Formación de especialistas en Latinoamérica. Rol de las universidades chilenas

Chile has a physician rate of 1.7/1,000 inhabitants, lower than the average of the OECD countries (3.2/1,000). The country currently has 22 medical schools and more than 10,000 new doctors are expected by 2020. There are public and private medical schools in the country, with a unique system of admission that considers the qualifications of secondary education, specific tests of university selection and adjustments according to the origin of the students, in order to improve equity in access. Accreditation of a medical degree is a requirement for all universities. At the end of the course, there is an habilitation exam that measures theoretical competences for graduates of Chilean universities and also a practical one for those studying abroad. The Ministry of Health of Chile has estimated that there is a shortage of specialists in the country, as well as a problem of geographical distribution. To progressively overcome this situation, the state has developed an expansive plan of specialization programs, under a strict system of quality accreditation, taking into account that the specialization programs in Chile are all dependent on universities. The state supports most specialist training programs, requiring graduates to work in the public health network at the end of their programs. Each university can finance its own programs with repayment periods in the same institution. The accreditation of specialists depends on structures regulated by the state.     

Formación de médicos especialistas en México

Medical education in Mexico is heterogeneous since there are more than 140 public and private Schools and Faculties of medicine, with particular Programs and characteristics. However, the predominant educational model is the traditional initial training in basic sciences followed by clinical practice, some of them, with incorporation in their programs of competencies instead of objectives and attention to learning more than teaching. In postgraduate training there is greater uniformity, since although there is diversity in the Programs, a significant number follows the program of the National Autonomous University of Mexico (UNAM), since about 50% of the students of specialty are enrolled in this University. There are other programs in some State Universities and Private Universities.What stands out for being uniform throughout the country is the National Medical Residency System, since the process of incorporation and development of the process are regulated by the Interinstitutional Commission for the Training of Human Resources in Health (CIFRHS). An organization made up of representatives of educational and health institutions, which has among its functions the elaboration and application of the National Examination of Aspirants for Medical Residencies (ENARM), and the intervention in the training process, highlighting the great disproportion between the demand of these postgraduate studies and the capacity of supply.     

Repercusiones académicas de la educación virtual en los estudiantes de Latinoamérica: validación de una escala

IntroductionThe advent of the COVID-19 pandemic has forced students to be able to adapt to new means of education. The closure of educational centers has generated a massive migration to virtuality and, often, neither the institutions nor the students were prepared for this modality.ObjectiveTo validate a scale that measures the academic repercussions as a consequence of the measures taken by the pandemic among university students in 13 countries of Latin America.MethodologyInstrumental, analytical and cross-sectional study. The sampling was non-probabilistic and by convenience. Evaluations of form and substance were carried out. The substantive evaluation was carried out by expert judgment, and a small pilot was conducted to evaluate the form of the items.ResultsIn the substantive analysis, item 1 was the most relevant (V = 0.93; 95% CI: 0.82-0.98), as was the case for representativeness and clarity. Furthermore, the preliminary analysis of the items shows that item 6 has the highest mean score (M = 2.67) and item 1 the lowest (M = 2.19). Regarding variability, item 4 (SD = 1.40) shows the greatest dispersion. The relevance of the exploratory factor analysis is justified by the Kaiser-Meyer-Olkin coefficient (0.854) and Bartlett's test (17716.5; gl = 15; p = 0.000) being acceptable and significant.ConclusionsThe REP-ACAD-COVID-19-LAT scale is a valid and reliable scale to measure the impact of virtuality in times of health emergency such as the COVID-19 pandemic.     

La participación universitaria directa en la formación de médicos especialistas en México

Introduction

The University of Veracruz implemented the General Study Plan for Medical Specialties in 2013. The courses included in this study plan are mandatory, as they are important to improve specialised medicine skills for medical specialists of the future. Since it is not possible to deliver attendance-based courses, medical education, health services and systems and human development courses were offered online.

Bases conceptuales de las actividades profesionales a confiar para la educación de profesionales de la salud en Latinoamérica

The concept of entrustable professional activities emerged as an attempt to overcome some of the criticisms to the competency-based medical education approach; it has had a broad impact in practice and health professions education research. It has been disseminated internationally with its English acronym: EPA. This approach proposes to orient assessment and teaching to specific activities in the profession, which allows the integration of several competencies, and to determine which responsibilities can be entrusted to the trainee, in a gradual and explicit manner. The model assumes the definition of levels of supervision that allow progressive autonomy for each EPA, in students or residents, once they demonstrate the required competencies. Practice, supervision and feedback in real clinical scenarios are key to the development of autonomy in EPA performance. The dissemination of the EPA approach is still limited in Latin America, but it has the potential to create a significant contribution to curriculum design and evaluation, and to assessment practices of health professionals across their careers. It provides a deep review of the assumptions under which healthcare professional practice decisions are made, at under and postgraduate levels.     

Educación médica en América Latina: Venezuela

The medical studies in Venezuela begin in 1763, being the Central University of Venezuela (UCV), seat of the first faculty of medicine. At present in the country there are 9 Schools of Medicine in 8 National public universities; 6 autonomous with dissimilar curricula. It is awarded as a Medical Surgeon, and all of them have the goal of forming a doctor according to the requirements of the health systems: the General Practitioner. In 2005, the teaching of medicine outside formal university schools began with the National Training Program Comprehensive Community Medicine, product of the Sandino agreement between Venezuela and Cuba. The title to be awarded would be The Integral Community Medicine (MIC), with its consequences for the health system and for the health of the population.The number of Specialization Courses as well as the Masters have increased, so that by 2012, there were 171 Postgraduate Courses fully functioning in the Faculty of Medicine of the UCV and in total there are 351 Specialization Courses, Masters and Doctorates In the Medical Schools of the Venezuelan Universities. Admission to postgraduate courses is done through admission tests organized by the Postgraduate Studies Commissions of the respective Faculties of Medicine. The student receives during the years of training a salary scholarship from the host institution of the postgraduate course. Once the postgraduate residence is finished and after the defense of a Special Degree Work (TEG), the university degree is conferred by the corresponding university. In recent years, a serious situation has arisen, as regards the Specialization Courses, such as the marked decrease in the annual demand for these courses, a phenomenon that has affected most of them, with their evident repercussions on the number of postgraduate residents in hospitals. Research indicates among the factors that are causing this problem are: the evident phenomenon of medical migration that is occurring in Venezuela, low remuneration, continued governmental disqualification towards the national medical profession and preference given to foreign doctors, personal insecurity, the positive attitude of other nations to the possibility of well-trained Venezuelan physicians, the burden of care, and the deterioration of the infrastructure of our health centers. A proposal is made for the transformation of medical education in Venezuela; to construct a friendly and transferable methodology for the design of Curricula by Professional Competence with the objective of orienting the process of curricular transformation of the medical studies in degree and postgraduate in the country. There are many barriers but we have taken up the challenge and will take advantage of the resources to improve our pedagogical practices.     

Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual

El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su ense?anza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar.     

Metodologías complementarias de aprendizaje para la adquisición de competencias en la formación de especialistas y actividades profesionales confiables

The resident's learning is developed through the work in different settings such as: the hospital ward, the primary health center, the operating room, the participation in congresses or in committees, etc. Even so, this performance has to be complemented with methodologies that involve specific activities to develop those competencies that cannot be worked on a day-to-day basis (critical thinking, cooperative work, emotion management, etc.). We present other methodologies aimed to achieve those competencies, such as problem-based learning, the projects method, the case method, and the critical incidents, gamification, role-playing games or the resident's logbook, highlighting the competencies that each of them help to acquire.We dedicate a section to entrustable professional activities (EPAs), an operational methodological approach that facilitates the implementation of competency-based medical education and evaluation through clinical activities. The combination of complementary methodologies with clinical activities completes the map to acquire the competencies required in specialized training and guide the tutor in order to plan the training of the specialist.     

Acreditación y resultados de la educación médica en México

Objective

To determine whether the medical education programs recognised for their quality achieve better results in the National Medical Residency Examination.