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EDITORIAL
Medical education at the University of São Paulo Medical School
Joaquim Edson VieiraI, Luiz Fernando Ferraz da SilvaII, Edmund Chada BaracatIII,
Corresponding author
edmund.baracat@hc.fm.usp.br

corresponding author
I Faculdade de Medicina da Universidade de São Paulo, Department of Surgery, Discipline of Anesthesiology, São Paulo/SP, Brazil
II Faculdade de Medicina da Universidade de São Paulo, Department of Pathology, São Paulo/SP, Brazil
III Faculdade de Medicina da Universidade de São Paulo, Department of Gynecology and Obstetrics, Discipline of Gynecology, São Paulo/SP, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para10" class="elsevierStylePara elsevierViewall">The Faculdade de Medicina da Universidade de S&#227;o Paulo &#40;FMUSP&#41; is beginning a new undergraduate medical curriculum in 2015&#46; This model reduces the time allotted to lectures and increases the time devoted to tutored discussions and to clinical reasoning&#44; without neglecting the need to acquire information and scientific foundations that guide the practice of medicine&#44; ensuring that the curriculum is always grounded in the best evidence&#46; Anchored in research precepts from the field of medical education&#44; resulting from numerous large meetings with teachers and students&#44; and supported by international experts&#44; the new FMUSP curriculum accounts for several important dilemmas in medical education&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">Included among these dilemmas are the continuous and cumulative acquisition of new scientific information&#59; new approaches to health care and the treatment of acute and chronic diseases&#59; and recognition of social&#44; economic and cultural determinants of health for both individuals and populations&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">The following examples may illustrate the most common dilemmas faced by medical educators for the layperson&#46; In particular&#44; the advent of magnetic resonance imaging did not replace computed tomography&#44; which in turn did not replace ultrasonography&#44; which did not replace X-ray exams&#44; and so forth&#46; It is thus necessary to know the principles of all of these techniques&#46; As another example&#44; this time using the medical literature &#91;<a href="http://www.ncbi.nlm.nih.gov/pubmed">http&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;pubmed</a>&#93;&#44; between the 1970s and 2010&#44; the time necessary to study all of the texts considered as well-established content &#40;articles and reviews in medicine&#41; increased from 20&#37; of the time dedicated to a medical course&#44; or 10&#44;000 hours in six years&#44; to sevenfold&#46; That is&#44; if medical training depended only on theoretical content&#44; the addition of new information would result in the completion of such training requiring approximately 40 years &#40;assuming no new developments over those 40 years&#41;&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">In practice&#44; graduating with a medical degree in 6 years &#40;which is traditional in Brazil&#41; is no longer considered the end of education&#46; This is clear when we observe that doctors never exhaust the need to update their knowledge with both &#8220;sensu lato&#8221; post-graduate courses and other forms of continued education&#46; However&#44; there is a need for systematic education during undergraduate education&#44; focusing on basic information and nuclear or fundamental medical knowledge and centering the process on the student&#44; who must finish medical school in six years with the ability to continue learning &#40;learning to learn&#41;&#46; Additionally&#44; complementary to the addition of new knowledge in the field of medicine&#44; the theme of &#8220;social determinants of health&#8221; &#91;<a href="http://www.ssrn.com/en/">http&#58;&#47;&#47;www&#46;ssrn&#46;com&#47;en&#47;</a>&#93; has become more frequent in the medical literature since the 1990s and has significantly highlighted the need for new generations of health professionals to study and perform research&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">Building a medical curriculum is not a simple or quick task&#46; This process requires beginning with a strong and dynamic basis&#44; followed by continuous evaluation for long-term improvement&#46; Along these lines&#44; the FMUSP constantly discusses its curriculum&#44; which is quite healthy&#46; However&#44; the institution recently decided to reinforce its national leadership with a new curricular model&#46; This model&#44; presented here&#44; was created based on interviews with all coordinators of the FMUSP Disciplines and Clerkship&#44; which evolved into working groups&#44; or task forces that worked to integrate the thematic content for the basic and clinical sciences&#46; Specifically&#44; between 2012 and 2014&#44; international experts in medical education from the US&#44; Canada and Portugal visited the FMUSP and&#44; through a collaborative and ongoing dialogue&#44; including both students and faculty&#44; created the new curriculum&#46; The new curriculum therefore arose from the curricula of many other medical schools&#44; with important additional contributions from professors in other units of the Universidade de S&#227;o Paulo&#44; scholars from the field of medical education&#44; and medical experts as well as researchers&#44; all of whom are dedicated and committed to the training of FMUSP students&#46; The curriculum is thus the result of an institutional effort that involved both the FMUSP and the University via three institutes &#40;Biomedicine&#47;ICB&#44; Chemistry&#47;IQ&#44; and Biosciences&#47;IB&#41; that are involved in medical education&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">The term used for the current stage of development of this new curriculum has been &#8220;capillarity&#8221; &#40;a good choice&#44; considering its medical relevance&#41; because medical education now affects everyone&#39;s &#40;troubled&#41; daily life via FMUSP teachers and students as well as hospital doctors&#44; whose roles as professors of medicine are essential and recognized&#46; No unanimity is expected from smart institutions&#59; disagreement is an important force driving further development and improvement&#46; The most prepared institutions show resilience &#40;mainly before destabilizing events&#41;&#44; adapting and changing for the better on the verge of new developments&#44; which are always arising&#46;</p><p id="para70" class="elsevierStylePara elsevierViewall">We at the USP Medical School are all excited to welcome the new and to support what has been consolidated&#44; as well as being hopeful&#44; committed and engaged&#46; Nevertheless&#44; no one is puzzled by or indifferent to the challenges&#46; This is a good sign for all&#59; with this new curriculum&#44; we want to be even closer to society to offer the highest levels of health care and relevant scientific production and to participate in social development with ethics&#44; humanism and transparency&#46; In particular&#44; the Universidade de S&#227;o Paulo hopes to maintain its leadership and to ensure the education of the best doctors&#44; scientists and citizens to serve society&#46;</p></span>"
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Article information
ISSN: 18075932
Original language: English
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