the Registers; 25 residents rotated in the area and generated their own research projects. 59 posters were presented in local and international congresses. Currently 6 original articles are in process of publication and 2 in peer review evaluation. A survey was carried out to evaluate the area where 76% (35/46) of the participants believed that they have acquired new skills; with 93% (44/47) using these knowledges in their every day practice. A 100% thought that they were adequately oriented in their projects, their ideas being fully respected (97%) (45/46). The inclusion of the Research Area in Internal Medicine improved the knowledge of the process of clinical Investigation and increased independent scientific production.

Primary health care physicians' knowledge, use, and attitude towards online continuous medical education in Saudi Arabia

To determine the knowledge, attitude, and use of primary health care [PHC] physicians of online continuous medical education [OCME] in the regions of Riyadh, Kingdom of Saudi Arabia. This is a cross-sectional analysis using a self administered questionnaire. The physician sample was selected to cover all Riyadh regions [city of Riyadh, and all accessible clinics in the villages, and cities outside of Riyadh]. The study was conducted from April until May 2007. The data were analyzed using the Statistical Package for Social Sciences software version 12. Out of the 613 questionnaires distributed, 483 was completed and returned. Approximately two-thirds of the participants are aware of OCME. Almost all were interested to learn more regarding OCME. Although 80% of the participants are currently using the internet to obtain medical knowledge, only one-third are using OCME. Ninety percent of those who are using OCME think that it will improve their patient's care. The use of OCME is significantly related to the level of computer skills the physicians have. There was no statistical significant difference on the use of OCME on one hand, and age, gender, level of education, years of experience, and location on the other hand. The PHC physicians have favorable attitude towards OCME, however, their use is quite minimal. More effort is needed to encourage our physicians to utilize this promising method of continuous education, and to understand the challenges and obstacles against using it

The modest but growing Brazilian presence in psychiatric, psychobiological and mental health research: assessment of the 1998-2002 period

The objective of the present survey was to assess the Brazilian scientific production in psychiatry, psychobiology, and mental health during the 1998-2002 period. The universities' graduate programs concentrate the vast majority of the scientific production in Brazil. We assessed the annual reports from the graduate programs to the Brazilian Ministry of Education concerning master's and doctoral theses and the articles published in journals indexed by the Institute of Scientific Information (ISI). There are nine Master's and Doctoral graduate programs dedicated to research in psychiatry, neuropsychiatry, psychobiology, and mental health in the country, seven being located in southern states. During the 5-year period, from 1998 to 2002, 186 students received their doctorate degree (37/year). The programs published 637 articles in journals indexed by ISI, the majority of them in journals with an impact factor higher than 2. The research advisors' productivity varied among graduate programs, ranging from 0.6 to 2.0 articles per year in ISI-indexed journals. Despite the substantial barriers faced by the Brazilian scientific community (mainly financial and writing difficulties), Brazil's scientific mental health production is on the rise. The number of articles published in ISI-indexed journals has doubled without a significant increase in the number of graduate theses, suggesting that there was an improvement in both the quality of the scientific production and the productivity of the graduate programs. Based on these data, it is reasonable to predict a tendency to an increase in production over the next few years.

El perfil del médico psiquiatra colombiano / Stereotype of the Colombian Psychiatrist

Objetivo: determinar el perfil del psiquiatra colombiano desde tres aspectos fundamentales: estándares de vida, desarrollo académico y desempeño laboral. Diseño: estudio observacional descriptivo de corte transversal tipo encuesta, realizada entre diciembre 2002 y marzo 2003. Muestra: 234 psiquiatras escogidos de forma aleatoria con una muestra representativa decada región. Resultados: 130 hombres y 46 mujeres. La edad promedio de los psiquiatras encuestados fue de 48,6 años, casados 72,73 por ciento, con un promedio de dos hijos. El 77,27 por ciento pertenece a la Asociación Colombiana de Psiquiatría. El 51,7 por ciento de los psiquiatras ha realizado otros estudios que llevan a título. El número promedio de participaciones en actividades de actualización en los últimos doce meses es de 1,12 para congresos nacionales. Los formatos preferidos para educación continuada incluyen: congresos nacionales y seminarios. La principal área para recibir educación continuada son las psicoterapias. El 74,43 por ciento está de acuerdo con la recertificación del gremio. La entidad preferida para tal actividad es la Asociación Colombiana de Psiquiatría, con un promedio de años propuestos para la recertificación de 4,9 años. El 92,05 por ciento de los psiquiatras está laborando actualmente. En promedio, trabajan 5,23 días, entre nueve y doce horas diarias. Para la mayoría de ellos su práctica está orientada hacia la farmacoterapia y otras terapias biológicas. El 77,84 por ciento de los psiquiatras tiene un ingreso inferior al esperado, el 71 por ciento están satisfechos con su trabajo actual...

Ateneos en el Hospital Centro de Salud Zenón J. Santillán de San Miguel de Tucumán: un breve análisis / Athenaeums of Centro de Salud Zenón J. Santillán Hospital at San Miguel de Tucumán

Los ateneos de Clínica Médica permiten el acercamiento de los profesionales de un Hospital y su mejor desempeño frente al paciente. En el Hospital Centro de Salud "Zenón J. Santillán" los ateneos se realizan desde el 2 de noviembre de 1977 hasta la fecha (noviembre 1999). Los mismos se suspendieron por un período de 4 años. Se realizaron 255 Ateneos en los 18 años de actividad, con un promedio anual de 23 ateneos y 3731 profesionales asistentes. El Departamento de Clínica Médica presentó el mayor número de casos. Se observó que sólo el 10 por ciento de los profesionales participaron en los Ateneos. La escasa concurrencia probablemente se repite en diversas provincias de nuestro país.