Modelagem de custeio para mensuração de custos na graduação médica com base em um projeto político-pedagógico de uma instituição pública: estudo metodológico / Cost modeling for cost measurement in medical graduation based on a political-pedagogical project of a public institution: a methodological study

A Constituição da República Federativa do Brasil, de 1988, tem entre seus direitos fundamentais a educação e a saúde, temas sociais que são assegurados às pessoas que se encontram dentro do território nacional. Os tópicos são inseridos no ordenamento jurídico brasileiro através das leis infraconstitucionais, ao longo da sua história. A educação está amparada pelas Diretrizes e Bases da Educação Nacional, que legalizaram o tema em três níveis, entre os quais o nível superior, que se baseia nas Diretrizes Curriculares Nacionais direcionadas às instituições de ensino superior. A promulgação da Lei nº 8.080/1990 criou o Sistema Único de Saúde brasileiro, assegurando a todos o acesso universal e igualitário. A importância dos enunciados requer recursos públicos humanos, materiais, físicos e financeiros na prestação do serviço, alinhados aos elementos básicos necessários ao estudo de custo, o qual se volta para eficiência, eficácia e economicidade, ancorados pelas prerrogativas legais de cunho econômico, financeiro e fiscal. Assim, com a perspectiva de unir os temas educação, saúde e custo, este trabalho teve como questionamento central mensurar o custo da formação em medicina, com base no projeto político-pedagógico de uma instituição de ensino superior. Para responder a essa indagação, a pesquisa objetivou criar uma modelagem de custeio para mensurar o custo da formação acadêmica, através da lógica acadêmica. O trabalho teve características descritivas; qualitativa; de estudo de caso; empírica e dedutiva. A metodologia empregada levantou os instrumentos pedagógicos das escolas públicas federais e algumas estaduais das capitais brasileiras, visando identificar elementos mensuráveis pelo método de custo. Entre os projetos que apresentaram elementos necessários, os dados encontrados no projeto pedagógico da Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro foram utilizados no estudo proposto. A modelagem sugerida quantificou o custo da formação médica de forma lógica segundo as características acadêmicas, dentro do Plano de Periodização da instituição. Concluiu-se que é possível mensurar os custos da formação médica com base nos projetos pedagógicos, aglutinando os recursos disponíveis institucionais consumidos na carga horária das disciplinas.

The 1988 Constitution of the Federative Republic of Brazil has among its fundamental rights education and health, social issues that are guaranteed to people within the national territory. The topics are inserted in the Brazilian legal system by infra-constitutional laws throughout its history. Education is supported by the National Education Guidelines and Bases, which legalized the topic at three levels, including the higher level, is based on the National Curriculum Guidelines aimed at higher education institutions. The enactment of Law no. 8.080/1990 created the Brazilian Unified Health System, ensuring universal and equal access to all. The importance of the statements requires public human, material, physical and financial resources in the provision of the service, which are aligned with the basic elements necessary for the cost study, focusing on efficiency, effectiveness, and economy, anchored by legal prerogatives of an economic, financial, and fiscal nature. Thus, with the perspective of uniting the themes of education, health and cost, the central issue of this work is measuring the cost of training in medicine, based on the political-pedagogical project of a higher education institution. To answer this question, the research aimed to create a costing model to measure the cost of academic training, through academic logic. The work had descriptive; qualitative; case study; empirical and deductive characteristics. The methodology used surveyed the pedagogical instruments of federal public schools and some state schools in Brazilian capitals, aiming to identify measurable elements using the cost method. Among the projects that presented necessary elements, the data found in the pedagogical project of the School of Medical Sciences of Rio de Janeiro State University were used in this study. The suggested modeling quantified the cost of medical training in a logical way according to academic characteristics, following the institution's Periodization Plan. It was concluded that it is possible to measure the costs of medical training based on pedagogical projects, bringing together the available institutional resources consumed in the course load.

Medicine, merit, money and caste: the complexity of medical education in India.

Private medical colleges in India are under the scanner. There is a longstanding debate about the selection methodology that should be followed for admissions in medical colleges. A significant proportion of aspirants are able to afford medical education in private colleges despite not clearing entrance examinations. Others gain entry purely on the basis of caste. Medicine deals with human life and, consequently, there is a widespread feeling that admission criteria in medical schools should be based only on merit as assessed in entrance examinations. This article examines some of these contentious issues.

Recuento histórico Escuela de Medicina de la Universidad de Puerto Rico 1950-2000 / Historical recollection Medical School of the University of Puerto Rico 1950-2000

The School of Medicine of the University of Puerto Rico was founded in 1950 with the mission of educating the much needed physician workforce in order to improve the health of a large portion of the population in Puerto Rico. The main events in its first fifty years of existence are summarized. Emphasis is given to the unique, mutually dependent association between the School of Medicine and the Department of Health of Puerto Rico. Soon after its organization, the school became a principal protagonist in the delivery of specialized medical care to the medically indigent population within the existing Regionalization Program of Health Care services in the island. With the creation and development of various other academic and health services institutions in the island, and the advent of a new system of health care in 1993, based on managed care; the School's interdependence with the Department of Health and its role in the direct care of the medically indigent have waned drastically. The School now faces its greatest challenges as it begins to insert itself into the economically competitive arena of the new health care system; and in redefining its commitments, while searching for new resources, alliances, teaching faculty, hospitals and clinics, enabling it to maintain its leadership in medical education, specialty training and scientific research in Puerto Rico.

Encuesta de profesionalismo de los profesores de medicina en México / Survey on the proffeisonality of medical teachers in Mexico

Objetivo. Se investigó el tipo de preparación académica y de relación laboral que tienen los profesores de escuelas de medicina mexicanos. Métodos. Se consideraron las modalidades de preparación académica como formal e informal, y las de la relación laboral como primaria y secundaria. Se consideró que la relación con la educación médica es profesional cuando fue formal y primaria. Se estudiaron 436 profesores de medicina escogidos al azar en 10 escuelas de medicina en México. Resultados. Sólo el 2.8 por ciento (n=12) tuvo relación profesional con la educación médica. En las escuelas privadas la proporción se redujó a 1.3 por ciento (n=1). Conclusiones. La educación médica constituyó el quehacer profesional de un pequeño número de profesores. La educación médica parece estarse dando como una actividad secundaria e informal de un gran número de docentes

El financiamiento del postítulo: una revisón indispensable en la modernización de la educación superior universitaria en salud / Postgraduate training financing: an essential review in the modernization of university health teaching

Due to social and economical changes in the chilean university and health systems in the last decades, the traditional financing model of the Faculty of Medicine and postgraduate training programs became obsolete. The progressive reduction of the fiscal budget has forced the search of alternate financing sources. The payment of specialization is, at the present moment, an obliged, inappropiate and without compensation subsidy of the universities to the public and private health system, that profite of training professionals and to the specialists that acquire skills that will increase their earnings. Equable financing systems should be stablished in which the direct beneficiaries, institutions or individuals, would pay the expense. A national schoolarship fund or deferred credits seem reasonable alternatives that should be promply established to allow the survival of university postgraduate training programs