[Some notes on the history of the experimental surgery laboratory. Reflections on its relevance in education and surgical research]. / Algunas notas sobre la historia del Laboratorio de Cirugía Experimental. Reflexiones sobre su importancia en la educación e investigación quirúrgica.

The progress of medicine has largely been due to research, and for surgery, in particular, the experimental surgical laboratory has been considered fundamental to the surgeon's education. In this study, a general view of experimental surgery is given in animal models based on bioethical norms as well as to design, create and apply different surgical procedures before performing in humans. Experimental surgery also facilitates surgical teaching and promotes the surgeon's scientific reasoning. Methods. This is a retrospective and descriptive study. Data were collected from direct and indirect sources of available publications on the historical, bioethical and educational aspects of medicine, focusing on surgery. The important facts corresponding to the field of experimental surgery and applicable in Mexico were selected. Concepts of experimental surgical models and of the experimental surgery laboratory were described. Bioethical considerations are emphasized for care of experimental animals. Finally, this work focuses on the importance of surgical experimentation in current and future development of the surgical researcher. Conclusions. Experimentation with animal models in a surgical laboratory is essential for surgical teaching and promotes development of the scientific thought in the surgeon. It is necessary for surgical research and is fundamental for making progress in surgery, treatment and medicine as science.

[Reflections on the quality of medical school curricula in Mexico]. / Reflexiones sobre la calidad de la carrera de medicina en México.

INTRODUCTION: At the end of the XXth century, collegiate efforts (evaluation and accreditation) were carried out to identify the quality of undergraduate medical education in Mexico. The growth of medical schools during the 1970's had stabilized and the combination of other factors had contributed to increase its quality. MATERIAL AND METHODS: Analytic-descriptive research of selected indicators of the medical curricula from the sixties to the year 2000: entry, enrollment, and drop out rates, graduates, title, selection by the national postgraduate exam of medical residences (ENARM), faculty members and creation of medical schools. Statistical analysis included chi2 and T tests. RESULTS: In the seventies the number of medical schools doubled and the country increased its entry by 400%, enrollment by 700% and the number of graduates by 600%. The drop out rates and title efficiencies remained stable with averages of 76.2 and 76.4%, respectively: the first one that reflects the efficiency of the educational system, was not different in the period studied, when student's t- test (p < 0.01) was used. In the nineties, entry, enrollment and graduates increased again by 300, 400 and 700%, compared with the seventies. One out of every two graduates was selected by the ENARM in 1991 and in 2001, one out of six. CONCLUSIONS: The growth in enrollment and graduates once again, stands in contrast with the drop out rate that has remained stable. This suggests that the country has not increased significantly the quality of its medical education. The latter could be verified for each institution with the indicators used in the present study and by the assessment and accreditation of the programs.

Reflexiones sobre la calidad de la carrera de medicina en México / Reflections on the quality of medical school curricula in Mexico

Introducción: en los años noventa del siglo pasado se iniciaron acciones colegiadas (evaluación y acreditación) para identificar la calidad de los estudios de licenciatura en medicina en México, porque después del crecimiento excesivo de su matrícula en los setenta, mostró cierta estabilidad que, con otros factores, se supone contribuyó a elevar su calidad. Material y métodos: investigación analítico-descriptiva de algunos indicadores de la educación médica (licenciatura) de los sesenta al año 2000: ingreso, matrícula, eficiencia terminal, egreso, titulación, selección mediante examen nacional de residencias médicas (enarm), personal docente y establecimiento de escuelas. Se compararon las variables con χ² y T de student. Resultados: en los setenta los planteles se duplicaron e incrementaron el ingreso en 400%, matrícula 700% y en consecuencia los egresados 600%. Las eficiencias terminal y de titulación se mantuvieron estables con promedios de 76.2 y 76.4%, respectivamente. La primera que refleja la eficiencia del sistema educativo, no fue diferente en el periodo analizado al aplicar T de student con una p < 0.01. En los noventa ingreso, matrícula y egreso se incrementaron nuevamente en 300, 400 y 700%, respecto con los sesenta. Uno de cada dos egresados fueron seleccionados por medio del enarm en 1991 y en 2001, uno de cada seis. Conclusiones: el incremento de nueva cuenta, de matrícula y egreso contrasta con la estabilidad de las eficiencias terminal y en la titulación, lo que sugiere que el país no ha incrementado significativamente la calidad de su educación médica, lo que podría verificarse para cada institución con los indicadores estudiados y el apoyo de la evaluación y acreditación.

Introduction: At the end of the XXth century, collegiate efforts (evaluation and accreditation) were carried out to identify the quality of undergraduate medical education in Mexico. The growth of medical schools during the 1970s had stabilized and the combination of other factors had contributed to increase its quality. Material and methods: Analytic descriptive research of selected indicators of the medical curricula from the sixties to the year 2000: entry, enrollment, and drop out rates, graduates, title, selection by the national postgraduate exam of medical residences (ENARM), faculty members and creation of medical schools. Statistical analysis included χ² and T tests. Results: In the seventies the number of medical schools doubled and the country increased its entry by 400%, enrollment by 700% and the number of graduates by 600%. The drop out rates and title efficiencies remained stable with averages of 76.2 and 76.4%, respectively; the first one that reflects the efficiency of the educational system, was not different in the period studied, when student's t-test (p < 0.01) was used. In the nineties, entry, enrollment and graduates increased again by 300, 400 and 700%, compared with the seventies. One out of every two graduates was selected by the ENARM in 1991 and in 2001, one out of six. Conclusions: The growth in enrollment and graduates once again, stands in contrast with the drop out rate that has remained stable. This suggests that the country has not increased significantly the quality of its medical education. The latter could be verified for each institution with the indicators used in the present study and by the assessment and accreditation of the programs.

Elementos para el estudio de la violación sexual / Elements for the study of rape

Objetivo. Aportar información para describir algunas características de la violación sexual en la Ciudad de México. Material y métodos. Estudio descriptivo de las víctimas de violación atendidas en una institución de atención especializada, de 1990 a 1996. Con el apoyo de psicoterapeuta se aplicó un cuestionario semiestructurado sobre las características de la víctima, el agresor y las circunstancias en que se realizó la violación. Resultados. Se estudiaron 531 víctimas de las cuales 85.8 por ciento fueron del sexo femenino; casi la mitad, menores de edad, y hubo una mediana de nueve años de escolaridad. Todos los agresores fueron del sexo masculino, 62 por ciento conocidos de la víctima; de éstos 86.7 por ciento eran familiares o personas cercanas a la familia. En los domicilios de la víctima o del agresor ocurrieron 55.4 por ciento de las violaciones; 49.2 por ciento de los casos se presentaron en cuatro de las 16 delegaciones del Distrito Federal. Conclusiones. En la población estudiada la mujer fue el género con más riesgo de ser violada, pero en el grupo de 5 a 14 años de edad fue el hombre. Los desempleados y subempleados son el grupo con mayor probabilidad de llegar a ser agresores. El riesgo de la violación es mayor ante un familiar, la pareja o amigo de la familia que con un extraño, en el domicilio más que en otro sitio. Los hallazgos sugieren pautas para establecer programas preventivo y de atención especializada a víctimas y agresores

Objective. To describe some characteristics of rape in Mexico City. Material and methods. Descriptive study of rape victims who attended a specialized institution between 1990 and 1996. A support psychotherapist applied a semistructured questionnaire on the victims characteristics, the aggressor and the circumstances of the rape. Results. A total of 531 victims were studied, 85.8% were females, almost half were minors and the median of scholarity was nine years. All aggressors were males, 62% were known to the victim, 86.7% were relatives or near to the family. Aggression occurred at the home of the victim or aggressor in 55.4% of the cases, 49.2% of the cases occurred in 4 of the 16 City districts. Conclusions. In the studied population, women were the gender with greatest risk of being raped, except in the 5 to 14 year old group in which boys were in greater risk. Unemployed and underpaid men were the most frequent aggressors. There is a greater risk of being raped by a member of the family, couple or friend than by a stranger, and in the victim's or the aggressor's home more than anywhere else. Findings point to the necessity of establishing preventive programs and providing specialized attention to victims and aggressors.