Internato de Saúde Mental para alunos de Medicina: qual o melhor cenário de formação? / Internado de Salud Mental para alumnos de Medicina: ¿ cuál es el mejor escenario de formación? / Mental Health Internship for Medical students: which is the best training setting?

As Diretrizes Curriculares do curso de graduação em Medicina de 2014 incluem a Saúde Mental (SM) como uma das áreas obrigatórias do internato. O objetivo deste trabalho é apresentar o internato integrado de SM e de Medicina de Família e Comunidade (MFC) da Universidade Federal do Rio de Janeiro (UFRJ) e a fundamentação da escolha da Atenção Primária à Saúde (APS) como cenário de formação dos internos. Trata-se do relato da experiência do internato integrado de SM e MFC da UFRJ e da discussão de seus marcos teóricos. A alta prevalência de sofrimento psíquico e transtornos mentais na APS, o fato de ela ser a porta de entrada do Sistema Único de Saúde (SUS) e o fato de que a faculdade de Medicina deve formar médicos generalistas fazem deste cenário lócus privilegiado para o treinamento dos internos de Medicina em SM.(AU)

Las Directrices Curriculares del Curso de Graduación en Medicina de Curso de 2014 incluyen la salud mental (SM) como una de las áreas obligatorias del internado. El objetivo de este trabajo es presentar el internado integrado de SM y Medicina de Familia y Comunidad (MFC) de la UFRJ y la fundamentación de la Escuela de Atención Primaria de la Salud (APS) como escenario de formación de los internos. Se trata del relato del internado integrado de SM y MFC de la UFRJ y de la discusión de sus marcos teóricos. La alta prevalencia de sufrimiento psíquico y trastornos mentales en la APS, el hecho de que la APS es la puerta de entrada del sistema único de salud (SUS) y el hecho de que la facultad de medicina debe formar a médicos generalistas, hace que este escenario sea un locus privilegiado para el entrenamiento de los internos de medicina en salud mental.(AU)

The 2014 Curricular Guidelines of the medical undergraduate courses include Mental Health (MH) as one of the required areas of internship. The objective of this paper is to present the integrated internship for MH and Family and Community Medicine (FCM) of UFRJ, as well as the rationale for choosing Primary Health Care (PHC) as the setting for the internship training. It presents a report of the experience of the integrated internship for MH and FCM of UFRJ and the discussion of its theoretical frameworks. The high prevalence of psychological distress and mental disorders in PHC, the fact that PHC is the gateway to the unified national health system (SUS) and the fact that the medical school must train general practitioners, make PHC a privileged locus for the training of medical interns in mental health.(AU)

Tempo do Brasil traduzir para a prática o currículo Médico Baseado em Competência por meio de Atividades Profissionais Confiáveis (APCs) / Tiempo de Brasil traducir a la práctica el Currículo Médico Basado en Competencia por medio de Actividades Profesionales Confiables (APCs) / The time has come for Brazil: translating Competence Based Medical Education into practice by Entrustable Professional Activities (EPAs)

As competências médicas apresentadas pelas Diretrizes Curriculares Nacionais (DCN) e as políticas de incentivo à formação de mais médicos popularizaram temas como aprendizado ativo e competência. Distorções na implementação curricular resultaram em abordagens fragmentadas e reprodutivas das práticas com distanciamento do processo de trabalho. Vários países ocidentais, ao buscarem o aprimoramento da Educação Médica Baseada em Competência, adotaram as Atividades Profissionais Confiáveis (APCs) na tradução bem-sucedida desse referencial para a prática clínica. Este estudo perspectivo apresenta as APCs no âmbito da educação médica brasileira como possível solução para a melhor efetivação do Currículo Médico Baseado em Competência (CMBC). O estudo descreve as APCs, de seu conceito à realização; provê subsídios para seu entendimento e análise de sua capacidade em mediar uma formação médica mais qualificada e responsiva às necessidades de saúde locais; e contribui com a literatura brasileira na área.(AU)

Las competencias médicas presentadas por las Directrices Curriculares Nacionales y las políticas de incentivo a la formación de más médicos popularizaron temas tales como aprendizaje activo y competencia. Distorsiones en la implementación curricular resultaron en abordajes fragmentados y reproductivos de las prácticas con distanciamiento del proceso de trabajo. Diversos países occidentales, al buscar el perfeccionamiento de la Educación Médica Basada en Competencia, adoptaron las Actividades Profesionales Confiables (APCs) en la traducción exitosa de esas referencias a la práctica clínica. Este estudio perspectivo presenta las APCs en el ámbito de la educación médica brasileña, como posible solución para la mejor efectuación del Currículo Médico Basado en Competencia (CMBC). El estudio describe las APCs, desde su concepto hasta su realización, proporciona subsidios para su entendimiento y análisis de su capacidad para mediar una formación médica más calificada y responsiva a las necesidades de salud local y contribuye con la literatura brasileña en el área..(AU)

The medical competencies presented by the National Curriculum Guidelines and the policies to encourage the education of more physicians have popularized themes such as competence and active learning. Distortions in the curricular implementation resulted in a fragmented and reproductive approach of the practices distancing them of the work process. Several Western countries seeking improvement of the Competence-Based Medical Education (CBME), have recently adopted the concept of Entrustable Professional Activities (EPAs) to better translate this benchmark into clinical practice. This article presents the EPAs for Brazilian medical education as a possible solution for CBME accomplishment. The study explores the EPAs, from their concept to their realization. It aims to provide insights for their understanding and analysis of their capacity as a mediator for more qualified training and more responsivity to local health needs, contributing to the literature in the area..(AU)

Características generales de la educación médica en México. Una mirada desde las escuelas de medicina / General characteristics of medical education in Mexico. A look from medical schools

Resumen: Objetivo: Conocer las características de la educación médica e identificar sus fortalezas y debilidades. Material y métodos: Se realizó un estudio transversal y cuantitativo para conocer las características de la educación médica en 29 escuelas de medicina en México, entre abril y septiembre de 2017. Se utilizó un cuestionario con escala tipo Likert para explorar el contexto, la regulación, la estructura, el proceso, los resultados y el impacto de la educación médica. Se realizó un análisis bivariado con ji cuadrada y una significancia estadística depigual o menor a 0.05. Resultados: El contexto político obtuvo 64%, el contexto económico 10%, los mecanismos de regulación 31%, la estructura educativa 61% y el impacto social 93%. Conclusiones: Se requiere fortalecer las políticas públicas, la regulación y la inversión pública, para mejorar la calidad de la educación médica.

Abstract: Objective: To know the characteristics of medical education and identify its strengths and weaknesses. Materials and methods: A transversal and quantitative study of the characteristics of medical education in 29 medical schools in Mexico was carried out, between April and September 2017. Questionnaire with Likert scale was applied to explore context, regulation, structure, process, results and impact of medical education. Bivariate analysis was performed with a Chi square test and the significance level was equal to or less than 0.05. Results: The political context obtained 64%, economical context 10% and mechanisms of regulation 31%. The educational structure was 61% and the social impact was 93%. Conclusions: Public policies, regulatory mechanisms and public investment must be strengthened to improve the quality of medical education.

Producción científica y licenciamiento de escuelas de medicina en el Perú / Scientific production and licensing of medical schools in Peru

La nueva ley universitaria 30220 del 2014 creó la obligatoriedad del licenciamiento institucional de todas las universidades peruanas a cargo de la Superintendencia Nacional de Educación Superior Universitaria - SUNEDU, el primer programa de pregrado en pasar por el mismo proceso será medicina. El licenciamiento de programas de medicina es necesario para garantizar que las condiciones en que se imparte la carrera en el Perú son las adecuadas, con la alta posibilidad de cierre de algunas escuelas de medicina. Una vez que una escuela de medicina haya demostrado que cumple con las condiciones básicas de calidad, se realiza una evaluación cualitativa y una cuantitativa que incluye tres criterios: producción científica en Web of Science, impacto medido a través del índice H, y resultados del examen nacional de medicina, para determinar los años de licenciamiento. Este artículo realiza una evaluación de los indicadores cuantitativos vinculados a investigación usando Web of Science y Scopus, además de hacer revisiones técnicas y metodológicas de los mismos; así como sugerencias para los otros indicadores.

The new university law 30220 of 2014 introduced the mandatory institutional licensing of all Peruvian universities by the National Superintendence of Higher University Education (SUNEDU, in Spanish). The first undergraduate program to go through this process will be medicine. The licensing of medical programs is necessary to ensure that the conditions in which the program is taught in Peru are adequate, with a high probability of closing some medical schools. Once a medical school has demonstrated that it meets the basic conditions of quality, a qualitative and quantitative evaluation is carried out that includes three criteria: scientific production in the Web of Science, impact measured through the H index, and results of the national medical exam, to determine the years of licensing. This article evaluates the quantitative indicators linked to research using Web of Science and Scopus, in addition to making technical and methodological revisions of them. Suggestions for the other indicators are also covered by this article.

Introducing a legal mandate for basic medical education accreditation in Korea / 한국의학교육

No abstract available.

Creación de un laboratorio virtual para la enseñanza universitaria de la embriología humana en sus aspectos biológicos, éticos y sociales / Create a virtual laboratory for university teaching human embryology in its biological, social and ethical aspects

Las tecnologías de información y comunicación (TICs) tienen un alto potencial de desarrollo en la educación a distancia para apoyar los procesos de enseñanza/aprendizaje. Por otro lado, el desarrollo científico y tecnológico no depende sólo de los conocimientos científicos y de la experiencia técnica cumulada. Por el contrario, están condicionados por factores sociales, económicos, culturales, éticos y políticos. El núcleo central de la Embriología Humana es el desarrollo. Su enseñanza se basa tradicionalmente en métodos explicativos e ilustrativos desarrollados sobre un paradigma biológico. Nuestro objetivo general consistió en diseñar un ambiente virtual (Laboratorio) de apoyo para la enseñanza/aprendizaje a distancia de la Embriología humana en sus aspectos biológicos, éticos y sociales destinado a los alumnos de grado y postgrado de las Ciencias de la Salud. Nuestros objetivos específicos fueron : a-realizar actividades relacionadas al proyecto: búsqueda bibliográfica, encuestas, trabajos académicos, b- producir y seleccionar recursos digitales adecuados a los temas biológicos, éticos y sociales, c- diseñar un laboratorio virtual con los recursos disponibles para la enseñanza universitaria de la embriología humana. -Se realizaron: 1-búsqueda bibliográfica a través de las plataformas PubMed/Medline, Scimago/Scopus y Biblioteca Virtual en Salud (BVS)/Cielo, Cochrane. 2- encuestas estructuradas en base a opciones múltiples a fin de conocer la opinión de los estudiantes sobre la incorporación de actividades opcionales virtuales. 3- trabajos académicos con las experiencias presenciales y virtuales locales e internacionales entre diferentes unidades académicas de Argentina, Chile y Brasil ( grado y post-grado).

ABSTRACT: Communication and Information Technology (TICs) has a high potential for development in distance education to support teaching and learning. Scientific and technological developments do not solely depend on scientific knowledge and technical skills acquired through experience. Rather, they are also shaped by a multitude of factors, including social, economical, cultural, ethical and political influences. The central core of human embryology is development. Teaching of embryology has been traditionally based on explanatory and illustrative methods developed on a biological paradigm. Our overall objective was to design a virtual environment (Lab) to support distance teaching and learning of human embryology in its biological, social and ethical aspects. This environment would be intended for undergraduate and graduate students of the Health Sciences. Our objectives were: a-to produce project-based activities, b-to produce and select appropriate digital resources covering biological, ethical and social issues and c-to design a virtual laboratory with the resources available to the human embryology university education. Were performed: 1-through literature search platforms PubMed / MEDLINE, Scimago / Scopus and Virtual Health Library (VHL) / Heaven, Cochrane. 2 - structured surveys based on multiple options to obtain the views of students on incorporating virtual optional activities. 3 - reports the experiences and virtual local and international between different institutions in Argentina, Chile and Brazil (undergraduate and graduate)l.

La cultura ética de la investigación biomédica en Venezuela / the ethical culture of the biomedical research in Venezuela

La investigación biomédica en seres humanos requiere principios bioéticos, de los cuales la autonomía es fundamental para proteger la dignidad de las personas objeto de estudio. Con la finalidad de analizar si existe cultura ética de investigación en Venezuela y si se respecta la autonomía de sujetos participantes en investigaciones biomédicas, independientemente de su competencia o incompetencia legal para otorgar su consentimiento, se realizó el presente trabajo. En él se analizan críticamente estos aspectos, de acuerdo con la cultura ética planteada por Lavery y el modelo de libertades preconizado por Sen. Asimismo, se realizó un análisis del ejercicio de la autonomía de niños y niñas y adolescentes establecido en la doctrina del menor maduro y en los instrumentos legales disponibles en el país. Se concluye que existe vulnerabilidad de la autonomía de las personas, particularmente de niños, niñas y adolescentes debido a factores que afectan el contexto humano, político y económico-social del país

The biomedical research in human beings requires of bioethics principles from which the autonomy is essential to proyect the dignity of prople which are the subject of study. The present study was carried out with the aim of analyzing if there is an ethical culture of reseach in Venezuela and if the subjects' autonomy that take part in biomedical research is respected, independently of its legal or illegal competency in order to give its consent. In this study these aspects are critically analyzed in accordance with the ethical culture expressed by Lavery and the model of liberties recommended by Sen. Likewise, an analysis of the practice of children and adolescents autonomy was carried out, established in the doctrine of the mature minor as well as in the legal instruments available in the country. It is concluded that there is a clear vulnerability of people's autonomy, especially the children and adolescents' autonomy, due to several factors that affect the human, political and socio-economical context of the country

Procedimentos legais e protocolos para utilização de cadáveres no ensino de anatomia em Pernambuco / Legal procedures and protocols for use of cadavers in anatomy courses in Pernambuco, Brazil

A aquisição de cadáveres para estudo e pesquisa vinha sendo feita tradicionalmente utilizando-se corpos não reclamados, sem grandes formalidades. Com a complexidade dos tempos atuais, o simples encaminhamento desses corpos às escolas de Medicina passou a ser temido com o receio de transgredir a lei. Isso desencadeou uma redução no número de cadáveres para as aulas de Anatomia. Esta realidade motivou o Departamento de Anatomia da Universidade Federal de Pernambuco, juntamente com outras instituições do Estado, a pesquisar mecanismos legais que solucionassem a escassez de cadáveres para estudo e pesquisa. A metodologia utilizada constou de reuniões de discussão e apresentação de protocolos de recebimento de cadáveres com base principalmente na legislação vigente. Os resultados obtidos foram: (a) publicação do Provimento 28/2008 da Corregedoria Geral de Justiça do Tribunal de Justiça do Estado de Pernambuco, que dispõe sobre o registro de óbito dos cadáveres destinados às escolas de Medicina para fins de ensino e pesquisa; (b) criação de protocolos para o aproveitamento de cadáveres no Estado de Pernambuco. Concluímos que o conhecimento das atribuições por parte de cada uma das instituições envolvidas facilitará o processo de aproveitamento dos cadáveres.

The acquisition of cadavers for research and teaching has traditionally relied on unclaimed corpses, without major formalities. With the complexity of modern times, the mere transfer of these corpses to medical schools has come to be feared on grounds that it may break some law. This has reduced the number of cadavers available for anatomy classes. The Department of Anatomy at the Federal University in Pernambuco, Brazil, together with other institutions from the State, responded by studying legal mechanisms to overcome the lack of cadavers for research and teaching. The methodology consisted of discussion meetings and presentation of protocols for receiving cadavers, based mainly on the prevailing Brazilian legislation. The results were: (a) publication of Provision 28/2008 by the Pernambuco State Court, ruling on death certificates for cadavers scheduled for transfer to schools of medicine for research and teaching and (b) the creation of protocols for the use of cadavers in the State of Pernambuco. We conclude that knowledge of the attributions of the various institutions involved in the process will facilitate the use of cadavers in research and teaching activities.

La Acreditación de Programas de Formación en Medicina y la Orientación hacia la APS / Accreditation Training Programs in Medicine and the orientation towards PHC

El propósito de esta publicación es contribuir al conocimiento sobre las acciones que en materia de evaluación y acreditación de los programas de formación de médicos se están desarrollando en la Región de las Américas como mecanismos de regulación y mejora de la calidad de los mismos. Constituye un interés particular para la Organización Panamericana de la Salud (OPS/OMS) a discusión y consideración de la estrategia de la Atención Primaria de la Salud (APS) en la formación y en la acreditación como prescriptora de modelos de calidad de atención. En este libro, correspondiente a la Serie Renovación Primaria de la Salud en las Américas se dedica especial atención a la inclusión del enfoque de Atención Primaria de la Salud renovada (APS) en los procesos de evaluación de la calidad y la acreditación de los programas de formación de médicos, su valoración en la comunidad académica, en los grupos de pares encargados de la acreditación y en el trabajo conjunto entre las universidades y los ministerios de salud y educación.

Problem of unrecognized medical degree / diploma who is at fault.

Medical education is the subject matter of both Union and State Governments and Medical Council of India is the sole supervising body of medical education and maintaining its standard. Problem of recognition of medical degrees / diplomas is prevalent in almost all the States of India and in most of the medical specialties. Holders of unrecognized degree / diploma may face problem of employment / promotion, etc. Thus, leading to filing of litigations in the court, some of which are decided and others are still pending in the Indian Courts. This paper deals with review of this problem, brief discussion of relevant court decisions, Government Orders and Medical Council of India (MCI) notifications, etc. thus, help in solving the problem to great extent by making concerned persons aware about the issue and to take initiative to solve the problem of very much public interest.

La relación docente-asistencial en el nuevo contexto que establece la reforma de salud / The relationship between health care and teaching activities in the context of the Health Care Reform

The new laws of the health reform in Chile, modified the pre-existent relationship between teaching and health care activities. This relationship allows the training of health care professionals by Universities, in the clinical services of the National System of Health Services that is dependent of the Ministry of Health. The new law established new requirements for specialization and quality of care accreditation. Up to the moment, the relationship between Health Care Services and the Universities was based on harmonic and consensual agreements between both counterparts. With the new law, such relationship becomes more relative and is based on new norms. Therefore, it is of utmost importance to establish a regulated and equilibrated relationship between both institutions, to assure the best possible training of health care professionals, in terms of skills and competences, to adequately satisfy the health needs of the population.

Responsabilidade civil e ética dos médicos - as queixas em tocoginecologia no CRM-SP / Civil and ethical liability of physicians- the complaints in gynecology and obstetrics to the São Paulo state medical board

Nos últimos anos os médicos têm sido alvo de processos indenizatórios e éticos com freqüência cada vez maior. A Medicina é profissão muito visada e, entre suas especialidades, particularmente a tocoginecologia, não somente em razão dos riscos que comporta , mas também, em alguns casos, por uma visão equivocada do poder judiciário das obrigações dos médicos. As decisões nos processos éticos dos conselhos regionais de Medicina influem na justiça comum e por isso devem ser seguidos com bastante atenção. O objetivo desta revisão á dar uma visão do ponto de vista de um médico-advogado, dos processos envolvendo responsabilidade civil e ética, mostrando a atual situação dos tocoginecologistas junto ao CRM-SP. Após breve introdução histórica são abordadas as causas de responsabilidade civil e os artigos legais que lhe dão base. As responsabilidades do médico, do hospital e dos planos de saúde são vistas separadamente, bem com os mecanismos de indenização. É feita a descrição da natureza administrativa do processo ético, chamando a atenção para o fato do caráter legal de suas penas, que com freqüência, serve de base para sas decisões da justiça comum. A prevenção ainda é o melhor remédio para fazer face ao problema; o bom exercício da medicina e a boa relação médico-paciente ainda são as melhores soluções para minimizar a incidência de tais ações. È conveniente que os médicos tenham noções dos mecanismos jurídicos de tais demandas de maneira a poder evitá-las...

Autorización para el ejercicio profesional médico en Chile: experiencia de la comisión de reválida de la Escuela de Medicina de la Universidad de Chile período 1984-1999 / Medical practice licensing in Chile: experience of the re-valuation committee of the medical school of Universidad de Chile, 1984-1999

We report the experience of the re-valuation committee of the University of Chile Medical School, in the period 1984-1999. This experience is relevant to the licensing processes in Latin America. We report the political, legal and regulatory backup and the academic criteria used to esatblish different evaluation methodologies. We also communicate the main results obtained. Factors such as the country and University conferring a title, nationality and length of service of the applicant, influence in the percentage of licensure exammination approval. Some modifications to the licensure process should be incorporated but, the overall results obtained, fully justify the existence of this licensure committee