ABSTRACT
Introducción: Los avances tecnológicos y educativos en ciencias médicas durante los últimos cincuenta años han sido mayores que en toda la historia de la humanidad. Objetivo: Caracterizar la formación del especialista de cirugía general en el mundo en su devenir histórico y actual. Métodos: Se hizo una revisión bibliográfica en las bases de datos CUMED, SciELO, LILACS, Web of Science y PubMed, mediante el motor de búsqueda de información Google Académico. Fueron seleccionados 23 artículos: 19 (82,6 por ciento) del quinquenio 2016-2020, publicados en español e inglés, concernientes al objetivo propuesto, para lo cual se aplicó el método teórico de investigación científica histórico-lógico. Desarrollo: A partir del siglo xix, la evolución de la cirugía en el mundo discurre desde sus limitaciones ocasionadas por el dolor, las infecciones, las hemorragias y el shock hasta el vertiginoso desarrollo de la anestesiología y la reanimación, la asepsia y antisepsia, los novedosos métodos de diagnóstico y tratamiento, la cirugía de trasplante de órganos y tejidos, la cirugía de mínimo acceso, la simulación y la robótica durante el siglo xx y en el presente. Conclusiones: Los avances educativos en la formación profesional durante el período de especialización en cirugía general no marchan al ritmo del desarrollo tecnológico a escala mundial. De ahí surge la necesidad de potenciar al máximo el proceso de enseñanza y aprendizaje de posgrado mediante el desarrollo de estos avances educativos, de manera que no queden a la zaga de los progresos tecnológicos(AU)
Introduction: Technological and educational advances in medical sciences during the last fifty years have been greater than in the entire history of humanity. Objective: To characterize the training of general surgery specialists worldwide considering its historical and current evolution. Methods: A bibliographic review was carried out in the databases CUMED, SciELO, LILACS, Web of Science and PubMed, using the search engine Google Scholar. Twenty-three articles were selected: 19 (82.6 percent) from the five-year period 2016-2020, published in Spanish and English, concerning the set objective, for which the theoretical method of historical-logical scientific research was applied. Development: From the 19th century on, the evolution of surgery worldwide goes from its limitations caused by pain, infections, bleeding and shock to the dizzying development, during the twentieth century and nowadays, of anesthesiology and resuscitation, asepsis and antisepsis, novel methods for diagnosis and treatment, organ and tissue transplant surgery, minimal access surgery, simulation and robotics. Conclusions: Educational advances in professional training during the period of specialization in general surgery do not go in step with technological development on a global scale, hence the need to maximize the postgraduate teaching and learning process through the development of these educational advances, in order for them not to be left behind technological progress(AU)
Subject(s)
Humans , Specialization/history , General Surgery/history , General Surgery/trends , Professional Training , Surgeons/education , Teaching , LearningABSTRACT
Resumo Ao longo século XX, as profundas alterações que ocorreram na Medicina apenas podem ser completamente esclarecidas se forem observadas numa perspectiva histórica, pois elas sempre ocorreram em resposta a influências externas, umas científicas e tecnológicas, outras de ordem social. A moderna Medicina Familiar é uma das muitas disciplinas novas que se desenvolveram durante o curso da história da Medicina e aqui debatemos de forma crítica, os últimos 40 anos dos cuidados primários em saúde em Portugal, começando em 1971, mesmo antes da Declaração de Alma-Ata (1978). Ao longo do percurso, em 2005, surge a Reforma dos Cuidados Primários em Saúde em Portugal e as novas unidades de saúde familiar, que até setembro de 2019 atendiam cerca de 94% dos cidadãos portugueses, ou seja, mais de nove milhões e meio de pessoas. No final dessa trajetória, de forma solidária e voluntária, esta Reforma serviu de inspiração para outra, no Brasil, na cidade do Rio de Janeiro, em 2009. Por fim, apresentamos os desafios apontados na Declaração de Astana de 2018, dentre elas, a questão da força de trabalho nos cuidados de saúde primários, como fator essencial para o desempenho e a sustentabilidade dos sistemas de saúde.
Abstract Throughout the twentieth century, the profound changes that have taken place in Medicine can only be wholly explained if observed from a historical perspective, for they have always occurred in response to external influences, some scientific and technological, others of a social nature. Modern Family Medicine is one of the many new disciplines that have developed during medical history, and we critically discuss the last 40 years of primary health care in Portugal, which started in 1971, long before the Alma-Ata Declaration (1978). Along the way, in 2005, the Primary Health Care Reform emerges in Portugal, along with the new family health facilities, which until September 2019, attended about 94 % of Portuguese citizens, i.e., 9,5 million people. At the end of this course, in solidarity and voluntarily, this Reform inspired another one in Brazil, in Rio de Janeiro, in 2009. Finally, we present the challenges pointed out in the 2018 Astana Declaration, among them, the issue of the workforce in primary health care as an essential factor for the performance and sustainability of health systems.
Subject(s)
Humans , Primary Health Care/history , Health Care Reform/history , Congresses as Topic/history , Family Practice/history , Portugal , Primary Health Care/organization & administration , Specialization/history , Brazil , Global Health , Kazakhstan , Health Care Reform/organization & administration , Community Health Centers/history , Community Health Centers/legislation & jurisprudence , Community Health Centers/organization & administration , Congresses as Topic/organization & administration , Academies and Institutes/history , Academies and Institutes/organization & administration , Europe , Family Practice/organization & administration , National Health Programs/history , National Health Programs/legislation & jurisprudence , National Health Programs/organization & administrationABSTRACT
Resumen Se analiza la constitución de la pediatría como un saber médico especializado en Buenos Aires, entre 1890 y 1920. Se busca mostrar que este proceso resulta de un doble movimiento: la delimitación y caracterización del niño como un particular objeto de conocimiento e intervención y la institucionalización de ciertos médicos como un grupo profesional que procura legitimar su especificidad tanto hacia el interior de la medicina como en el campo social más amplio. Luego de contextualizar socio históricamente las preocupaciones del saber médico acerca de la infancia, se profundiza en el modo en que ésta es construida, así como en el movimiento asociativo y académico que permite a los pediatras constituirse como un grupo de especialistas portadores de un saber experto.
Abstract It analyzes the set-up of pediatrics as a specialized medical field in Buenos Aires, between 1890-1920. The article seeks to demonstrate this process as a result of two movements: the delimitation and characterization of children as a particular object of knowledge and intervention, and the institutionalization of some physicians as a professional group that sought to legitimate their specificity within the medicine field and beyond. After contextualizing socially and historically the concerns of medical knowledge on childhood, it explores with detail how the field was constructed, and the associative and academic movement that allowed pediatricians to constitute themselves as a group of specialists that bear a specific expertise.
Subject(s)
Humans , Child , History, 19th Century , History, 20th Century , Pediatrics/history , Specialization/history , Argentina , CitiesABSTRACT
En el presente artículo se hace referencia histórica a las disposiciones legales de reconocimiento de la formación y titulación de los médicos especialistas en el Perú mediante programas de estudios universitarios, previstos desde el año 1928, que culminaron el año 1973, con la autorización legal de la autoridad pertinente del Estado, de implementar el Programa de Segunda Especialización en Medicina Humana y a otorgar el título de especialista a nombre de la Nación al término de un programa universitario de residentado y capacitación especializada mediante la ômodalidad escolarizadaõ y el reconocimiento universitario de la ômodalidad no escolarizadaõ. En el Perú quedó establecido hasta la actualidad, que los títulos profesionales de especialista en medicina humana a nombre de la nación, tanto en la ômodalidad escolarizadaõ como en la ôno escolarizadaõ solo pueden ser otorgados por las universidades nacionales o privadas autorizadas para esta misión y que, además, ninguna otra institución pública o privada puede arrogarse esta función que corresponde exclusivamente a la universidad peruana...
In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the ôregular modalityõ, and the recognition by the university with the ônon-regular modalityõ. In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine ôin the Name of the Nationõ, both in ôregular modalityõ as well as in ônon-regular modalityõ, can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University...
Subject(s)
Humans , Education, Medical , Specialization , Specialization/history , PeruABSTRACT
Existe una antigua fábula popularizada en un poema escrito por el poema norteamericano John G Saxe en 1860. En él se demuestra como podemos estar equivocados si sustentamos nuestras opiniones con base a una insuficiente evidencia obtenida a través de un inadecuado estudio. Cada uno de los seis ciegos del poema se acercó al elefante para investigar cómo era pero tomando solo una parte aislada del animal. Cada uno se hizo de una solida pero errónea opinión de lo que realmente era un elefante. Discutieron entre sí defendiendo sus impresiones y como Saxe escribiera, "Los ciegos disputan y se querellan: cada uno está seguro de haber hecho bien su prueba...¡Cada uno tiene un poco de razón...y todos están equivocados!". El autor asimila al elefante a un paciente cuya queja es interpretada de manera diferente al ser analizada a través del juicio prejuiciado de diversos especialistas al interpretar fragmentos inconexos del todo indivisible que es el ser humano
There is old Indian fable made popular in a poem written by John G. Saxe in 1860. It demonstrates how we can be so very wrong by basing our opinions on insufficient evidence gained through inadequate studies. Each of the six blind men in the poem walked up to an imposing elephant to investigate what it investigate what it was-but each touched only one part of the animal. Each man had a faulty yet strong opinion of what an elephant was really like and disputed the others with great vigor. As Saxe wrote, "through each was partly in the right, and all were in the wrong! "The author compares the elephant to a patient whose complaint is interpreted differently when analyzed through the prejudiced judgment of various specialist who interpret unconnected fragments of the fully indivisible human being
Subject(s)
Humans , Blindness/pathology , Specialization/history , Intelligence , Internal Medicine/history , Touch Perception/physiology , Poetry as Topic/history , Sensation/physiology , Biology , Data Collection , Elephants , Health Sciences , MedicineABSTRACT
Trata-se de um estudo na perspectiva histórica, tendo como objetivo caracterizar os cursos de especialização em enfermagem pediátrica neonatal das escolas de enfermagem públicas do Estado do Rio de Janeiro (1986 a 1999). As fontes primárias escritas são os relatórios e a legislação dos cursos existentes nos departamentos das escolas de enfermagem e nos acervos históricos das universidades...
Subject(s)
Humans , Infant, Newborn , Child , Education, Nursing, Graduate/history , Pediatric Nursing/history , Specialization/history , Child HealthABSTRACT
Se hace un relato histórico de cómo fue el desarrollo en los sistemas de formación del médico para alcanzar la meta de ser un especialista en el campo de su elección, en las décadas de 1940 hasta 1992, año en el cual se organiza por el Gobierno Nacional el servicio público de la Educación Superior, Ley 30 de 28 de diciembre de 1992.
Historical portrayal of how the formation of higher medical education, post-graduated specialties, developed in Colombia, dating from 1940 until 1992. In 1992 the Colombian government organizes Higher Medical Education by Law N° 30 passed on the 28 of December of 1992. In the article the author expresses how more organized this education may have become it may have lost some of its mystic and ethical vitality.