Repercussões das diretrizes curriculares nacionais de 2014 nos projetos pedagógicos das novas escolas médicas / Repercusiones de las directrices curriculares nacionales de 2014 en los Proyectos Pedagógicos de las nuevas escuelas médicas / Repercussions of the 2014 national curricular guidelines on the pedagogical projects of new medical schools

As Diretrizes Curriculares Nacionais orientam a constituição dos currículos para ordenamento da formação profissional em saúde e os projetos pedagógicos dos cursos as articulam às práticas pedagógicas. Esta pesquisa analisou as repercussões das Diretrizes Curriculares de 2014 nos projetos pedagógicos das escolas médicas criadas após sua publicação. De abordagem qualitativa, faz análise documental dos referidos projetos orientada pela hermenêutica crítica. Os achados revelam forte alinhamento dos projetos analisados às diretrizes curriculares. Identificou-se deslocamento do paradigma flexneriano para a integralidade, tendendo para formação de profissionais voltada às reais necessidades da população. Outros achados são as diferenças na concepção do médico de formação geral e na utilização das metodologias ativas de ensino-aprendizagem. Evidenciou-se ainda matrizes curriculares com concepções cuja proposta de integração ensino-serviço-comunidade não pareceu estar garantida, sugerindo a manutenção de propostas baseadas em disciplinas. (AU)

Las Directrices Curriculares Nacionales orientan la constitución de los currículos para ordenamiento de la formación profesional en salud y los Proyectos Pedagógicos de los Cursos las articulan con las prácticas pedagógicas. Esta investigación analizó las repercusiones de las Directrices Curriculares de 2014 en los Proyectos Pedagógicos de las escuelas médicas creadas después de su publicación. De abordaje cualitativo, hace análisis documental de los referidos proyectos orientados por la hermenéutica crítica. Los hallazgos revelan un fuerte alineamiento de los proyectos analizados con las directrices curriculares. Se identificó un desplazamiento del paradigma flexneriano para la integralidad, tendiendo a la formación de profesionales enfocada en las necesidades reales de la población. Otros hallazgos son las diferencias en la concepción del médico de formación general y en la utilización de las metodologías activas de enseñanza aprendizaje. Se evidenciaron también matrices curriculares con concepciones cuya propuesta de integración enseñanza-servicio-comunidad no parecía estar garantizada, sugiriendo el mantenimiento de propuestas con base en asignaturas. (AU)

The Brazilian national curricular guidelines on health education steer curriculum composition so as to organize professional training in this field. Pedagogical projects for courses connect these guidelines to pedagogical practices. This study assessed the repercussions of the 2014 curricular guidelines for the pedagogical projects of medical schools that were created after publication of the guidelines. A qualitative approach was taken, with analysis on documents of these projects guided by critical hermeneutics. Strong alignment between these projects and the curricular guidelines was found. A shift from the Flexner paradigm to comprehensiveness was identified, such that the professional training tended towards the real needs of the population. Differences in the conception of general medical practitioners and in the use of active teaching-learning methodologies were found. Curricular conceptions in which the proposed teaching-service-community integration did not seem to be guaranteed were evident, thus suggesting that proposals based on disciplines had remained present. (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.

Desempeño de las escuelas de medicina en México: resultados del Examen Nacional para Aspirantes a Residencias Médicas / Performance of medical schools in Mexico: Results from the Examen Nacional para Aspirantes a Residencias Médicas

Resumen: Objetivo: Evaluar el desempeño de las facultades y escuelas de medicina (FEM) utilizando como subrogado los resultados del Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017, empleando cinco criterios de desempeño (CD) por cada FEM: dos oficiales y tres creados exprofeso. Resultados. En 2016 y 2017 se registraron sustentantes de 112 y 115 FEM, respectivamente. Dependiendo del CD, la FEM que quedó clasificada en el primer lugar obtuvo entre 5 y 20 puntos más que la del segundo lugar, y entre 23 y 98 puntos más que la FEM ubicada en el último lugar. Aproximadamente 25% de los sustentantes fueron calificados como "deficientes en conocimientos" y aproximadamente 80% de éstos provenían de menos de un tercio de las FEM. Conclusiones: El ENARM arroja información sobre el desempeño de las FEM. Aproximadamente uno de cada cuatro sustentantes obtuvo puntajes menores al aprobatorio en cualquier especialidad.

Abstract: Objective: To assess the performance of medical schools (FEM) by analyzing the results of their applicants in the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Five performance criteria, two official and three created on purpose, were calculated from the ENARM-2016 and -2017 official databases to assess FEM performance. Results: In 2016 and 2017, applicants registered from 112 and 115 FEM, respectively. Depending on the performance criteria, the FEM in the first place obtained 5 to 20 points more than the one placed second, and 23 to 98 points more than the FEM in the last place. Approximately 25% applicants were classified as "knowledge-deficient," and about 80% of these originated from less than one third of the FEM. Conclusion: The ENARM results provide information on the performance of the FEM. Approximately one of every four applicants obtained scores lower than the approval threshold of any specialty.

Mapping the scientific research on the negative aspects of the medical school learning environment

SUMMARY Objective: We sought to understand the landscape of published articles regarding medical schools' learning environments (LE) worldwide, with an explicit focus on potentially negative aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviours, burnout, violence and mistreatment among students and physicians. Methods: A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest and PsycINFO) through December 31, 2016, including 12 themes: learning environment - general, hidden curriculum (negative), unethical behaviours, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities' discrimination, professional misconduct, and "other" negative aspects. Results: Of 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviours (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century. Conclusion: There is a clear increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention paid to experimental, longitudinal, and cross-cultural study designs.

RESUMO OBJETIVO: Buscou-se entender o panorama dos artigos publicados sobre os ambientes de aprendizagem (AA) das escolas médicas em todo o mundo, com um foco explícito nos aspectos potencialmente negativos do AA como um esforço para identificar áreas específicamente necessitadas de remediação ou intervenção que poderiam evitar futuros comportamentos não profissionais, violência e maus-tratos entre estudantes e médicos. Métodos: Foi realizada uma análise bibliométrica em seis bases de dados eletrônicas (PubMed/Medline, Web of Science, Biblioteca Cochrane, Scopus, Eric-ProQuest e PsycInfo) até 31 de dezembro de 2016, incluindo 12 temas: ambiente de aprendizagem - geral, currículo oculto (negativo), comportamentos antiéticos, bullying/trote, violência, discriminação sexual, homofobia, racismo, discriminação social, discriminação de minorias, má conduta profissional e "outros" aspectos negativos. Resultados: Dos 9.338 artigos encontrados, 710 preencheram os critérios de inclusão. Os temas mais comuns foram LE geral (233 artigos), comportamentos não profissionais (91 artigos) e discriminação sexual (80 artigos). Aproximadamente 80% dos artigos foram publicados no século XXI. Conclusão: Há um claro aumento em artigos científicos sobre aspectos negativos da escola de medicina LE em periódicos de alta qualidade, especialmente no século XXI. No entanto, mais estudos são necessários para investigar aspectos negativos do LE com maior atenção aos desenhos de estudos experimentais, longitudinais e transculturais.

Modelo pedagógico para el mejoramiento del desempeño docente con enfoque de competencias en la especialidad de pediatría / Pedagogical model for the improvement of teaching performance based on an approach to competences in the specialty of Pediatrics

Introducción: Una de las tendencias a nivel mundial es el enfoque de competencias en el ámbito académico, para lo cual es necesaria la preparación de los profesores que permita un desempeño docente con este enfoque. Objetivo: El trabajo tiene como objetivo diseñar un modelo pedagógico para el mejoramiento del desempeño docente con enfoque de competencias en la especialidad de Pediatría de la Facultad de Ciencias Médicas Salvador Allende en correspondencia con las exigencias sociales y del Sistema Nacional de Salud cubano. Material y métodos: Se utilizaron métodos teóricos, empíricos y estadísticos. De una población de 32 profesores, participó 65,62 por ciento y sus dos directivos. El muestreo fue incidental. Resultados: Es un modelo pedagógico. Se estructura en dos niveles: conceptual y metodológico. El conceptual comprende los fundamentos teóricos, las ideas rectoras, las dimensiones y la finalidad. El metodológico se concreta en su dinámica de aplicación y se estructura en cuatro etapas con objetivos definidos y un conjunto de acciones: Etapa I: Identificación de la posibilidad de obtención de información y su pertinencia; Etapa II: Determinación de problemas; Etapa III: Diseño de actividades para el mejoramiento del desempeño docente con enfoque de competencias. Etapa IV: Evaluación del modelo. Conclusiones: La modelación como método científico permitió la elaboración de un modelo pedagógico para el mejoramiento del desempeño docente con enfoque de competencias de los profesores de la especialidad de Pediatría de la Facultad de Ciencias Médicas Salvador Allende. La validación del modelo resultó estadísticamente significativa(AU)

Introduction: The approach on competences in the academic field is one of the trends worldwide; therefore, professors´ preparation that leads to a teaching performance based on this approach is necessary. Objective: This work is aimed at designing a pedagogical model for the improvement of teaching performance with an approach on competences in the specialty of Pediatrics in Salvador Allende Medical Faculty in accordance with the social demands of the Cuban National Health System. Material and methods: Theoretical, empirical, and statistical methods were used. Out of a total population of 32 professors, the 65,62 percent of them and the two directors participated in the study. Sampling was incidental. Results: It is a pedagogical model, which is structured in two levels: conceptual and methodological. The conceptual level comprises the theoretical basis, principal ideas, dimensions, and purpose. The methodological level limits itself in its application in dynamics and it is structured in four stages with defined objectives and a group of actions: Stage I: Identification of the possibility of obtaining information and its relevance; Stage II: Setting of problems; Stage III: Design of activities for the improvement of the teaching performance with an approach on competences. Stage IV: Evaluation of the model. Conclusions: The method of scientific modeling allowed the development of apedagogical model for the teaching performance with an approach on competences in the professors of the specialty of Pediatrics in Salvador Allende Medical Faculty. The validation of the model was statistically significant(AU)

¿Es tiempo de modificar la vinculación pregrado postgrado en la educación médica chilena? Reflexiones sobre una vía de doble titulación Médico cirujano/Doctor en ciencias médicas / Time to change the graduate-postgraduate liaison in Chilean medical education? Reflections about a double certification as Physician and Doctor in medical sciences

In the last 150 years, scientific research has produced extraordinary discoveries in Medicine and there is no doubt that research will continue contributing substantially in the future but there is no the same conviction regarding how to provision such capacities in medical graduates. In Chile, the Faculties of Medicine created several doctorate programs in Medical Sciences (Ph.D.) to strengthen medical research. However, the low number of physicians who apply to these programs is a caveat. These programs provide the advanced third-cycle competencies expected by students aspiring for an excellence research certification and their incorporation into academia. Universities stand out in their capacity to adapt themselves to educational needs, developing programs designed to fill specific gaps. Ph.D. programs intercalated to the medical career show that this is the correct approach. The development of specific doctorate programs for the small number of physicians interested in research and for medical students with a strong interest in research could be an innovative solution to motivate and encourage them to develop a career in clinical investigation. Using this approach, Medical Schools and Doctorate in Medical Sciences programs would jointly stimulate the training of medical scientists.

Desarrollo de una matriz conceptual para la innovación curricular en profesiones de la salud / Concept frame for curricular innovation in health care schools

We herein describe the conceptual dimension of the curricular innovation process carried out in the Faculty of Medicine of the University of Chile. We describe the context of innovation. The theoretical pertinence and relevance of a competence driven curriculum for health care professionals is discussed. The epistemological, ontological and didactic dimensions of the curricular innovation are examined. A main issue is the notion of competence and its significance in professional training. The curriculum is essentially considered as a moral endeavor, especially for health care professionals and their quest to improve the quality of life of the population.

Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition / Ensino da Geriatria nas faculdades de medicina do Brasil em 2013 e reflexões sobre a adaptação ao processo de transição demográfica e epidemiológica

Summary Objective: This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. Methods: 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC) were found, as seen on the MEC website (www.emec.mec.gov.br) in February 2013. Based on the list of institutions, the authors created a database. Results: Brazil's Southeast region is the one presenting most of the courses, both offered as core or elective subjects, in the area of Geriatrics. The Midwest region had the least offer of Geriatrics and Elderly Health and Care courses. The Southeast region presents the greater absolute number of institutions with elective subjects, followed by the South and Northeast regions, each with a single institution. The Southeast region was at the same time the one that presented the biggest absolute number of institutions offering core subjects in the area of Geriatrics, being followed by the Northeast, South, North, and Midwest regions. Conclusion: By analyzing the availability of courses that emphasize aging and Geriatrics in brazilian medical schools, the present study reveals that specialized training should be encouraged with respect to the specificities of health care given to the elderly population, which has a higher frequency of chronic and degenerative diseases.

Resumo Objetivo: o estudo tem como objetivo delinear o perfil de instituições de ensino médico que adotaram em grade curricular disciplinas de Geriatria, saúde dos idosos ou envelhecimento, e comparar esse perfil com distribuição demográfica e dados epidemiológicos de saúde da população brasileira, utilizando dados de até 2013. Métodos: foram pesquisadas 180 instituições de ensino superior (IES) contendo cursos de medicina cadastrados no sistema do Ministério da Educação e Cultura (MEC), que constavam no site: emec.mec.gov.br, acessado em fevereiro de 2013. A partir da lista de instituições encontradas, fez-se a construção do banco de dados. Resultados: a região Sudeste é a que apresenta maior oferta de disciplinas na área de Geriatria, tanto obrigatórias quanto optativas. A região Centro-oeste foi a que menos se destacou na oferta de disciplinas de cuidado ao idoso. A região Sudeste apresenta maior número absoluto de disciplinas optativas, seguida pelas regiões Sul e Nordeste, com apenas uma instituição cada. A região Sudeste também foi a que apresentou maior número absoluto de instituições que ofertavam disciplinas obrigatórias na área de Geriatria, sendo seguida pelas regiões Nordeste, Sul, Norte e Centro-oeste. Conclusão: o presente estudo, por meio da análise do perfil de oferta de disciplinas que enfatizam o envelhecimento e a saúde do idoso nas instituições de ensino médico brasileiras, aponta como essencial o estímulo à capacitação dos profissionais no que tange às especificidades do atendimento de saúde à população idosa, com aumento crescente de doenças crônico-degenerativas.

Dermatology relevance to graduates from the Universidade Estadual de Campinas Medical School

AbstractBACKGROUND:Some research indicates that physicians do not dominate the expected dermatological content for the proper exercise of the profession. This fact compromises their diagnostic and therapeutic performance, generating unnecessary costs.OBJECTIVE:The aim of this study was to evaluate the relevance of Dermatology and the knowledge acquired in the specialty during the undergraduate course in clinical practice of graduates at the State University of Campinas Medical School (FCM/UNICAMP).METHOD:A questionnaire with 22 closed questions and two open ones was electronically sent to physicians who had graduated more than 10 years ago and others for less than 10 years. In the first group, physicians were trained by the same curriculum and in the second group there were subjects trained by the old and the new curriculum.RESULTS:Of the 126 respondents, 83% had completed a specialization course. Among all, 82% did not study dermatology after graduation. The majority considered that Dermatology has high relevance in clinical practice, regardless of the group. There was a statistically significant difference between non-dermatologist doctors graduated for more than 10 years and those graduated for less than 10 years regarding confidence about lesion diagnosis, diagnostic investigation and treatment of skin diseases. Physicians who have graduated for a longer time feel more insecure in relation to patients with dermatoses. Concerning contributions offered by graduation program completion they prioritized outpatient care, ability to diagnose, knowledge of pathology, research and knowledge of lesions.CONCLUSION:This study has shown that Dermatology is relevant in medical practice and more recent graduates from the FCM/UNICAMP feel less insecure when treating a patient with dermatoses.

Teaching patient safety in the medical undergraduate program at the Universidade Federal de São Paulo / Ensino sobre segurança do paciente no curso de Medicina da Universidade Federal de São Paulo

Objective To analyze the Educational Project of the undergraduate medical course to verify what is taught regarding Patient Safety and to enable reflections on the educational practice. Methods A descriptive study, using document research as strategy. The document of investigation was the Educational Project of the medical course, in 2006, at the Escola Paulista de Medicina of the Universidade Federal de São Paulo. The theoretical framework adopted was the Multi-Professional Patient Safety Curriculum Guide of the World Health Organization, which led to the preparation of a list with 153 tracking terms. Results We identified 65 syllabus units in the Educational Project of the course, in which 40 (61.5%) addressed topics related to Patient Safety. Themes on the topic “Infection prevention and control” were found in 19 (47.5%) units and teaching of “Interaction with patients and caregivers” in 12 (32.5%); however content related to “Learning from errors to prevent harm” were not found. None of the framework topics had their proposed themes entirely taught during the period of education of the future physicians. Conclusion Patient safety is taught in a fragmented manner, which values clinical skills such as the diagnosis and treatment of diseases, post-treatment, surgical procedures, and follow-up. Since it is a recent movement, the teaching of patient safety confronts informative proposals based on traditional structures centered on subjects and on specific education, and it is still poorly valued. .

Objetivo Analisar o Projeto Pedagógico do curso de graduação em Medicina para verificar o que se ensina sobre segurança do paciente e propiciar reflexões sobre a prática educacional. Métodos Estudo descritivo, utilizando-se como estratégia a pesquisa documental. O documento de investigação foi o Projeto Pedagógico do curso de Medicina (ano base 2006), da Escola Paulista de Medicina da Universidade Federal de São Paulo. O referencial teórico adotado foi o Multi-Professional Patient Safety Curriculum Guide da Organização Mundial da Saúde, elaborando-se uma lista de 153 termos rastreadores. Resultados Foram identificadas 65 unidades curriculares no Projeto Pedagógico do curso, dentre as quais 40 (61,5%) lidavam com assuntos relacionados à segurança do paciente. Temas do tópico “Prevenção e controle da infecção” foram encontrados em 19 (47,5%) unidades e o ensino sobre “Interação com paciente e cuidadores” em 12 (32,5%), no entanto, conteúdos relacionados a “Aprendendo com os erros para evitar danos” não foram encontrados em nenhuma. Verificou-se que nenhum dos tópicos do referencial teve os temas propostos ensinados em sua totalidade durante o período de formação do futuro médico. Conclusão O ensino sobre segurança do paciente é ministrado de forma fragmentada valorizando-se as habilidades clínicas como diagnóstico e tratamento da doença, pós-tratamento, procedimentos cirúrgicos e acompanhamento. Por se tratar de um movimento recente, o ensino sobre segurança do paciente se confronta com propostas formativas baseadas em estruturas tradicionais, centradas nas disciplinas e na formação específica, sendo ainda pouco valorizado. .

Vinte e dois anos de um Curso Informativo de Cirurgia Plástica / 22 years of an Informational Overview Course on Plastic Surgery

Há 22 anos, um curso informativo de cirurgia plástica para acadêmicos de medicina, promovido pela integração de quatro escolas médicas, três universidades e pela regional da Sociedade Brasileira de Cirurgia Plástica vem sendo ministrado, contribuindo para a educação médica em Curitiba, uma cidade de dois milhões de habitantes, em uma área metropolitana de aproximadamente três milhões de pessoas. Este curso informativo proporciona uma visão abrangente da especialidade, para que acadêmicos de medicina possam avaliar sua vocação pessoal para o exercício da cirurgia plástica, além de fornecer conhecimentos básicos indispensáveis à formação de qualquer médico. Anualmente o curso é ministrado em 47 horas e ofertado para 120 alunos. O programa inclui 70% de "cirurgia reconstrutiva" e 30% de "cirurgia estética", sendo a maioria dos professores membros titulares da Sociedade Brasileira de Cirurgia Plástica. Nos primeiros 19 anos de atividade (1992 a 2010), 4,6% dos alunos que concluíram o curso cursaram residência em cirurgia geral, foram admitidos na residência em cirurgia plástica e hoje fazem parte da Sociedade Brasileira de Cirurgia Plástica. O curso tornou-se um importante instrumento de educação médica, complementando o currículo de quatro escolas médicas e promovendo a cirurgia plástica como especialidade única e indivisível, enfatizando a importância da prova de especialista em cirurgia plástica e a conveniência da escolha e da indicação destes especialistas para a realização de qualquer procedimento no âmbito da cirurgia plástica.

For 22 years, a reproducible introductory overview course on plastic surgery for medical students, cosponsored by four medical schools, three universities and the regional chapter of the Brazilian Society of Plastic Surgery (SBCP), has contributed to medical education in Curitiba, a city of 2 million, and serving a metropolitan population of nearly 3 million people. This course helps medical students determine if plastic surgery is the right choice for them and provides valuable information about the specialty itself that will serve all participants as they go forward into their chosen fields, as plastic surgeons or not. This broad-ranging 47 hour course, limited to 120 students, is fully enrolled every year. Its content is weighted approximately 70% toward reconstructive plastic surgery and 30% toward aesthetic plastic surgery. Most lectures are presented by plastic surgeons who are full members of the SBCP. During its first 19 years of operation, 4.6% of the students completing the course have gone on to a general surgery residency followed by a plastic surgery residency, and are current SBCP members. The course has become a valuable educational and marketing tool for the regional chapter of the SBCP. It promotes the unique scope of the specialty and increases awareness among participants, as well as among their many personal and professional contacts (currently and in the future) about the benefits of becoming fully qualified, board-certified plastic surgeons.

Los saberes en el rediseño del plan de estudios de la carrera de medicina: escuela “José María Vargas” de la Universidad Central de Venezuela 2a parte / The knowledge in redesigning the curriculum of the medical course: school

La elaboración de las competencias del perfil de egreso del médico de la Escuela de Medicina “José María Vargas” partió de las consideraciones que una comisión de la UNESCO hiciera a finales de la década de los años noventa sobre los aprendizajes(1). Al considerar la importancia del aprendizaje, que no es sólo de conceptos, sino también de habilidades de diversos tipos, por ejemplo, cognitivas, sociales, destrezas, actitudes y valores que se integran en la denominada competencia, la Comisión de Currículo de la institución procedió a estudiar una variedad de aspectos relacionados a la competencia laboral y a la competencia educativa. A partir de esos dos conceptos se generaron la definición de competencia yla definición de competencia médica; se elaboraronlas competencias del perfil de egreso de ese profesionaly se continuó luego con el análisis de los enunciados de las mismas(2). En esta propuesta de plan de estudios, el saber-saber y el saber-hacer se desprendieron de la evaluación de los contenidos de las asignaturas del plan de estudios vigente, la opinión de los docentes que las administran, los nuevos avances científicos y tecnológicos en materia de salud, las políticas y programas del Estado y las políticas de la institución universitaria. Los valores y las actitudes, es decir el saber ser y el saber convivir, obedecen a las expectativas que tiene la sociedad del ser y del actuar de ese profesional de la salud, como médico y como ciudadano. Los resultados de este análisis han sido divididos en dos partes. En la Parte I, ya publicada en esta revista(3), se hace referencia a los aspectos generales de los saberes y al saber-saber. En la Parte II se presenta el resultado del análisis del saber- hacer, el saber-ser y el saber-convivir.

The elaboration of the profile by medical competencies of our Medical School had its origin in the considerations of the Commission of Unesco at the end of the nineties about education. By considering the importance of learning, not only concepts should be considered, but also diferent abilities like cognitive, sicial, attitudes, values and abilities. Our Curricular Comision decided to study aspects related to laboral competence and educative competence. In this proposal the know-know and know-to do concepts originated from the evaluation of the different contents of the current study plan, the opinion of the teachers, the new technologival and scientific advancements in health, the State and Universities politics. The values and attitudes, meaning know to be and know to live together, originate from the expectations that the society has about this professional as a physician and a citizen. The first parte has been published before (Med Interna (Caracas), 2012, vol 28: 196 - 201).