Medical education

摘要

Over the years, producing good physicians has been a huge challenge worldwide. Over the last two decades, this issue has gained notorious interest in Brazil, due to the uncontrolled expansion of medical schools, many of which are unable to adequately prepare students for professional practice. In any community, good healthcare professionals are essential to promote health, prevent illness, and cure or rehabilitate patients. People do not easily tolerate failures or errors in medical practice, so it is understandable that society continuously demands excellent skills and competence among physicians. In this context, the irreplaceable role of qualified medical schools emerges. Medical education, which is a continuous process, comprises three stages: undergraduation, post-graduation, and continuous education. The first two stages have an established duration, while the latter, by definition, is endless. Undergraduation and post-graduation, as in any area of teaching and learning, are based on the combination of four essential elements: pedagogical projects, physical structures, teachers, and students. It is vital that these four components are present simultaneously and work together. Well-conceived educational projects, adequate physical infrastructure, and good teachers are not enough; one cannot expect competent professionals if the students are not minimally qualified to assimilate the theoretical knowledge and practical skills required. Therefore, one of our major contemporary challenges is to ameliorate the training of students during their elementary and secondary education to improve the quality of medical education in the future. Without well-prepared students, higher education cannot achieve its goal. This has indeed been a justified concern. One of the most important requirements in every professional training process is the acquisition of a competence set (knowledge, skills, and attitudes), which is essential for the professional to do their job properly. In medicine, many general and specific competences are required. Therefore, the educational project, the laboratory infrastructure, the health facilities, and the teachers should be well articulated to enable the acquisition of these competencies. Besides the essential technical and scientific skills, it is still expected that physicians be prepared to practice with humanism, ethics, and professionalism. 1 The knowledge that doctors need to acquire is notoriously enormous. 2 Although they are necessary for good training, biological components alone are not enough to prepare competent professionals. Reasonable training in philosophy, anthropology, sociology, literature, and other content of the social sciences is absolutely essential for future doctors to understand the insertion of the person in their families and communities. Neglecting the fact that individuals continuously interact with and take part in the social environment is a serious mistake that should not be made in good medical schools. Much has been debated about the objectives, content, and methodology of medical training. Although it is possible to develop good professionals by different ways of teaching and learning, some principles are adopted worldwide. A solid scientific basis on the origin, development, and evolution of diseases is absolutely essential to rationally guide the prophylactic, therapeutic, and diagnostic procedures. Therefore, the basic principles of structure and function of cells, tissues, organs, and systems, are the firmest pillar on which medical training stands. Understanding how different internal and external injuries interact with individual defense and adaptation mechanisms in the process of illness development is essential to intervention or treatment. Due to the extraordinary and rapid advances of knowledge in health sciences during the last few decades, many diseases can now be faced with a reasonable chance of treatment success, which has resulted in a tremendous increase in expectancy and quality of life for many people, who, even in the recent past, would have died prematurely or lived in conditions of great suffering. The gains brought by these conquests are well known and undeniable. Medical education can benefit from scientific progress in many ways. On one side, technically qualified teachers with a reasonable scientific background act more effectively with their patients and communities; on the other, they can induce scientific thinking in their students and encourage them to adopt scientific attitudes. Although many people consider research to be something done only in sophisticated laboratories and with animal experiments, scientific activities can be undertaken in any medical activity. As is well known, considerable knowledge progress can be achieved solely based on meticulous clinical observations. Thus, medical schools need to continually stimulate their students in their curiosity and desire to explore the natural environment, in which we