Monitoreo del impacto en la formación de especialistas en Medicina Intensiva y Emergencias en Matanzas / Monitoring the impact in the formation of specialist in intensive medicine and emergencies, Matanzas

Introducción: la evaluación y acreditación de la calidad en la formación de las especialidades médicas en Cuba, conceptualiza el monitoreo del impacto como el proceso dirigido a evaluar la correspondencia entre los objetivos del programa y los resultados alcanzados por sus participantes en el entorno social donde se desarrollan profesionalmente. Objetivo: aplicar la metodología diseñada para el monitoreo del impacto en la formación de las especialidades médicas en el Programa de Medicina Intensiva y Emergencias. Materiales y métodos: se realizó un estudio de corte pedagógico donde se aplicó la metodología diseñada en la Universidad de Ciencias Médicas de Matanzas, para monitorear el impacto en la formación de la especialidad de Medicina Intensiva y Emergencias, desarrollado en el Hospital Universitario Comandante Faustino Pérez Hernández. Participaron 6 egresados, 11 profesores, 8 tutores y 4 directivos de la última edición concluida (octubre de 2016 a noviembre de 2019). Resultados: se observó un alto impacto en la institución y mediano en el individuo, con contraste entre el diagnóstico inicial y durante la formación: de excelencia en el 100 % de los residentes, pero un diagnóstico final con 33,3 % excelente y 66,6 % bien. No se evaluó la etapa de transferencia o impacto en la sociedad, por el corto de tiempo de experiencia laboral de los egresados. Conclusiones:la metodología aplicada permitió conocer un mediano impacto en la formación de los egresados de Medicina Intensiva y Emergencias, por contrastación entre el diagnóstico inicial y durante la formación, de excelente con un diagnóstico final de bien (AU).

Introduction: the evaluation of the quality in the formation of the medical specialties in Cuba, conceptualize the monitored of the impact like the process directed to evaluate the correspondence among the objectives of the program and the results reached by their participants in the social environment where they are developed professionally, guaranteeing the relevancy of the program. Objective: to apply the methodology designed for the monitored of the impact in the formation of the medical specialties in the program of intensive Medicine and emergencies. Materials and methods: carried out a study of pedagogic court where the methodology was applied designed in the Medical University of Matanzas, for the monitored of the impact in the formation of the specialty of intensive Medicine and emergencies, developed in the university hospital "Faustino Pérez Hernández." They participated six graduate, four directives, 11 professors and tutors of the last concluded edition, from October of the 2016 to November of the one 2019. Results: a high impact was observed in the institution and medium in the individual, with a contrast among the initial diagnosis and during for formation of excellence in 100% of the residents, with a final diagnosis of 33,3% excellent and 66,6% well. It was not evaluated the transfer stage or impact in the society, for the short of time of labor experience of the graduate. Conclusions: the applied methodology allowed to know the medium impact in the formation of graduate in Intensive Medicine and Emergencies in Matanzas, for a contrast among the initial diagnosis and during the formation of excellent with the final diagnosis of well (AU).

¿Es tiempo de modificar la vinculación pregrado postgrado en la educación médica chilena? Reflexiones sobre una vía de doble titulación Médico cirujano/Doctor en ciencias médicas / Time to change the graduate-postgraduate liaison in Chilean medical education? Reflections about a double certification as Physician and Doctor in medical sciences

In the last 150 years, scientific research has produced extraordinary discoveries in Medicine and there is no doubt that research will continue contributing substantially in the future but there is no the same conviction regarding how to provision such capacities in medical graduates. In Chile, the Faculties of Medicine created several doctorate programs in Medical Sciences (Ph.D.) to strengthen medical research. However, the low number of physicians who apply to these programs is a caveat. These programs provide the advanced third-cycle competencies expected by students aspiring for an excellence research certification and their incorporation into academia. Universities stand out in their capacity to adapt themselves to educational needs, developing programs designed to fill specific gaps. Ph.D. programs intercalated to the medical career show that this is the correct approach. The development of specific doctorate programs for the small number of physicians interested in research and for medical students with a strong interest in research could be an innovative solution to motivate and encourage them to develop a career in clinical investigation. Using this approach, Medical Schools and Doctorate in Medical Sciences programs would jointly stimulate the training of medical scientists.

Tendencias actuales de programas de estudio de pregrado y posgrado con orientación a la Atención Primaria de la Salud / Current trends in undergraduate and postgraduate studies programs oriented to primary health care i: en

Introducción: el pregrado y posgrado en la Atención Primaria de Salud, tiene un importante rol en el perfeccionamiento y superación de los recursos humanos que laboran en ese nivel de atención, toda vez que es la base del sistema de salud cubano. Objetivo: exponer las tendencias actuales de los planes y programas de estudio de pregrado y posgrado con orientación a la Atención Primaria de Salud, con la intención de provocar la reflexión en torno a la posición de los autores declarada en el presente trabajo. Métodos: se realizó un análisis de la literatura especializada en pregrado y posgrado. Se empleó el análisis histórico-lógico, el análisis documental y la sistematización. Resultados: se analizan las tendencias actuales de la educación de pregrado y posgrado y se declaran sus puntos de vistas, relacionados con el plan de estudio de las carreras. Conclusiones: sugieren sean sometidos a una valoración continua y perfeccionamiento curricular, teniéndose en consideración la inclusión de los nuevos problemas de salud que surgen en la comunidad y que favorecen la adquisición de competencias y mejor desempeño de los profesionales en formación(AU)

Introduction: Undergraduate and postgraduate studies in primary health care have an important role in the development and improvement of human resources working at this healthcare level, since it is the basis of the Cuban health system. Objective: to present the current trends of the curriculums and programs of undergraduate and postgraduate studies oriented to primary health care, aiming at provoking reflection about the authors' position stated in this paper. Methods: An analysis was carried out into the specialized literature about undergraduate and postgraduate studies. We used the methods of historical and logical analysis, document analysis and systematization. Results: current trends in undergraduate and postgraduate education are analyzed and their views are related to the studies programs of the majors. Conclusions: it is suggested that they be subject to continuous assessment and improvement, taking into consideration the inclusion of new health problems that arise in the community and that foster the acquisition of skills and improved performance of undergraduate students(AU)

Medical education in India: Time to make some changes.

India is in need of well-trained doctors. We highlight and analyse some of the problems affecting medical education in India and their possible solutions. The medical education system can be reviewed under four heads: selection of students, medical training, evaluation, and the development and accreditation of faculty. In India, students enter medical colleges without receiving sufficient orientation about the profession. If students were given some exposure to various professions in the final years of school, it would help address this issue. Medical students are selected on the basis of pre-medical tests consisting of multiple-choice questions, the validity of which is being questioned increasingly. There is no coordination between the scheduling of lectures on various diseases and their management and the clinical exposure of the students. Active involvement in treatment is limited to the final year, called internship, which is hampered by preparation for postgraduate entrance examinations. Efforts should be made to provide hands-on experience at an earlier time in the course. A systematic and reliable programme for evaluation is a must. There is a need for a shift in the focus of evaluation, which should assess the application of knowledge rather than the ability to recall facts. The replacement of the traditional long-/short-case examinations with more valid and reliable instruments for the assessment of clinical skills should be considered. ‘Vision 2015’, a document developed by the Medical Council of India, contains many notable recommendations for the improvement of the current system. If these are implemented effectively, the impact of improvement in Indian medical education will be felt globally.

Sugestões para a academia melhorar a saúde da medicina

A academia, por sua vez, necessita parar de julgar produção científica da área clínica com os mesmos critérios utilizados para áreas básicas. Todo pesquisador sabe que não se pode utilizar os mesmos tipos de balança para análises de pesos de ordem de grandeza muito diferentes. Uma maneira simples seria avaliar os currículos de médicos candidatos à academia, com pesos iguais para cada uma de suas obrigações específicas, ou seja, dar pesos iguais às atividades de ensino, pesquisa e extensão (ou assistência médica) e fazer-se uma média aritmética desses resultados. Ou seja, exigir-se maior formação científica da residência médica e valorizar a competência profissional na hora da avaliação acadêmica do médico: óbvio, porém, fundamental para toda a sociedade.

Aproximación a la pertinencia social del posgrado de cardiología de la Universidad de Los Andes / Approach to the social relevance of the cardiology fellow of Los Andes University

El paradigma de la misión de las universidades está cambiando y se cuestiona su papel como agentes transformadores de la sociedad, a la vez que se promueve que las políticas de salud sean diseñadas sobre la base de evidencias obtenidas mediante la investigación. El presente trabajo intenta estimar la pertinencia social del posgrado de cardiología de la universidad de Los Andes, mérida, Venezuela (PCULA). Encuesta anónima realizada a los egresados del PCULA en el lapso 1978 - 2002. Treinta y un preguntas en ocho secciones. 63 de los 100 egresados llenaron la encuesta. El 84,54% seleccionó tener una actualización aceptable; sólo el 20% manifestó ejercer exclusivamente en el sector público; la mayoría consideró deficientes las condiciones para el ejercicio público; 87,30% clasificó como deficiente el entorno público y privado para la investigación; el 47,62% participaba en cardiología preventiva, sólo el 22,22% dijo haber creado a dirigir algún programa de esta índole; el 63,96% no llegaba a cinco presentaciones en congresos, el 69,84% tenía cuatro o menos publicaciones, apenas el 8,94% tenía cinco o más divulgaciones en cardiología preventiva; el 90,48% consideró aceptable el entrenamiento en el PCULA, con la excepción del obtenido en cardiología preventiva; el 69,73% catalogó de laboriosa la obtensión de trabajo como cardiólogo; el 38,10% consideró inadecuado el nivel socio-económico alcanzado; y el 64,08% realizó estudios de super-especialización. Apesar de una alta calidad, el PCULA evidencia parámetros de baja pertinencia social.

The paradigm of the mission of universities is changing and their role as agents for change in society is being questioned while, at the same time, designing health policies based on research findings is being promoted. This paper attempts to assess the social relevance of the postgraduate course in cardiology at Universidad de Los Andes, Mérida, Venezuela (PCULA). An anonymous survey conducted on students who graduated from the PCULA during the period 1978-2002. Thirty-one questions in eight sections. Sixty-three of the 100 graduates completed the questionnaire. Of that number, 84.54% indicated that the course’s level of refresher content was acceptable; only 20% said they practiced exclusively in the public health sector; the majority considered conditions for practicing in the public sector to be deficient; 87.3% classified the environment, in both the public and private sectors, as being deficient for engaging in research; 47.62% was involved in preventive cardiology; only 22.2% said they had created or directed a program of this type; 63.96% had given less than five papers at congresses; 69.84% had four or less publications; only 8.94% had five or more publications in preventive cardiology; 90.48% considered the training offered on the PCULA to be acceptable, except for the training in preventive cardiology; 69.73% classified obtaining work as a cardiologist as being an uphill task; 38.10% considered the socio-economic level achieved to be inadequate; and 64.08% had done “superspecialization” studies. Despite the high quality of the PCULA, evidence of parameters of low social relevance is apparent.

Projeto político-pedagógico da Escola Médica / Political-pedagogical project of medical school

A tese sobre o Projeto Político-Pedagógico da Escola Médica é uma produção da Linha de Pesquisa sobre Informação e Educação em Saúde do Programa de Pós-Graduação em Ciências Médicas da Universidade do Estado do Rio de Janeiro (PGCM/UERJ), cuja proposta de multidisciplinaridade incentiva e apóia contribuições mútuas entre as áreas de Educação e Saúde. Atendendo, também, à proposta do Programa, esta pesquisa gerou dois artigos, um publicado na Revista Brasileira de Educação Médica (Qualis A) e outro aceito para publicação pela Revista da FAEEBA - Educação e Contemporaneidade. Os artigos apresentam análises e resultados desta pesquisa, cujo objetivo foi reunir argumentos teóricos e conceituais sobre a importância do Projeto Político-Pedagógico no ensino superior, de modo geral, e na Escola Médica de modo particular. A metodologia incluiu procedimentos de pesquisa bibliográfica, ensaio teórico e análise de conteúdo aplicada a bibliografia e a respostas de alunos do PGCM/UERJ, através de um exercício, que possibilitou comparar as respostas antes e após a leitura do primeiro artigo gerado pela pesquisa. Nas considerações conclusivas, corroboradas pelos argumentos teóricos e conceituais reunidos pela pesquisa, destaca-se a importância do Projeto Político-Pedagógico da Escola Médica em suas funções integradora e atualizadora de princípios e ações que se realizam no presente e se projetam no futuro, de modo fundamentado, crítico e participativo.

This thesis about the Pedagogic Political Project of the Medical School is a production of the Research Line of Information and Education in Health of the Medical School at the University of the State of Rio de Janeiro (PGCM/UERJ), whose proposal of multidisciplinary, gives supports to a mutual contribution between the Education and Health areas. Attending to the proposal of the program, this research has generated two articles in the Brazilian Journal of Medical Education (Qualis A) and another accepted by the FAEEBA Journal - Education and Contemporarily. The articles present the analysis and results of this research, whose aim was to bring theoretical and conceptual arguments about the importance of the Pedagogic Political Project in Superior Education, in general, and in the Medical School, in particular. The methodology includes bibliographic review, theoretical essays and content analysis applied to the bibliography and to the PGCM/UERJ student's responses, by means of an exercise, which has allowed us to compare the answers before and after the reading of the first article generated by the research. The final considerations, corroborated by the theoretical and conceptual arguments collected by the research, highlighted the importance of the Pedagogic Political Project of the Medical School in its integrating and renewing functions of the principles and actions that are made in the present and which are projected to the future, in a grounded, critical and participative way.

Revalidação do título de especialista / Specialist's title revalidation

Neste artigo os autores discutem aspectos relacionados à revalidação do título de especialista, destacando a sua importância e fazendo um breve histórico do processo em nosso País.

Desafios ao estudante de mestrado em saúde / Chalencing to the students in health mastership

Este estudo, levanta questionamentos e dúvidas que perpassam o cotidiano dos estudantes do Mestrado em Saúde. Aborda seus conflitos e desafios para ultrapassar o modelo tradicional em pesquisa para novos paradigmas. Amplia as reflexões do indivíduo pesquisador para o contexto que envolve a Ciência Médica.

La actual formación de médicos especialistas en Chile / The current training of specialist physicians in Chile

En Chile, la formación de médicos especialistas se desarrolló exitosamente a partir de la década de 1950, lo que permitió dotar de especialistas a los hospitales complejos en todo el país. Lamentablemente, la rigurosidad y calidad de la formación se ha deteriorado con el transcurso del tiempo. Esto es más grave aún porque la demanda por especialización será creciente en función del aumento significativo de estudiantes de medicina. El objetivo de este documento es llamar la atención sobre este serio problema invitando a los involucrados a aunar voluntades y contribuir a que la formación de especialistas retome la senda que tuvo por años y que representó un gran aporte a la medicina nacional.