La Escuela Finochietto. Una mirada personal retrospectiva y prospectiva / Finochietto School. A personal retrospective and prospective view

En este artículo el autor primero relata su ingreso y su formación como cirujano en la Escuela Finochietto; comparte sus sentires íntimos, las anécdotas y las experiencias vividas junto a discípulos directos de Ricardo Finochietto, en particular con su maestro, Delfín Luis Vilanova. Más adelante, el relato cuenta sobre su especialización como cirujano plástico junto al Dr. José Alberto Cerisola, también discípulo directo de Finochietto. Y por último, el autor habla sobre su proceso de «mutación¼ de cirujano a terapeuta y sobre cómo influyó la formación como cirujano en la Escuela en el desarrollo de la técnica terapéutica que emplea. (AU)

In this article, the author first relates his admission and training as a surgeon at the Finochietto School. He shares his intimate feelings, anecdotes and experiences with direct disciples of Ricardo Finochietto, particularly with his teacher, Delfín Luis Vilanova. Later on, he talks about his specialization as a plastic surgeon together with Dr. José Alberto Cerisola, also a direct disciple of Finochietto. Finally, he refers to the process of "mutation" from surgeon to therapist and how his training as a surgeon at the School influenced the development of the therapeutic technique that he uses. (AU)

El final del Hospital Rawson y la diáspora finochiettista. A 45 años de estos hechos / The end of the Rawson Hospital and the finochiettista diaspora. 45 years after these events

La Asociación Médica Argentina (AMA) reconoce el valor de la Escuela Quirúrgica de los hermanos Finochietto y por tal motivo efectúa un homenaje anual desde el año 2002. En este artículo se hace una breve reseña histórica del Hospital Rawson, donde se inició y desarrolló dicha escuela. Se resaltan dos hechos: por un lado, el término "diáspora finochiettista", porque la dispersión de los cirujanos fue obligada y tuvieron que abandonar su lugar de procedencia original, el Hospital Rawson y, por el otro, que dicho nosocomio nació y murió como consecuencia de movimientos políticos cívico-militares. (AU)

The Argentine Medical Association (AMA) recognizes the value of the Surgical School of the Finochietto brothers, and for this reason has paid an annual tribute since 2002. Tthis article provides a brief historical review of the Rawson Hospital, where the school was initiated and developed. Two facts are highlighted: on the one hand, the term "Finochiettista diaspora" because the dispersal of the surgeons was forced and they had to leave their original place of origin, the Rawson Hospital; and on the other hand, the fact that this hospital was born and died as a consequence of civil-military political movements. (AU)

O Desenvolvimento Docente na FMRP-USP: contexto histórico / Faculty Development at Ribeirão Preto School of Medicine at University of São Paulo (FMRP-USP): A contextualized historical review

O objetivo desse artigo é contextualizar historicamente as ações de desenvolvimento docente realizadas na Facul-dade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP) desde sua fundação até a criação do Centro de Desenvolvimento Docente para o Ensino (CDDE) para as Profissões da Saúde, que foi a primeira unidade formal da instituição para a educação para o ensino dos seus professores e preceptores. Apresentamos um pano-rama sobre o conceito atual de desenvolvimento docente, o papel de fundações internacionais de fomento e de regulamentações governamentais locais na consolidação dessas atividades no país, além de ações dos diretores e professores da Faculdade de Medicina, visando a capacitação profissional para o exercício da docência desde a sua fundação. Finalmente, abordamos o contexto de criação do CDDE, os profissionais participantes e dados da partici-pação docente nas cinco primeiras edições do "Módulo Básico" de ensino para as profissões da saúde na FMRP-USP, o primeiro e mais importante programa estruturado de capacitação docente oferecido pelo centro. (AU)

The objective of this article is to historically contextualize Faculty Development (FD) actions carried out at the Ribeirão Preto School of Medicine at University of São Paulo (FMRP-USP), since its foundation up until the creation of the Center for Faculty Development (CDDE) in Health Professions Education (HPE). CDDE is the first formal unit of the institution with the mission to support educators (Faculty Members and Preceptors) to improve their educa-tional practices: to teach, facilitate learning, assess, design curriculum, and evaluate programs. We present here an overview for the concept of Faculty Development, the role of international funding foundations and local govern-ment regulations in the consolidation of these activities in Brazil. We also describe the school administration actions and pioneer Faculty members that created the foundations for the first Faculty Development Center at FMRP-USP. Finally, we address the context of the creation of the CDDE and the describe participants characteristics of the first five editions of the Essentials Skills Module on HPE. (AU)

Medical education: the historical framing of the medical curriculum and the challenges of renewal in the 21st century / Educação médica: a construção histórica do currículo médico e os desafios de renovação no século XXI

The study proposes a critical and exploratory analysis of the historical formation of the medical curriculum, including the pedagogical models and contemporary challenges. Contemporary Medicine has faced challenging transformations in the 21st century, such as population aging, technological and scientific advances, epidemiological transition, wide access to informationby society. The knowledge society requires new generations of physicians to develop interdisciplinary professional skills and the technical-scientific domain. Given the ongoing transformations in contemporary medical practice, it is up to the academic community to deconstruct obsolete teaching paradigms, to foster the design of new pedagogical practices, congruent with the new medical profile desired in the 21st century.

O estudo propõe uma reflexão crítica e exploratória acerca da construção histórica do currículo médico, seus modelos pedagógicos e desafios contemporâneos. A Medicina contemporânea tem enfrentado transformações desafiadoras no século 21, como envelhecimento populacional, avanços tecnológicos e científicos, transição epidemiológica, facilidade de acesso e informação pela sociedade. A sociedade do conhecimento impõe às novas gerações de médicos o desenvolvimento de competências profissionais interdisciplinares, além do domínio técnico-científico. Diante das transformações em curso na prática médica contemporânea, cabe a comunidade acadêmica a desconstrução de paradigmas de ensino obsoletos, de maneira a propiciar a concepção de novas práticas pedagógicas, congruentes com novo perfil médico almejado no século XXI.

La universidad médica en Cuba durante la etapa colonial / The medical university in Cuba during the colonial period

RESUMEN Se realizó una investigación sobre la universidad médica en Cuba, incluyendo la enseñanza de la Medicina y la Estomatología, con el objetivo de explicar su evolución histórica durante la etapa colonial. Se enfatizó en las principales figuras que ejercieron en este período, las primeras publicaciones médicas, y las instituciones y centros asistenciales que regían la práctica de la medicina. Se concluye que la universidad médica en Cuba se fundó sobre una base escolástica y tradicionalista. A partir de 1842, la enseñanza de la Medicina se desarrolló con la creación de nuevos planes de estudios, el incremento de profesionales capacitados, la publicación de revistas científicas de alto prestigio, y la aparición de centros docentes de gran calidad (AU).

ABSTRACT A research was carried out on the medical university in Cuba, including the teaching of Medicine and Dentistry, with the aim of explaining its historical evolution during the colonial period. The authors emphasized the main figures who worked during this period, the first medical publications, and the institutions and healthcare centers that implemented the practice of medicine. It is concluded that the medical university in Cuba was founded on a scholastic and traditionalist basis. From 1842, the teaching of Medicine developed with the creation of new curricula, the increase of trained professionals, the publication of high-quality scientific journals, and the emergence of high-quality teaching centers (AU).

Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias, 39 años formando médicos militares / University of Medical Sciences of the Revolutionary Armed Forces, 39 years training military doctors

El 7 de octubre de 1981, por el acuerdo No. 1074 del Comité Ejecutivo del Consejo de Ministros, se creó el Instituto Superior de Medicina Militar, hoy Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias, como centro de educación superior, adscrito al Ministerio de las Fuerzas Armadas Revolucionarias. Constituye la única institución docente de nivel superior de su tipo en el Cuba, para la formación de médicos militares, estomatólogos, enfermeros y tecnólogos de la salud. Las vías de ingreso a la universidad, son los alumnos egresados de las escuelas militares Camilo Cienfuegos y del servicio militar. La universidad arriba a su 39 aniversario, con satisfacción y logros en las ciencias médicas, pedagógicas y de la educación médica. Tiene un claustro de profesores, que responde a las exigencias y necesidades de la educación superior cubana, la salud pública y el Ministerio de las Fuerzas Armadas Revolucionarias. Dentro de los profesores, es un honor contar varios que ostentan la Orden Carlos J. Finlay, por sus aportes a la ciencia; con miembros del contingente Henry Reeve, que han trabajado y trabajan en varias partes del mundo; así como poseedores de la Distinción por la Educación Cubana...(AU)

Medical schools in Brasil: population, economic and historical analysis

SUMMARY BACKGROUND To describe the current distribution and historical evolution of undergraduate courses in medicine in Brasil. METHODS Analytical cross-sectional study of secondary data. Through the Ministry of Education, the data of the medical courses were obtained, and through the Brazilian Institute of Geography and Statistics, the population and economic data of the Brazilian states were obtained. RESULTS In Brasil, there were 298 medical courses (1,42 courses / million inhabitants) in January 2018, totaling 31,126 vacancies per year, with 9,217 gratuitous vacancies (29.6%) and 17,963 vacancies in the hinterland (57, 7%). In Brazilian states, there are positive and statistically significant (p <0.001) correlations of the variables: "vacancies" and "population" (R 0.92); "vacancies" and "gross domestic product" ("GDP") (R 0.83); "percentage of vacancies in the hinterland" and "population in the hinterland" (R 0.71) and "percentage of vacancies in the hinterland" and "GDP" (R 0.64). There was a negative and statistically significant correlation between "gratuitous vacancy percentage" and "GDP" (R -0.54, p = 0.003). More paid courses than gratuitous courses and more courses in the hinterland than in the capitals have been created since 1964, in proportions that have remained similar since then, but in higher numbers since 2002. CONCLUSIONS The distribution of medical courses in Brasil correlates with the population and economical production of each state. The expansion of Brazilian medical education, which has been accelerated since 2002, is based mainly on paid courses in the hinterland, in the same pattern since 1964.

RESUMO OBJETIVO Descrever a distribuição e evolução histórica das vagas em cursos de graduação em medicina no Brasil. MÉTODOS Estudo transversal analítico de dados secundários. No Ministério da Educação obtiveram-se dados dos cursos de medicina e no Instituto Brasileiro de Geografia e Estatística foram obtidos dados populacionais e econômicos dos estados. RESULTADOS Havia no Brasil, até janeiro de 2018, 298 cursos de medicina (1,42 curso/milhão de habitantes), totalizando 31.126 vagas anuais, com 9.217 vagas gratuitas (29,6%) e 17.963 vagas no interior do País (57,7%). Nos estados há correlações positivas e significativas (p<0,001) das variáveis: "vagas em medicina" e "população" (R 0,92); "vagas em medicina" e "produto interno bruto" ("PIB") (R 0,83); "percentual de vagas em medicina no interior" e "população no interior" (R 0,71) e "percentual de vagas em medicina no interior" e "PIB" (R 0,64). Há correlação negativa e significativa entre "percentual de vagas gratuitas" e "PIB" (R -0,54, p=0,003). Passaram a ser criados mais cursos pagos do que gratuitos e mais cursos no interior do que nas capitais a partir de 1964 (p <0,001), e a relação curso/milhão de habitantes aumentou a partir de 2002 (p<0,001). CONCLUSÕES A distribuição de vagas em cursos de medicina no Brasil correlaciona-se à população e à produção econômica de cada estado. A expansão do ensino médico brasileiro, acelerada além do crescimento populacional a partir de 2002, é baseada principalmente em cursos pagos no interior dos estados brasileiros, característica inalterada desde 1964.

Esa diaria gotera de la muerte: Mortalidad infantil y los albores de la medicina pediátrica en la provincia de Santiago, Chile, 1870-1913 / That daily trickle of death: Infant mortality and the dawn of pediatric medicine in the province of Santiago, Chile, 1870-1913

RESUMEN Este artículo aborda el problema de la mortalidad infantil en la provincia de Santiago, Chile, y el desarrollo de la medicina pediátrica durante la segunda mitad del siglo XIX e inicios del XX, a través de especialistas que contribuyeron a organizar los conocimientos y prácticas que estructuraron su ejercicio profesional. Para emprender este objetivo y sistematizar este nuevo campo médico, se analizan los antecedentes relativos a la formación de la Facultad de Medicina y el quiebre que representó la aparición de una asignatura dedicada a las enfermedades de la niñez. La investigación se encuentra respaldada en diversas fuentes históricas, entre ellas, la prensa escrita, bibliografía médica, memorias de titulación y el Anuario Estadístico de la República de Chile. La inauguración de los hospitales de niños expresa una institucionalidad, en la que los facultativos posicionaron su labor, pusieron en práctica los tratamientos científicos y, lo más importante, se convirtieron en espacios que permitieron la disminución de la mortalidad infantil.

ABSTRACT This article deals with the problem of infant mortality in Santiago, Chile, and the development of pediatric medicine during the second half of the nineteenth century and the beginning of the twentieth century. Emphasis is placed on the specialists who contributed to organizing the knowledge and practices that structured their professional field. In order to pursue the objective and systematize this new medical field, our analysis suggests the decisive role of the establishment of the Faculty of Medicine and the appearance of coursework dedicated specifically to childhood diseases. Our research is based on various historical sources including the press, medical literature, thesis archives, and the Anuario Estadístico de la República de Chile [Statistical Yearbook of the Republic of Chile]. Likewise, the inauguration of children's hospitals expresses an institutional setting where physicians position their work, put scientific treatments into practice, and most importantly, they become spaces that allow for the reduction of infant mortality.

First stages towards the establishment of Brazilian neurology faculties / Primeiros passos das escolas de neurologia do Brasil

ABSTRACT The establishment of modern medicine in Brazil was marked by the arrival of the Portuguese Court in 1808, when the Bahia and Rio de Janeiro Faculties of Medicine were founded. The French School of Medicine exerted a strong influence on Brazilian medicine and on the main pioneers of Brazilian neurology. The elite of "Parisian neurology" trained students and doctors from around the world, and were mentors to the pioneers of Brazilian neurology in the early 20th century. In this article, the authors review the origins of neurology faculties in Brazilian medicine and the main pioneers of Brazilian neurology. Neurology is certainly a continuously changing field and has always adapted to new advances and discoveries, and it is an honor for the authors to pay homage to their pioneers.

RESUMO O estabelecimento da medicina moderna no Brasil foi marcado pela chegada da corte portuguesa em 1808, quando foram fundadas as faculdades de medicina da Bahia e do Rio de Janeiro. A Escola Francesa de Medicina exerceu forte influência na Medicina Brasileira e nos principais pioneiros da Neurologia Brasileira. A elite da "Neurologia parisiense", treinou estudantes e médicos de todo o mundo e foram os mentores dos pioneiros da neurologia brasileira no início do século XX. Neste texto, os autores revisam as origens das faculdades de Neurologia na Medicina Brasileira e os principais pioneiros da Neurologia Brasileira. A neurologia é certamente um campo em constante mudança e sempre se adaptou a novos avanços e descobertas, e é uma honra para os autores homenagear seus pioneiros.

George Deacon and the circulation of homeopathic therapies in Lima (1880-1915) / George Deacon e a circulação de tratamentos homeopáticos em Lima (1880-1915)

Abstract Homeopathy arrived from the United States to Peruvian soil in the last decades of the nineteenth century, broadening the repertoire of existing medical knowledge, which included an emerging medical profession, Chinese herbalists, and indigenous practitioners. This article examines the circulation and use of homeopathic therapies and medicines in Lima from the time when the American homeopath George Deacon initiated his practice, in the 1880s, until his death, in 1915. Although homeopathy was not the most widely used medical therapy in the country, it nevertheless posed a threat to professional medicine and the School of Medicine's desired monopoly of the field of medicine.

Resumo A homeopatia originária dos EUA adentrou solo peruano nas últimas décadas do século XIX, ampliando o repertório de conhecimento médico existente até então, o qual incluía uma profissão médica em ascensão, herbolários chineses e médicos locais. Este artigo analisa a circulação e o uso de tratamentos e medicamentos homeopáticos em Lima desde o período em que o homeopata norte-americano George Deacon iniciou sua prática, nos anos 1880, até sua morte, em 1915. Embora a homeopatia não fosse o tratamento médico mais disseminada no país, ela representou uma ameaça à medicina profissional e ao monopólio do campo da medicina almejado pela escola tradicional.

Impacto da Reforma Cabanis no ensino médico do Brasil: ensaio de arqueologia neofoucaultiana / The impact of Cabanis reform on medical education in Brazil: an essay in neo-Foucauldian archeology

Resumo O ensaio avalia o impacto da Reforma Cabanis na configuração do modelo de formação em saúde que se tornou hegemônico no Brasil. Primeiro, discute o processo de construção social, ideológica e institucional do modelo de assistência à saúde da França pós-revolucionária. Em seguida, introduz os principais elementos da Reforma Cabanis, analisando aspectos curriculares e pedagógicos da nova proposta de ensino médico baseado em profissionalismo, disciplinaridade e especialização que resultou num sistema de ensino superior sem universidades. Depois avalia o processo histórico que resultou no "afrancesamento" do sistema educacional brasileiro, resultando num modelo de formação em saúde baseado em faculdades, hospitais, aulas, disciplinas, especialidades e diplomas.

Abstract This text assesses the impact of the Cabanis reform on the formation of the health training model which became hegemonic in Brazil. First, we shall briefly discuss the process of constructing the social, ideological, and institutional framework for healthcare in post-revolutionary France. Next the main elements of the Cabanis reform are introduced, analyzing curricular and pedagogical aspects of the new plan for medical education based on professionalism, disciplines, and expertise that resulted in a system of higher education without universities. This is followed by assessment of the historical process which resulted in the "Francization" of the Brazilian educational system, particularly in higher education and more specifically medical education, producing a model of health training based on colleges, hospitals, classrooms, disciplines, skills, and diplomas.

El impacto de la reforma Cabanis en la formación histórica de la universidad argentina y en la educación superior en salud / The impact of the Cabanis reform on the historical formation of the Argentine university and on higher education in health

RESUMEN En este ensayo, proponemos evaluar el impacto de la reforma Cabanis en la configuración del modelo de formación en salud que se hizo hegemónico en Argentina. Primero, analizamos la reestructuración del sistema educacional francés desencadenada por la revolución de 1789, principalmente en sus dimensiones político-institucionales. Segundo, discutimos brevemente el proceso de reconstrucción social, ideológica e institucional del sistema de salud en la Francia postrevolucionaria. Tercero, introducimos la reforma Cabanis, propuesta de enseñanza médica basada en profesionalismo, disciplinariedad y especialización que resultó en un sistema de enseñanza superior sin universidades, e indagamos en torno a sus principales aspectos curriculares y pedagógicos. Finalmente evaluamos la secuencia de eventos y procesos que, durante todo el siglo XIX, con fuerte gravitación cabanisiana a través de la Idéologie, conformaron los rasgos principales tanto de la enseñanza de la salud y de la medicina como del modelo de educación superior basado en facultades que actualmente predomina en la República Argentina.

ABSTRACT In this essay, we seek to evaluate the impact of the Cabanis reform on the configuration of the health education model that became hegemonic in Argentina. First, we analyze the restructuring of the French educational system triggered by the revolution of 1789, primarily in its political and institutional dimensions. Second, we briefly discuss the process of the social, ideological and institutional reconstruction of the health system in post-revolutionary France. Third, we introduce the Cabanis reform, a proposal for medical education based on professionalism, disciplinarity and specialization that resulted in a higher education system without universities, looking into its main curricular and pedagogical aspects. Finally, we evaluate the sequence of events and processes that, throughout the 19th century, with strong Cabanisian influence through the Idéologie, shaped both the principal features of teaching health and medicine and the higher education model based on faculties currently predominant in the Argentine Republic.

Desenmascarando a los impostores: Los médicos profesionales y su lucha contra los falsos médicos en Perú / Unmasking impostors: Professional physicians and their struggle against fake doctors in Peru

RESUMEN La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.

ABSTRACT The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.

Profesor Doctor Aníbal Humberto Daniel Castañé Decoud: un catedrático asunceno de prolongada gestión institucional / Professor Doctor Aníbal Humberto Daniel Castañé Decoud: a paraguayan professor with prolonged institutional management

Así como la memoria institucional permite valorar hechos rescatables y evitar pasados errores, la trayectoria académica, imitando la vida misma, sobrelleva tiempos apacibles y tormentosos. En este contexto, y cercanos al centenario de nuestra Facultad y de las tradicionales Cátedras de Anatomía Normal e Histología y Embriología, fue emprendida la tarea de evocar a quienes asumieron sucesivamente la máxima responsabilidad en esta última desde 1920 hasta mediados de los 70s. De esta manera, este artículo concluye con tal saga biográfica haciendo foco en el Profesor Doctor Aníbal Humberto Daniel Castañé Decoud, el catedrático asunceno quien, merced a su desempeño académico, pudo enfrentar y superar variados desafíos durante su prolongada gestión (AU)

As well as the institutional memory allows appreciating ancient facts and avoiding past faults, the academic trajectory, as life by itself, undergoes calm and turbulent times. Within this context, and close to the centenary of our Faculty and the ensuing traditional Chairs of Normal Anatomy and Histology and Embryology, a remembrance of those professors who successively assumed the highest responsibility in the latter one from 1920 to mid-70s was carried out. In this way, this article concludes that biographic saga focusing on Professor Doctor Aníbal Humberto Daniel Castañé Decoud, the Paraguayan professor who, endowed by his academic background, could face and overcome varied challenges during his prolonged management (AU)

Las dos primeras escuelas argentinas de Cirugía Plástica. Sus comienzos, a través de la mirada de uno de sus protagonistas / The first two argentine schools of Plastic Surgery. Its beginnings, through the look of one of these protagonists

Se relatan los hechos y las personas que influyeron en la creación de las dos primeras escuelas argentinas de cirugía plástica: la de la Universidad del Salvador (USAL) y la de la Sociedad Argentina de Cirugía Plástica - Asociación Médica Argentina (SACPER-AMA). (AU)

The events and people that influenced the creation of the first two Argentine Schools of Plastic Surgery, are explained: one at the University of Salvador (USAL) and the other at the Argentine Society of Plastic Surgery - Argentine Medical Association (SACPER-AMA). (AU)