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)

La enseñanza de la bioética para el fortalecimiento de la práctica biomédica y la investigación en las escuelas de ciencias de la salud / The Teaching of Bioethics for the Strengthening of Biomedical Practice and Research in Healthcare Sciences Schools / O ensino da bioética para o fortalecimento da prática biomédica e de pesquisa nas escolas de ciências da saúde

Introducción. La UNESCO define la bioética como el estudio sistemático, pluralista e interdisciplinario, para resolver los problemas éticos planteados por la medicina, las ciencias sociales y de la vida, comprendiendo lo relativo a los adelantos científicos aplicados a seres humanos y su relación con la biósfera. La UNESCO, asistida por un comité internacional de expertos, presentó en el 2016 el plan de estudios básico de bioética "The Bioethics Core Curriculum", orientado a fortalecer su enseñanza en ambientes universitarios. El objetivoprincipal de este manuscrito fue identificar los referentes conceptuales y los esfuerzos multilaterales para la inclusión de la bioética en los currículos, señalando su pertinencia para el mejoramiento continuo, el fortalecimiento de la enseñanza y la investigación en las ciencias biomédicas. Temas de reflexión. Referentes conceptuales vigentes, esfuerzos multilaterales en la enseñanza de la bioética, política nacional de ética de la investigación, bioética e integridad científica. Conclusiones. La bioética, como ciencia de la supervivencia, es un pilar fundamental para la práctica de las ciencias biomédicas. Es evidente la necesidad de formar y preparar de manera adecuada a los futuros profesionales, líderes de opinión, académicos, investigadores, políticos y tomadores de decisiones en aspectos bioéticos, con el propósito de mejorar y fortalecer la formulación de referentes bioéticos en la práctica biomédica y la investigación en ciencias de la salud.

Introduction. UNESCO defines bioethics as the systematic, pluralist, and interdisciplinary study to resolve the ethical problems posed by medicine, social sciences, and life, understanding matters related to scientific progress applied to human beings and their relationship with the biosphere. In 2016, UNESCO, aided by an international committee of experts, presented "The Bioethics Core Curriculum", aimed at strengthening its teaching in universities environment. The main objective of this manuscript was to identify the conceptual references and multilateral efforts for the inclusion of bioethics in curricula, indicating their relevance for continuous improvement, strengthening of teaching, and research in biomedical sciences. Topics of reflection. Current conceptual references, multilateral efforts in bioethics teaching, national research ethics, bioethics, and scientific integrity policy. Conclusions. Bioethics, as a survival science, is a fundamental pillar for the practice of biomedical sciences. The need to educate and adequately prepare future professionals, opinion leaders, academics, researchers, politicians, and decision makers in aspects of bioethics is obvious, in order to improve and strengthen the formulation of bioethical references in biomedical practice and research in healthcare sciences

Introdução. A UNESCO define bioética como o estudo sistemático, pluralista e interdisciplinar para resolver os problemas éticos colocados pela medicina, ciências sociais e da vida, incluindo questões relacionadas aos avanços científicos aplicados ao ser humano e sua relação com a biosfera. A UNESCO, auxiliada por um comitê internacional de especialistas, apresentou em 2016 o currículo básico de bioética "The Bioethics Core Curriculum", visando fortalecer seu ensino em ambientes universitários. O objetivo principal deste manuscrito foi identificar as referências conceituais e os esforços multilaterais para a inclusão da bioética nos currículos, apontando sua relevância para a melhoria contínua, fortalecimento do ensino e da pesquisa em ciências biomédicas. Tópicos de reflexão. Referências conceituais atuais, esforços multilaterais no ensino de bioética, política nacional de ética em pesquisa, bioética e integridade científica. Conclusões. A bioética, como ciência da sobrevivência, é um pilar fundamental para a prática das ciências biomédicas. Fica evidente a necessidade de formar e preparar adequadamente futuros profissionais, formadores de opinião, acadêmicos, pesquisadores, políticos e tomadores de decisão em aspectos bioéticos, com o objetivo de melhorar e fortalecer a formulação de referências bioéticas na prática biomédica e na pesquisa em ciências da saúde.

Luisa Francisca Acosta Ortega. Liderazgo con nombre de mujer / Luisa Francisca Acosta Ortega. Lidership with a woman´s name

En este artículo se resaltan las cualidades humanas y otros aspectos de la vida de quien fuera Vicedecana Académica de la Facultad de Estomatología y posteriormente Directora del Centro Provincial de Información de Ciencias Médicas de Santiago de Cuba, en el período de abril del 2014 hasta abril del 2022. Se destacan los logros alcanzados a lo largo de su quehacer, desde que inició en la Universidad Médica hasta nuestros días, así como su valioso aporte a la docencia y a la formación de diversos grupos de educandos, además, se realzan los avances alcanzados en la revista MEDISAN en su etapa de Directora del Centro de Información hasta el día de su feliz jubilación.

The human qualities and some other aspects of the life of the Academic Vice-dean of the Estomatological Faculty and then the Head of the Provincial Information Center of Medical Sciences from Santiago de Cuba are highlighted in this work, in the period from April, 2014 to the same month in 2022.The achievements reached during her working life, since she began in the Medical University up to the present, as well as her valuable dedication to the teaching and training of different groups of students are presented, besides compiling achievements in journal MEDISAN during her leadership as Director of the Provincial Information Center up to the day of her happy retirement.

Hampering behaviors in a pioneer argentinean PBL medical curricular change / Conductas obstaculizadoras en un cambio curricular médico PBL argentino pionero

This communication records a series of obstructive behaviors not specified bibliographically detected in planners and/or executors from 2002 in a pioneering Argentine PBL medical curricular change. The results obtained were extracted mainly from the author's experience during his participation as a teacher in this process and from some related experiences recorded later in other Argentine medical schools that also develop curricular changes. In addition, he points to other design and implementation caveats not considered in a timely manner that negatively influenced that transformation. To date, unfortunately, all of this has contributed to the failure to meet the great expectations placed on it. This report may be useful for planners and implementers who pursue a successful PBL curriculum change by showing that, beyond the best intentions in this regard, particular behaviors, some of them linked to the human condition, can hinder its design and implementation. practice.

Esta comunicación registra una serie de conductas obstaculizadoras no especificadas bibliográficamente detectadas en planificadores y/o ejecutores a partir de 2002 en un cambio curricular médico PBL argentino pionero. Los resultados obtenidos se extrajeron principalmente de la experiencia del autor durante su participación como docente en este proceso y de algunas experiencias relacionadas registradas posteriormente en otras facultades de medicina argentinas que también desarrollan cambios curriculares. Además, señala otras advertencias de diseño e implementación no consideradas de manera oportuna que influyeron negativamente en esa transformación. Hasta la fecha, lamentablemente todo ello ha contribuido a que no se alcancen las grandes expectativas puestas en él. Este informe puede resultar útil para los planificadores e implementadores que persiguen un cambio curricular exitoso del ABP al evidenciar que, más allá de las mejores intenciones al respecto, comportamientos particulares, algunos de ellos vinculados a la condición humana, pueden dificultar su diseño y puesta en práctica.

Integração ensino-serviço na implantação de um curso de medicina no Paraná / Implementation of mental health care with the CIHP approach in primary care

Integrar o ensino de medicina e a rede municipal de saúde, segundo inúmeros estudos, contribui para a melhoria da formação médica e da assistência à saúde da comunidade atendida. O presente estudo analisou a integração ensino-serviço na Atenção Primária à Saúde (APS) entre o curso de medicina do Campus Toledo da Universidade Federal do Paraná (UFPR) e a Secretaria Municipal de Saúde (SMS) de Toledo, também no Paraná. Foram realizadas doze entrevistas semiestruturadas com participantes da gestão municipal, coordenação do curso de medicina de Toledo, estudantes de medicina, professores que têm aulas práticas na APS e profissionais de saúde da APS que recebem alunos. A hermenêutica foi utilizada na análise dos dados. Entre as dificuldades apontadas observou-se: estrutura física inadequada das Unidades Básicas de Saúde (UBS), comunicação parcial entre a SMS e a universidade, falta de um Contrato Organizativo de Ação Pública de Ensino-Saúde (COAPES) pactuado etc. Como sugestões para a melhoria do processo de integração, destacaram-se a capacitação da equipe de saúde e o planejamento da infraestrutura física.

Integrating medical education and the municipal health network, according to numerous studies, contributes to improving medical training and health care in the community served. This study analyzed the teaching-service integration in primary health care (PHC) between the medical course at the Toledo Campus of the Federal University of Paraná (UFPR) and the Municipal Health Department (SMS) of Toledo, PR. Twelve semi-structured interviews were carried out with participants from the municipal administration, the coordination of the Toledo medicine course, medicine students, teachers who teach practical classes at PHC, and health professionals from PHC who receive students. Hermeneutics was used in the data analysis. Among the difficulties pointed out, it was observed: the inadequate physical structure of the Basic Health Units (UBS), partial communication between the SMS and the university, thelack of an Organizational Contract for Public Education-Health Action (COAPES) agreed upon, etc. As suggestions for improving the integration process, the training of the health team and the planning of the physical infrastructure were highlighted.

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 docencia médica en Santiago de Cuba a 60 años de su fundación / Medical teaching in Santiago de Cuba after 60 years of its foundation

La formación integral de los profesionales con elevada preparación científico-técnica y humanística ha sido el principal objetivo de los centros de educación médica en Cuba. La Universidad de Ciencias Médicas de Santiago de Cuba ha trabajado para cumplir con este propósito a lo largo de todos estos años en correspondencia con el mo delo del profesional que precisa nuestra sociedad, donde la dimensión socio-humanista, la formación cultural y de valores constituyen pilares en este proceso formativo. La presente propuesta tiene el propósito de dirigir la mirada a diferentes aristas relacionadas con este tema a los 60 años de fundada la docencia médica en Santiago de Cuba.

The comprehensive training of professionals with a high scientific, technical and humanistic level has been the main objective of the medical education institutions in Cuba. The Medical University in Santiago de Cuba has been working to fulfil this purpose through all these years according to the professional model necessary for our society in which the social and humanistic feature, the cultural and values training are the key stone in this process. This proposal has the aim of taking a glance towards different topics related to this event, after 60 years of the medical teaching in Santiago de Cuba.

Prevalence of COVID-19 in medical school and residency in Porto Alegre, RS

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.

Financial burden and financial aid for medical students in Singapore: a national survey across all three medical schools

INTRODUCTION@#Singapore has had three medical schools since 2013. We undertook a cross-sectional quantitative national survey to determine the financial impact of medical education on medical students in Singapore.@*METHODS@#All 1,829 medical students in Singapore were invited to participate in this study. Information on demographics, financial aid utilisation and outside work was collected and analysed.@*RESULTS@#1,241 (67.9%) of 1,829 students participated in the survey. While the overall proportion of students from households with monthly incomes < SGD 3,000 was only 21.2% compared to the national figure of 31.4%, 85.4% of medical students expected to graduate with debts > SGD 75,000. There were significant differences in per capita incomes among the schools, with 54.5%, 23.3% and 7.8% of Duke-NUS Medical School (Duke-NUS), NUS Yong Loo Lin School of Medicine (NUS Medicine) and Lee Kong Chian School of Medicine (LKCMedicine) students, respectively, reporting a per capita income of < SGD 1,000 (p < 0.001). There were significant differences in financial support: 75.0%, 34.1% and 38.8% of Duke-NUS, NUS Medicine and LKCMedicine students, respectively, received financial aid (p < 0.001). The top reasons for not applying for aid included a troublesome application process (21.4%) and the perception that it would be too difficult to obtain (21.0%).@*CONCLUSION@#Students in the three medical schools in Singapore differ in their financial needs and levels of financial support received. A national approach to funding medical education may be needed to ensure that financial burdens do not hamper the optimal training of doctors for Singapore's future.

La lucha antimicrobiana: Desarrollo de competencias en 6 universidades ecuatorianas / The antimicrobial fight: Development of skills in 6 Ecuadorian universities

Los microorganismos son seres vivos, que han ido adaptándose y evolucionando permitiendo su supervivencia, evadiendo las respuesta innata de los hospedadores e incluso modificando sus estructuras biológicas antes moléculas farmacológicas, que se han, en los últimos años, empleado de manera inadecuadas, bien sea por abuso o por deficiencia en el cumplimiento del esquema del tratamiento, o desaciertos para tratar un germen en específico y, como consecuencia, la actual crisis mundial por la resistencia a los antimicrobianos; considerado un problema de salud pública, requiere de esfuerzos multisectoriales e integrales que aporten soluciones mediatas, a corto y mediano plazo, sostenibles en el tiempo. Para ellos, es clave la formación de los nuevos profesionales, en el área de microbiología, de las diferentes carreras biomédicas. Es por ello, el presente estudio identificó las competencias que deben desarrollar los estudiantes, de seis universidades ecuatorianas. Se aplicaron cuestionarios, inquiriendo la importancia atribuida y el grado de desarrollo percibido de cada competencia mediante escala tipo Likert, además de seis dimensiones distribuidas en 40 indicadores. Se identificó mayor desarrollo de competencias en la identificación del patógeno, diagnóstico y análisis e interpretación de los resultados; además las seis dimensiones educativas fueron clasificadas como relevantes. Sin embargo, los resultados sugieren falencia en el desarrollo de competencias en la temática de resistencia antimicrobiana, por lo que se sugiere la revisión de los contenidos programáticos y aplicar nuevas herramientas pedagógicas que permitan al estudiantado aprender a aprender, aplicando un modelo socio-critico, y como base la investigación y el conocimiento científico actualizado(AU)

Microorganisms are living beings, which have been adapting and evolving allowing their survival, evading the innate response of the hosts and even modifying their biological structures before pharmacological molecules, which have, in recent years, been used inappropriately, either by abuse or deficiency in compliance with the treatment scheme, or failure to treat a specific germ and, as a consequence, the current global crisis due to antimicrobial resistance; considered a public health problem, it requires multisectoral and comprehensive efforts that provide immediate, short- and medium-term solutions that are sustainable over time. For them, the training of new professionals in the area of microbiology, of the different biomedical careers, is key. For this reason, this study identified the skills that students from six Ecuadorian universities should develop. Questionnaires were applied, inquiring about the importance attributed and the perceived degree of development of each competency using a Likert-type scale, in addition to six dimensions distributed in 40 indicators. Greater development of skills in the identification of the pathogen, diagnosis and analysis and interpretation of the results was identified; In addition, the six educational dimensions were classified as relevant. However, the results suggest a lack in the development of skills in the subject of antimicrobial resistance, so it is suggested to review the program contents and apply new pedagogical tools that allow students to learn to learn, applying a socio-critical model, and as a basis research and updated scientific knowledge(AU)

Logros y producción académica de la Escuela de Nutrición y Dietética. Universidad de los Andes. Venezuela / Achievements and academic production of the School of Nutrition and Dietetics. Universidad de los Andes. Venezuela

La carrera de Nutrición y Dietética hoy en día cuenta con un auge e importancia transcendental que radica fundamentalmente en la prevención, educación y atención de los problemas relacionados con la salud y la nutrición. Su objetivo es formar académicamente a los profesionales con un perfil que responda a las necesidades alimentarias y nutricionales de las personas desde una perspectiva integral. Se presenta una revisión de la historia, logros y producción académica de la Escuela de Nutrición y Dietética de la Universidad de Los Andes (ULA), desde su fundación en 1971 hasta el presente. La metodología utilizada fue la revisión de los archivos históricos de la Facultad de Medicina y entrevistas a los docentes. La transformación académica y administrativa ha permitido egresar 1600 profesionales y estudios de 4t0 nivel en la Especialización Nutrición Clínica. Su prestigiosa planta profesoral ha cristalizado, productos y proyectos tangibles, merecedores de distinciones y reconocimientos nacionales e internacionales. La Escuela de Nutrición y Dietética de la ULA es reconocida como una Institución Académica, de alta calidad con gran proyección al servicio de la humanidad y crecimiento profesional de la nutrición en el país(AU)

The Nutrition and Dietetics career today has a boom and transcendental importance that lies fundamentally in the prevention, education and care of problems related to health and nutrition. Its objective is to academically train professionals with a profile that responds to the food and nutritional needs of people from a comprehensive perspective. A review of the history, achievements and academic production of the School of Nutrition and Dietetics of the Universidad de Los Andes (ULA) is presented, from its foundation in 1971 to the present. The methodology used was the review of the historical archives of the Faculty of Medicine and several interviews with the professors. The academic and administrative transformation has allowed 1,600 professionals to graduate. The School of Nutrition and Dietetics offers 4th level studies in Clinical Nutrition Specialization and counts with a prestigious teaching staff that has crystallized tangible products and projects, deserving of national and international distinctions and recognitions. The School of Nutrition and Dietetics of the ULA is recognized as a high-quality Academic Institution with great projection at the service of humanity and professional growth of nutrition in the country(AU)

Financeirização e oligopolização das instituições privadas de ensino no Brasil: o caso das escolas médicas / Financialization and oligopolization of private teaching institutions in Brazil: the case of medical schools / Financiarización y oligopolización de las instituciones privadas de enseñanza en Brasil: el caso de las escuelas médicas

O contexto do artigo é a tendência global de aumento da participação do setor privado na formação de profissionais de saúde fortemente influenciada por políticas públicas. No Brasil, os cursos médicos privados se desenvolveram e expandiram com financiamentos governamentais e, recentemente, com o apoio do Programa Mais Médicos. O objetivo foi descrever e analisar os movimentos de reconfiguração empresarial do setor educacional com tendências de oligopolização e financeirização relacionadas à expansão recente do Ensino Médico no Brasil. Realizou-se abordagem qualiquantitativa, exploratória e descritiva associada a várias estratégias metodológicas, a fim de superar as limitações de acesso às informações, com coleta de dados em bases secundárias de acesso público. O setor privado é responsável pela oferta de 60% dos cursos e de 69% das vagas de medicina, das quais cerca de 31% são ofertadas por dez grupos educacionais. Nos grupos estudados destacam-se: dinamicidade do mercado educacional; mecanismos de financeirização e concentração; formação de oligopólio na oferta de Ensino Superior, em particular da formação médica. Tendência de concentração da oferta em instituições de Ensino Superior privadas desde os anos 2000. Similaridade dos maiores grupos nas estratégias de gestão, ampliação da participação no mercado, conformação do quadro de sócios, diversificação dos negócios e captação de investidores e capital financeiro. Programas governamentais, como o Programa Mais Médicos, contribuíram para a expansão e tendência de concentração do setor educacional privado com repasses de recursos públicos ou antecipação dos recursos. Tendência à oligopolização e à financeirização.

There is a global trend towards the private sector's growing participation in training healthcare professionals, influenced by public policies. In Brazil, private medical schools have developed and expanded with government financing, more recently with support from the More Doctors Program. The study aimed to describe and analyze movements in the corporate reconfiguration of the educational sector, with trends towards oligopolization and financialization related to the recent expansion of medical education in Brazil. An exploratory qualitative and quantitative approach was used, associated with various methodological strategies, to overcome the limitations in access to information, with data collection from open-access secondary databases. The private sector now accounts for 60% of the course supply and 69% of enrollment in medicine, 31% of which is supplied by ten educational groups. The groups studied here highlight the dynamic educational market, mechanisms of financialization and concentration, and formation of an oligopoly in the supply of higher education, particularly in medical training. There has been a trend towards concentration of the supply of institutions of higher learning since 2000. The largest groups employ similar management strategies, expansion of their market share, shareholder format, business diversification, and uptake of investors and financial capital. Government programs like the More Doctors Program helped expand and concentrate the private educational sector with government transfers or advance financing. The trend has been towards oligopolization and financialization.

Tendencia global de aumento de la participación del sector privado en la formación de profesionales de salud, fuertemente influenciada por políticas públicas. En Brasil, los cursos médicos privados se desarrollaron y expandieron con la financiación gubernamental y, recientemente, con el apoyo del Programa Más Médicos. El objetivo fue describir y analizar los movimientos de reconfiguración empresarial del sector educacional con tendencias de oligopolización y financiarización, relacionados con la expansión reciente de la enseñanza médica en Brasil. Abordaje cualicuantitativo, exploratorio y descriptivo, asociado a varias estrategias metodológicas, con el fin de superar las limitaciones de acceso a la información, con recogida de datos en bases secundarias de acceso público. El sector privado es responsable de la oferta de un 60% de los cursos y de un 69% de las plazas de medicina, de las cuales cerca de un 31% se ofertan por parte de diez grupos educacionales. En los grupos estudiados se destacan: dinamicidad del mercado educacional; mecanismos de financiarización y concentración; formación de oligopolio en la oferta de enseñanza superior, en particular de la formación médica. Tendencia de concentración de la oferta en instituciones de educación superior privados desde el año 2000. Similitud de los mayores grupos en las estrategias de gestión, ampliación de la participación en el mercado, conformación del esquema de socios, diversificación de los negocios, así como la captación de inversores y capital financiero. Programas gubernamentales, como el Programa Más Médicos, contribuyeron a la expansión y tendencia de concentración del sector educacional privado con la transferencia de recursos públicos o anticipación de los mismos. Tendencia a la oligopolización y la financiarización.

A medicina contemporânea pode fazer mal para os pacientes? / Can contemporary medicine damage patients?

O equilíbrio que o senso comum permite pode ser a resposta para que a interferência da ciência não incorra em transformação da ação médica, processo semelhante ao que ocorre em uma linha de montagem de uma fábrica. É preciso combinar ciência e arte, objetividade e subjetividade, em que a compaixão constitua a essência de toda a relação humana, princípio da medicina e necessária para que a prática médica conspire em busca do bem-estar que todos almejam e merecem.

The balance that the common sense allows can be the answer so that the necessary interference of science does not incur in the transformation of the medical action in the same process that occurs in an assembly line of a factory. It is necessary to combine science and art, objectivity and subjectivity, in which compassion constitutes the essence of the whole human relationship, the principle of medicine and necessary for medical practice to conspire in search of the well-being that everyone desires and desires.

Tendencias históricas en el proceso de dirección académica de la Facultad de Medicina No. 1 de Santiago de Cuba / Historical tendencies in the academic direction process of the Medicine Faculty No. 1 from Santiago de Cuba

El proceso de dirección académica de la Facultad de Medicina No. 1 de Santiago de Cuba, tuvo sus cimientos en el contexto de la Universidad de Oriente en 1962. Desde su fundación se ha concebido para redimensionar la academia, a tono con los problemas de salud de la población. Lo anterior posibilitó constatar, mediante la revisión de distintas publicaciones relacionadas con historia de la medicina, la carencia de estudios que analicen la dirección académica en la estructura de la facultad, como proceso integral e integrado, por lo cual se realizó el presente estudio con el objetivo de caracterizar las tendencias que distinguen el desarrollo de la dirección académica en el contexto educativo enunciado. Al respecto, se determinan los fundamentos que sustentan la necesidad de su perfeccionamiento. Se concluye, que se requiere de una gestión científico-metodológica pertinente, que impacte el entorno santiaguero, para satisfacer los problemáticas esenciales de salud, climáticas y sociales.

The process of academic direction of the Medicine Faculty No. 1 from Santiago de Cuba, had its foundations in the context of Oriente University in 1962. Since its foundation it has been conceived to resize the academy, according to the population health problems. The above-mentioned facilitated to verify, by means of the revision of different publications related to the history of medicine, the lack of studies that analyze the academic direction in the faculty structure, as integral and integrated process, reason why the present study was carried out aimed at characterizing the tendencies that distinguish the development of the academic direction in the enunciated educational context. In this respect, the foundations that sustain the necessity of its improvement are determined. It was concluded that a pertinent scientific-methodological administration that impacts the Santiago environment is required to satisfy the essential health, climatic and social problems.

Afrontamiento a la muerte en estudiantes de medicina del Paraguay en agosto 2021: estudio multicéntrico / Coping with death in Paraguayan medical students in August 2021: a multicenter study

RESUMEN Introducción: el afrontamiento a la muerte constituye una de las situaciones más difíciles y estresantes a las que se tienen que enfrentar los estudiantes de medicina por el contacto cercano a pacientes en riesgo vital. Objetivos: determinar el nivel de afrontamiento a la muerte en estudiantes de medicina. Metodología: se aplicó diseño con enfoque cuantitativo, de tipo observacional, transversal, multicéntrico. Se incluyó a estudiantes de medicina del Paraguay, de ambos sexos, en agosto 2021, que aceptaban participar del estudio. Se utilizó un cuestionario telemático. Se midieron variables sociodemográficas. El nivel de afrontamiento se determinó con la escala de Bugen. La investigación fue aprobada por Comité de Ética de la Universidad Privada del Este, Asunción. Resultados: se incluyeron 504 estudiantes, siendo del sexo femenino en 74 % y con edad media 22 ± 4 años. El 88 % de los encuestados eran de nacionalidad paraguaya (88 %) y 73 % de religión católica. La mayoría nació en Paraguay (88 %), era católica (73 %), se hallaba inscripta como donante de órganos (60 %) y tenía antecedente reciente de muerte de un familiar o amigo (76 %). La escala de Bugen detectó bajo nivel de afrontamiento a la muerte en 50 %, siendo 52 % en las mujeres y 42 % en los varones (p <0,05). Conclusión: el afrontamiento a la muerte en estudiantes de medicina fue bajo. Se sugiere incluir cursos, talleres y planes formativos dentro de las asignaturas o como actividades de extensión para mejorar ese aspecto en el currículo de las facultades de medicina del Paraguay.

ABSTRACT Introduction: coping with death is one of the most difficult tasks that medical students have to face. Objectives: to determine the level of coping with death in medical students. Methodology: we conducted an observational, cross-sectional, multicenter study. We included men and women, medical students from public and private universities from Paraguay in 2021, who agreed to participate in the study. A telematic questionnaire was used. Sociodemographic variables were measured. The level of coping was determined with the Bugen scale. The research was approved by the Comité de Ética of the Universidad Privada del Este, Asunción. Results: 504 students were included, 74 % being female and with a mean age of 22 ± 4 years. Most were born in Paraguay (88 %), were Catholic (73 %), registered as an organ donor (60 %), and had a recent history of the death of a family member or friend (76 %). The Bugen scale detected a low level of coping with death in 52 % of the women and 42 % of the men (p <0.05). Conclusion: coping with death in medical students was low. It is suggested to include courses or workshops to improve this aspect in the curriculum of the medical schools of Paraguay.

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).

Doctor Carlos Manuel Miyares Cao, paradigma de médico / Dr. Carlos Manuel Miyares Cao, an example of an outstanding doctor

José Martí sentenció: "Saberse sacrificar es el precio del éxito durable en todo", y con grandes sacrificios y éxitos en su vida laboral se resume la obra del Dr. Carlos Manuel Miyares Cao, un médico excepcional que supo vincular sus responsabilidades administrativas con la investigación y desarrollo, y la asistencia médica. Incansable luchador por los avances de la Medicina, gestor de la Escuela Cubana de Farmacología, representa un gran ejemplo para los médicos cubanos y de Latinoamérica. Durante su vida estudiantil, colaboró de forma destacada en las actividades que se desarrollaban en la época, siendo fundador de las milicias revolucionarias. Miyares Cao fue uno de los estudiantes de Medicina, fundador integrante de la Milicia Universitaria José Antonio Echeverría, quien con la simbólica camisa rojo vino, pantalón gris y boina negra, desfilaría el 27 de noviembre de 1959 desde la Universidad hasta la explanada de La Punta para rendir tributo a los 8 estudiantes de Medicina, y al decir de él, uno de sus más fraternales compañeros de estudios: ;lo recuerdo muy claro, alto, que por su estatura iba entre las filas finales, con su rifle y marchando con marcada disciplina, tal cual fue en su vida", con sus palabras reflejó los preceptos conceptuales que connotaron su existencia". El Dr. Miyares fue nombrado entre los primeros Instructores no graduados en la cátedra de Farmacología de la Facultad de Medicina de la Universidad de La Habana, tras la renuncia de los profesores universitarios. Asimismo, fundador de la AJR (Asociación Jóvenes Rebeldes) y Unión de Jóvenes Comunistas (UJC universitaria). Tuvo el privilegio de ser de los primeros egresados de la Revolución y su graduación, presidida, en el oriental Pico Turquino, por Fidel Castro, en 1965(AU)

José Martí said: "Knowing how to sacrifice is the price of lasting success for everything". The working life of Dr. Carlos Manuel Miyares Cao is summed up in great sacrifice and success. He was an outstanding doctor who knew how to link his administrative responsibilities to research and development and medical care. As a tireless fighter for the advances of medicine, he was the founder of the Cuban School of Pharmacology and a notable example for Cuban and Latin American doctors. During his student life, he collaborated with important activities that took place at his time, being founder of the revolutionary militias. During his medical studies, he was a founder member of the University Militias "José Antonio Echeverría". Wearing the symbolic red wine shirt, gray pants and black beret, he paraded on November 27, 1959 from the university to the Punta esplanade to pay tribute to the 8 medical students. One of his most fraternal fellow students says, "... I remember him very clearly; he was tall and because of his height he was among the ranks of the final lines; with his rifle he used to march with the discipline that characterized him during all his life." With his words, he illustrated the principles and convictions that marked his existence. After the resignation of university professors, Dr. Miyares was appointed among the first undergraduate Pharmacy instructors at the Department of Pharmacology of the School of Medicine of the University of Havana. He was also the founder of the AJR (Association of Young Rebels) and the UJC (Union of Young Communists) in the university. He had the privilege to be one of the first graduates after de triumph of the Revolution. His graduation, which was held at Pico Turquino in eastern Cuba, was presided by Fidel Castro in 1965(AU)