Impact of a university teaching of integrative medicine on the social representations of undergraduate medical students.

Integrative medicine, need to be inoffensive, effective, and of quality (World Health Organization). In 2010, the American Society of Teachers of Family Medicine approved 19 competencies for teaching integrative medicine to residents. In 2018, the University of Rennes created a course: "Integrative Medicine and Complementary Therapies". Up until then, the only feedback from the courses was the students' opinions. We investigated the impact on medical students' social representation.We performed a sociological analysis of students' social representations before and after the course. The social representation is based on the way an individual creates his or her universe of beliefs and ideas. After hearing, "What word or group of words comes to mind when you hear people speak of integrative medicine and complementary therapies?", students were asked to provide 5 words/phrases, rank their importance, and show their attitude towards these words/phrases. The frequency and importance of these words/phrases were used to construct social representations (with central cores, and primary and secondary peripheries) before and after the course.Among the 101 students registered, 59 provided complete responses before and 63 after the course. Before, the central core comprised "hypnosis" and "alternative medicine", while after: "complementary care" and "global care". We only identified first periphery before the course: "acupuncture" and "homeopathy". 4 new contrasting elements: "integration with conventional treatment", "patient's choice", "personalisation of care", and "caring relationship of trust".This teaching course positively affected students' social representation of integrative medicine, and might promote their use during future practices.

Confronting Medical Diploma Mills: State Licensing Boards, Legislatures, and the Limits of Medical Authority in the 1920s.

In the standard story of the rise of professional authority in medicine in the 1920s, state medical licensing boards were partners in a coalition, led by the American Medical Association, to radically improve medical education. Boards obtained state laws that limited admission to licensing examinations to graduates of schools approved by the AMA, thus bringing about the rapid demise of low-quality schools by about 1925. The reality at the state level was quite different, however. Medical examining boards containing homeopaths, eclectics, and sometimes osteopaths could be far from reliable partners. Passing laws to benefit the medical profession was exceedingly difficult and dependent on local medical politics. Through the lens of a major medical diploma mill scandal revealed by a journalist in 1923, this paper examines reform efforts in three states greatly affected by the scandal: Missouri, where the scandal originated, Connecticut, and Massachusetts. In each of these states, graduates of low-quality schools as well as fake doctors from diploma mills were able to take a state examination and practice. This paper argues that the AMA, far from being the major player in the elimination of inadequate schools, could set standards but had to stay on the sidelines.

How do medical students engaging in elective courses on acupuncture and homeopathy differ from unselected students? A survey.

BACKGROUND: We aimed to investigate whether students at German medical schools participating in elective courses on acupuncture and homeopathy differ from an unselected group of students regarding attitudes and personality traits. METHODS: Elective courses on acupuncture and homeopathy in the academic half-year 2013/14 all over Germany were identified and participants invited to fill in a questionnaire including nineteen questions on attitudes towards Complementary and Alternative Medicine (CAM), orientation towards science, care and status orientation, and a short validated instrument (Big-Five-Inventory-10) to measure personality traits (extraversion, neuroticism, openness, conscientiousness, and agreeableness). Participants of a mandatory family medicine course at one university served as unselected control group. RESULTS: Two hundred twenty and 113 students from elective courses on acupuncture and homeopathy, respectively, and 315 control students participated (response rate 93%). Students participating in elective courses had much more positive attitudes towards CAM, somewhat lower science and status orientation, and somewhat higher care orientation than control group students (all p-values for three-group comparisons < 0.001). There were no differences between the three groups regarding personality traits with the exception of lower values for agreeableness in controls (p = 0.009). CONCLUSIONS: The findings of this study show that attitudes of students participating in elective courses on acupuncture or homeopathy at German medical schools differ to a considerable degree from the attitudes of unselected students.

[The teaching and application of alternative medicine in medical education programs].

The history of alternative medicine is perhaps as long as the history of human medicine. The development of evidence-based medicine has not annihilated alternative medicine. On the contrary, more people turn to alternative medicine because this approach to treatment serves as an effective remedial or supportive treatment when used in conjunction with evidence-based medicine. In contemporary healthcare, alternative medicine is now an essential part of integrated medicine. In Taiwan, most professional medical practitioners have not received proper education about alternative medicine and therefore generally lack comprehensive knowledge on this subject. While alternative medicine may be effective when used with some patients, it may also impart a placebo effect, which helps restore the body and soul of the patients. Medical staff with advanced knowledge of alternative medicine may not only help patients but also improve the doctor-patient relationship. There is great diversity in alternative medicine, with some alternative therapies supported by evidence and covered by insurance. However, there also remain fraudulent medical practices that may be harmful to health. Medical staff must be properly educated so that they can provide patients and their family a proper understanding and attitude toward alternative medicine. Therefore, alternative medicine should be included in the standard medical education curriculum. Offering classes on alternative medicine in university for more than 10 years, the author shares his experiences regarding potential content, lecture subjects, group experience exercises, and in-class activities. This article is intended to provide a reference to professors in university medical education and offer a possible model for alternative medicine education in Taiwan.

Integrative Medicine in Child Neurology: What Do Physicians Know and What Do They Want to Learn?

Pediatric neurology patients frequently use integrative medicine; however, providers may feel uncomfortable or unfamiliar with these therapies. Child neurologist attitudes toward integrative medicine and educational needs in integrative medicine have not been assessed. A national, anonymous survey was distributed to Child Neurology residents (n=294) and program directors (n=71) to assess attitudes toward specific integrative medicine modalities, practices in discussing integrative medicine with patients, and perceived need for a curriculum on integrative medicine; 61 (17%) partially and 53 (15%) fully completed the survey. Comparative analyses applied chi-square and independent t tests. Qualitative content analysis was performed on free text responses. Most providers surveyed consider mind and body practices safe (93% of respondents) and effective (84%), but have concerns about the safety of chiropractic manipulation (56% felt this was harmful), and the efficacy of homeopathy (none considered this effective). Few inquire about patient integrative medicine use regularly. Child Neurology residents are interested in further education on this topic.

The Bell Tolls for Homeopathy: Time for Change in the Training and Practice of North American Naturopathic Physicians.

North American naturopathic medicine is a distinct form of practice that is woven into the larger fabric of integrative medicine; in a number of US states and Canadian provinces, naturopathic doctors enjoy a wide scope of practice, including the ability to make diagnoses, order tests, use medical technology, write prescription drugs, and perform minor surgeries. However, the basic premise of naturopathic medicine and its guiding principles-considering the whole person and supporting healthy lifestyle behaviors-is the unifying approach in clinical practice. In the 1970s, homeopathy-considered in many circles to be a hypothesis-driven, fringe form of alternative medicine-became embedded into the training and practice of North American naturopathic doctors. Since the earliest days of its theory (circa 1800), homeopathy has escaped, and continues to escape, biological plausibility; however, the persistence of this modality (and the insistence by both its consumers and practitioners that it provides benefit) speaks to the role of expectations, beliefs, values, agency, context effects, and the placebo-at-large. It is our contention that the progression of professional naturopathic medicine in the 21st century requires a major transition in how it approaches the subject of homeopathy. We propose that students should be encouraged to critically analyze the tenets of homeopathy, its lesser known history, and the idea of homeopathy as a biomedicine that simply awaits untold chemicophysical mechanisms. Furthermore, the modality of homeopathy should be incorporated into the larger context of placebo studies, narrative medicine, ethics, and psychotherapeutic techniques.

Formación médica en la terapéutica no convencional en el mundo (homeopatía y acupuntura) / Medical training in non-conventional therapeutics in the world (homeopathy and acupuncture)

Utilizadas de forma complementaria, alternada o integrada con la medicina convencional, la demanda de la población por las terapias no convencionales se ha incrementado considerablemente en las últimas décadas, requiriendo de los médicos un conocimiento de las nociones básicas de tales enfoques terapéuticos para orientar a sus pacientes en relación con tratamientos distintos a aquellos que suelen prescribir. Entre las mismas, la homeopatía y la acupuntura se han considerado especialidades médicas en Brasil durante varias décadas. Objetivo: Describir el estado actual de la formación médica en terapias no convencionales (homeopatía y acupuntura) alrededor del mundo. Métodos: Actualizamos los datos relacionados con los estudios y revisiones publicados hasta 2013 a través de una revisión de los estudios más recientes incluidos en la base de datos PubMed. Resultados: En todos los países, la enseñanza de terapias no convencionales se considera un tema relevante para la formación de médicos como una función del creciente interés de la población en su uso, con un amplia variedad de enfoques dirigidos a los estudiantes de licenciatura y posgrado, médicos residentes y profesionales con otras especialidades médicas. Conclusiones: Las escuelas brasileñas de medicina deben proporcionar a los estudiantes de licenciatura y posgrado, así como a los médicos residentes, un conocimiento preciso de los supuestos teóricos y enfoques clínico-terapéuticos propios de la homeopatía y la acupuntura, entre otras terapias no convencionales.

Used as complementary to, alternating or integrated with mainstream medicine, the population's demand for non-conventional therapies has substantially increased in the past decades, requiring from doctors knowledge on the basic notions of such therapeutics to orient their patients regarding treatments different to the ones they usually prescribe. Among them, homeopathy and acupuncture are considered medical specialties in Brazil for various decades. Aim: To describe the current state of medical education in non-conventional therapies (homeopathy and acupuncture) around the world. Methods: We updated data resulting from studies and reviews published until 2013 through a review of more recent studies included in database PubMed. Results: In all countries the teaching of non-conventional therapies is considered a relevant topic for the training of doctors as a function of the increasing interest of the population in their use, with a broad range of approaches targeting undergraduate and graduate students, medical residents and doctors from other medical specialties. Conclusions: The Brazilian medical schools must provide undergraduate and graduate students and medical residents accurate knowledge on the theoretical assumptions and clinical-therapeutic approaches proper to homeopathy and acupuncture, among other non-conventional therapies.

Why Do Students Engage in Elective Courses on Acupuncture and Homeopathy at Medical School? A Survey.

BACKGROUND: We aimed to investigate why medical students in Germany participate in elective courses on acupuncture or homeopathy. METHODS: The study was a nationwide, cross-sectional survey. Elective courses on acupuncture and homeopathy in the academic half-year 2013/14 were identified by inquiries directed to all 37 German medical schools, to student initiatives, and organizations supporting such courses. Participants of courses were asked to fill in a questionnaire consisting of a free-text question on their motives and closed questions regarding personal experiences, personal environment, evidence, role of the therapy as a complement to conventional medicine, and opportunistic aspects in relation to the therapy chosen. RESULTS: Students participating in 16 of 18 identified acupuncture courses (n = 220) and 12 of 13 identified homeopathy courses (n = 113) filled in the questionnaire. Content analysis of the free text showed that personal experience, a feeling that conventional medicine is somehow incomplete, the belief that acupuncture or homeopathy could help to overcome this shortcoming, and positive characteristics attributed to the therapies were the main motives for participation. Quantitative analyses showed that own experiences and considering the therapy a useful complement to conventional medicine were similarly rated motives in both groups, while opportunistic aspects played almost no role. The influence of the personal environment was more important among homeopathy students, while acupuncture students considered their therapy better backed by evidence. CONCLUSION: In our survey, personal experiences and the belief that acupuncture or homeopathy allows grasping the patient more holistically were primary motives for participation.

An Evaluation on Medical Education, Research and Development of AYUSH Systems of Medicine through Five Year Plans of India.

INTRODUCTION: Indian system of medicine has its origin in India. The system is currently renamed as AYUSH, an acronym for Ayurveda, Yoga & Naturopathy, Unani, Sidha and Homeopathy. These are the six Indian systems of medicine prevalent and practiced in India and in few neighboring Asian countries. OBJECTIVE: The primary objective of this review was to gain insight in to the prior and existing initiatives which would enable reflection and assist in the identification of future change. MATERIALS AND METHODS: A review was carried out based on the five year plan documents, obtained from the planning commission web portal of Govt. of India, on medical education, research and development of AYUSH systems of medicine. RESULTS: Post independence, the process of five year planning took its birth with the initiation of long term planning in India. The planning process embraced all the social and technology sectors in it. Since the beginning of five year planning, health and family welfare planning became imperative as a social sector planning. Planning regarding Indian Systems of Medicine became a part of health and family welfare planning since then. During the entire planning process a progressive path of development could be observed as per this evaluation. A relatively sluggish process of development was observed up to seventh plan however post eighth plan the growth took its pace. Eighth plan onwards several innovative development processes could be noticed. Despite the relative developments and growth of Indian systems of medicine these systems have to face lot of criticism and appraisal owing to their various characteristic features. In the beginning the system thrived with great degree of uncertainty, as described in 1(st) five year plan, however progressed ahead with a vision to be a globally accepted system, as envisaged in 11(th) five year plan. CONCLUSION: A very strong optimistic approach in spreading India's own medical heritage is the need of the hour. The efforts are neither completely insufficient nor sufficient enough; hence a continuous endeavor for the revival and dissemination of India's own medical inheritance for the welfare of the society at large is highly desirable.

Homeópatas Latinoamericanos / Latin American Homeopaths

Un breve repaso por la historia de la Homeopatía, así como los antecedentes históricos de su llegada a los distintos países de América Latina, sirve como preámbulo para hablar de la Asociación Homeópatas Latinoamericanos, conformada por un extenso grupo de médicos que se ha convertido en una referencia académica de gran relevancia. Los miembros de este club, al cual pertenecen 523 personas, intercambian con sus pares información de la historia de la Homeopatía y aprenden bases conceptuales de las diferentes escuelas, al mismo tiempo que discuten aspectos ligados a las Materias Médicas y la repertorización. El foro permite, asimismo, conocer de múltiples casos clínicos de éxito, así como las diferencias y equivalencias en las escalas de dilución en muchos países del mundo.

A brief review of the history of Homeopathy, as well as the historical background of its arrival in the different countries of Latin America, serves as a preamble to talk about the Association of Latin American Homeopaths, made up of a large group of doctors that has become an academic reference of great relevance. The members of this club, to which 523 people belong, exchange with their peers information on the history of Homeopathy and learn conceptual bases of the different schools, while discussing aspects related to Medical Subjects and repertorization. The forum also allows for multiple clinical success stories, as well as differences and equivalencies in dilution scales in many countries of the world.

Estructuración de la Homeopatía en Brasil: directrices para el entrenamiento y la formación de recursos humanos / Structuring of Homeopathy in Brazil: guidelines for the training and education of human resources

La formación de recursos humanos de elevada cualificación en el área homeopática debe encararse como una de las prioridades para una sólida y definitiva consolidación de la Homeopatía en territorio brasileño. La cuestión de la estructuración de la Homeopatía en Brasil, por su parte, no puede ser convenientemente entendida sin un análisis de los sistemas formadores y captadores de recursos humanos homeopáticos. Es decir, el análisis debe recaer sobre la enseñanza homeopática de graduación y posgrado, pero también sobre las condiciones del mercado de trabajo para el médico homeópata. La reflexión sobre la enseñanza de la Homeopatía, en cambio, conduce inevitablemente al abordaje del problema de la investigación homeopática. Este artículo no tiene la intención de realizar un diagnóstico exhaustivo de la situación de la Homeopatía en lo que se refiere a la enseñanza, la investigación y el mercado de trabajo en Brasil. Sin embargo, a partir de algunos presupuestos y constataciones personales, delinearemos un marco general que permita definir algunas directrices relativas al problema de estructuración de la Homeopatía en Brasil.

The formation of highly qualified human resources in the homeopathic sector must be faced as a priority for a solid and definitive consolidation of Homeopathy in Brazilian territory. On the other hand, the structuring of Homeopathy in Brazil, cannot be conveniently understood without an analysis of both the training and recruiting systems for homeopathic human resources. In other words, the analysis must not only fall upon homeopathic teaching at a postgraduate level, but also the job-market conditions for the homeopathic physician. On the other hand, the reflection upon the teaching of Homeopathy, inevitably leads to an approach to the problem of homeopathic investigation. This article does not have the intention of carrying out an exhaustive diagnosis of the educational, investigational and jobmarket aspects of Homeopathy in Brazil. However, on some based budgets and personnel records, a general framework that will allow the definition of several directives pertaining to the problem of the structuration of Homeopathy in Brazil, will be outlined.

La COVID-19 por SARS-CoV-2 también ha afectado a la educación médica / COVID-19 by SARS-CoV-2 has also affected medical education

El virus SARS-CoV-2, además de provocar una pandemia con centenares de miles de enfermos y con decenas de miles de fallecidos, ha tenido la capacidad ("el poder") de romper las prácticas educativas estándar. Esto ha tenido, o puede tener, un beneficio: reconsiderar lo que es realmente importante y lo que no lo es tanto. Y eso tiene un gran valor para el docente y para el discente. Y también ha servido para reconocer y encontrar formas alternativas con las que se puede transmitir el saber. En definitiva, el profesor ha tenido la oportunidad de contribuir a crear un modelo educativo capaz de impulsar el desarrollo de nuevas formas y métodos de aprendizaje. Ciertas técnicas y recursos educativos han podido ser reconocidos como presentes o ausentes de nuestro sistema educativo. Esto implica que ciertos recursos han de estar presentes o que es preciso optimizar los que ya están disponibles para enseñar, para aprender o para evaluar. La tecnología permite facilitar el contacto directo entre profesor y alumno, entre profesores, y entre alumnos. Pero sobra decir que la tecnología ha de estar disponible.

The SARS-CoV-2 virus, besides causing a pandemic, with hundreds of thousands ill, and tens of thousands dead, has caused a major shift in standard education practices. This has had, or may have, one benefit: to reconsider what is ultimately relevant or not in the classroom. And this is of great value for the teacher and for the student. And it has also served to recognise and find alternative ways to transmit the knowledge. All things considered, the teacher has had the opportunity to contribute in creating an education with the aim of developing new ways and methods of learning. Certain educational techniques and resources have been recognised as present or absent in our education system. It is necessary for certain resources used to teach, learn and evaluate to be available and those that are already present, require optimization. Technology helps to provide direct contact between teacher and student, between teachers and between students. But it goes without saying that this technology has to be available.

Doctor Guillermo Soberón Acevedo: destacado médico mexicano / Doctor Guillermo Soberón Acevedo: outstanding Mexican doctor

En la presente entrevista, realizada en 1999, el doctor Guillermo Soberón Acevedo (1925- 2020) opina sobre distintos temas relacionados con la medicina y la salud pública. Comenta su proceso de formación como médico, la responsabilidad de los especialistas que se preparan en el extranjero y regresan a México, así como sus trabajos como rector de la UNAM y en el sector público, donde dirigió la transformación de la entonces Secretaría de Salubridad y Asistencia en la actual Secretaría de Salud. Asimismo, aborda temas como el carácter mutifacético de la medicina, la importancia de la investigación y las facultades de medicina, el valor de la certificación, el trabajo de los colegios y las asociaciones médicas y el futuro de la ciencia médica, además de que ofrece su punto de vista sobre la Homeopatía.

In this interview, conducted in 1999, Dr. Guillermo Soberón Acevedo (1925-2020) gives his opinion on different topics related to medicine and public health. He comments on his training process as a doctor, the responsabilities of the specialists who prepare abroad and return to Mexico, as well as his work as Rector of the Universidad Nacional Autónoma de México (National Autonomous University of Mexico) As well as his experience in the public sector, in which he directed the transformation of the then Secretaría de Salubridad y Asistencia (Ministry of Healthiness and Assistance) into the current Secretaría de Salud (Ministry of Health). It also addresses topics such as the multifaceted nature of medicine, the importance of research and medical schools, the value of certification, the work of medical colleges and associations, and the future of medical science, in addition to offering his point of view on Homeopathy.

Homeopathy as elective in undergraduate medical education--an opportunity for teaching professional core skills.

AIM: The evaluation of medical students' perceptions regarding an elective study course in Homeopathy in which small groups have participated annually for six years, at the Institute for General Practice and Family Medicine at the Otto Von Guericke University, Magdeburg. The course was assessed in terms of concept, delivery, and influence on students' professional development. METHODOLOGY: Since the autumn term of 2008/09, three group discussions have been conducted with thirty of the course participants (3 total electives). These discussions were semi-structured and guided by central topics; the analysis was qualitative and guided by content. RESULTS: The overall concept and implementation of the course were very successful. The main learning themes, that is, an emphasis on a more holistic and individual view of patients and the importance of a cooperative partnership between doctor and patient, were positively rated, regardless of the students' attitudes towards homeopathy. Their assessment was based on their previous experience and a comparison with conventional medical education. CONCLUSION: Homeopathy as an elective subject is not only useful for acquiring specific knowledge in integrative medicine, but also important as a means of developing physicians' core skills that are often not well considered in conventional medical education.

Complementary and Alternative Medicine Teaching: Evaluation of theTeaching-Learning Process of Integrative Practices in Brazilian Medical Schools / Práticas Integrativas e Complementares: Avaliação do Processo de Ensino-Aprendizagem em Práticas Integrativas nas Escolas Médicas do Brasil

ABSTRACT Context Complementary and Alternative Medicine (CAM) are unconventional care practices that, according to the World Health Organization, should be implemented in the Health System, particularly in poor regions of the country. In Brazil, they have been adopted by Care Programs and introduced into undergraduate medical education. In this study we were interested in evaluating the teaching-learning process of Integrative Practices in Brazilian medical schools. Methodology A cross-sectional study was carried out at Brazilian medical schools with a self-administered questionnaire for teachers and a secondary data survey was obtained from medical school websites and government database institutions. For the presentation of the variables, frequency distribution and the Pearson coefficient (X2) -Chi-square tests were used. The proportions were compared using the Chi-square test or the Fisher's Exact Test. When the expected value of a contingency table was equal to or greater than 5, the Chi-square test was used; in all other situations, Fisher's Exact Test was used. The difference between proportions was estimated by the Odds Ratio, calculated through simple logistic regression (95% CI). Results 57 of the 272 medical schools in Brazil address CAM, with it being proportionally higher in the South and Mid-West regions. The medical schools are highly concentrated in state capitals, and the Northeast region presents a significant concentration of medical schools with CAM in the capitals. The number of schools with active and traditional methodologies in CAM is equivalent. Homeopathy, Acupuncture and Integrative Medicine predominate, with a minority using Indigenous Practices, Chronotherapy and Anthroposophic Medicine. The new educational guidelines have not affected the number of schools with CAM. Growth in CAM has been insignificant (p <0.05) in the last ten years. Conclusion There has been no growth in teaching Complementary and Alternative Medicine in undergraduate medical training in Brazil since the introduction of the new curricular guidelines, even in view of the needs of the health system.

RESUMO Contexto Medicinas Complementares e Alternativas (MAC) são práticas de cuidados não convencionais que, segundo a Organização Mundial da Saúde, devem ser implementadas no sistema de saúde, particularmente nas regiões pobres do País. No Brasil, têm sido inseridas na saúde como Práticas Integrativas por meio de programas assistenciais e no ensino de graduação. Objetivou-se avaliar o processo de ensino-aprendizagem em Práticas Integrativas nas escolas médicas brasileiras. Metodologia Um estudo transversal foi realizado em escolas médicas brasileiras com um questionário autoaplicável para professores, e um levantamento de dados secundários foi obtido em websites de escolas médicas e instituições de bancos de dados governamentais. Na apresentação das variáveis utilizou-se a distribuição de frequências e os testes do coeficiente de Pearson (x2) - Qui-Quadrado. As proporções foram comparadas por meio do teste Qui-Quadrado ou do Teste Exato de Fisher. Quando o valor esperado de uma tabela de contingência foi igual ou superior a 5, utilizou-se o teste Qui-Quadrado; em todas as outras situações, utilizou-se o Teste Exato de Fisher. A diferença entre as proporções foi estimada pela Odds Ratio, calculada por meio de regressão logística simples (95% IC). Resultados Das 272 escolas médicas do Brasil, 57 abordam MAC, sendo essa proporção maior nas regiões Sul e Centro-Oeste. Há uma concentração de escolas médicas em capitais, e a Região Nordeste apresenta uma concentração significativa de escolas médicas com MAC nas capitais. O número de escolas com metodologias ativas e tradicionais no ensino de MAC é equivalente. A homeopatia, a acupuntura e a medicina integrativa predominam, com uma minoria usando práticas indígenas, cromoterapia e medicina antroposófica. As novas diretrizes educacionais não causaram impacto no número de escolas com MAC. O crescimento em MAC foi insignificante (p < 0, 5) nos últimos dez anos. Conclusão Não houve crescimento no ensino em Práticas Integrativas e Complementares no Brasil na graduação médica após as novas diretrizes curriculares, mesmo diante das necessidades do sistema de saúde.

Medical education in India: Time to encourage cross-talk between different streams.

Currently, India recognizes five different healthcare systems, collectively known as AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy), along with the conventional biomedicine. These systems have their own institutionalized structure for monitoring medical education and practice. However, because of the 'parallel' kind of policy model that is followed in India, there is no formal provision for any cross-talk between the professionals belonging to these different streams. This situation has not only given rise to mutual misgivings among these professionals regarding the strengths and weaknesses of each other, but also has led to a poor appreciation of the historical and socio-cultural connections these streams share with the community at large. To tackle these issues and to promote adequate participation of biomedicine experts in AYUSH-related research projects, 'introduction of an AYUSH module in the current curriculum of MBBS (Bachelor of Medicine and Bachelor of Surgery) program' has been proposed in this communication along with a possible roadmap for its implementation. It is also suggested that the experts in biomedicine be engaged for training AYUSH graduates in their respective specialties so that quality AYUSH education may be ensured.

Homeopatia na Graduação Médica: Trajetória da Universidade Federal Fluminense / Homeopathy in Medical Schools: Trajectory of the Universidade Federal Fluminense

RESUMO A medicina homeopática foi reconhecida pelo Conselho Federal de Medicina como especialidade médica em 1980 e desde então a presença de seu ensino na formação médica tem se ampliado no Brasil. Na graduação médica da Universidade Federal Fluminense (UFF), iniciou-se em 1994. Em estudo de caso com abordagem qualitativa, analisou-se a trajetória do ensino da Homeopatia no curso de Medicina da UFF utilizando-se análise documental, observação direta, entrevistas individuais de coordenadores e alunos, e grupo focal com ex-alunos das cinco disciplinas que abordam a medicina homeopática. Identificou-se uma trajetória de resistência e avanços, desencadeada no processo de reforma curricular em contexto de implantação do Sistema Único de Saúde (SUS) e ampliação da atenção primária. Apoiado na colaboração de profissionais externos à instituição, o ensino da Homeopatia na Medicina da UFF apresenta como principais desafios sua consolidação no currículo obrigatório, integração às demais clínicas, contratação de professores especialistas e recriação do ambulatório-escola em Homeopatia para prática supervisionada. A humanização da prática médica e a integralidade do cuidado foram suas contribuições mais mencionadas, numa perspectiva de integração e complementaridade da abordagem biomédica. Nas disciplinas obrigatórias, defende-se que os alunos possam desenvolver competências e habilidades para: (a) orientar e encaminhar pacientes à Homeopatia quando puderem ser beneficiados por esta medicina; (b) dialogar com colegas homeopatas no acompanhamento de pacientes comuns. As disciplinas optativas são importantes para alunos que queiram ampliar sua formação teórico-prática em Homeopatia, tendo em vista uma atuação profissional que inclua esta especialidade e lhes permita integrar os paradigmas vitalista e biomédico no cuidado em saúde. O ensino da Homeopatia na graduação médica da UFF é sustentado no compromisso de sua comunidade acadêmica com uma formação plural em saúde, capaz de propiciar aos futuros profissionais o uso de diferentes paradigmas para lidar com o processo de adoecimento, o corpo e as pessoas na sociedade contemporânea e, desta forma, contribuir para melhorar o relacionamento com pacientes, promover autonomia, diminuir abordagens invasivas e insensíveis, ampliar a integralidade do cuidado e a resolutividade do trabalho em saúde. O estudo crítico de sua trajetória oferece contribuições para uma reflexão sobre o ensino da Homeopatia também em outras escolas médicas, sejam as que já contemplem a Homeopatia em sua grade de disciplinas, sejam aquelas que estejam planejando inseri-la no currículo em resposta à demanda de alunos e professores.

ABSTRACT Homeopathic medicine was recognized by the Federal Council of Medicine as a medical specialty in 1980, and since then its teaching as part of medical training has grown in Brazil. Homeopathic medicine was first taight in Brazil in 1994 in the undergraduate medicine program of the Universidade Federal Fluminense (UFF). The history of teaching Homeopathy in the UFF medical course was analyzed in a qualitative-approach case study using documental analysis, direct observation, individual interviews with coordinators and students, and focus groups with alumni from five disciplines that address Homeopathy. The path identified involved resistance and progress, triggered by the curricular reform process in context of the implementation of the Brazilian Unified Health System (SUS) and the expansion of primary care. The teaching of Homeopathy in the UFF medical course was supported by the collaboration of external professionals. The major challenges included consolidating the discipline on the compulsory curriculum, acheiving integration with other clinics, hiring qualified teachers and recreating an outpatient Homeopathy school environment for supervised practice. From the perspective of integration and complementarity of the biomedical approach, humanized medical practice and comprehensive care were the most mentioned contributions. In the compulsory subjects it is argued that students can develop skills and abilities to: (a) guide and refer patients to Homeopathy whenever they might benefit from this medical practice; and (b) hold dialogues with homeopathy colleagues concerning the monitoring of common patients. The optional subjects are important for students who want to broaden their theoretical and practical training in Homeopathy, aimed at offering a professional practice that includes this specialty and permits the integration of the vitalist and biomedical paradigms in health care. The teaching of Homeopathy in the UFF undergraduate medical program is supported by its academic community's commitment to a plural health education that enables future professionals to use different paradigms for dealing with the disease process, the body and people in a contemporary society. This, in turn, contributes to improving relationships with patients, promotes autonomy, reduces invasive and insensitive approaches and expands comprehensive health care and resolute health work. This critical study of the trajectory of Homeopathy education in the UFF undergraduate medical course adds support to reflections on its teaching in other medical schools, including schools that already contemplate Homeopathy in their schedule or schools that are planning to include it in their curriculum in response to student and teacher demand.

Los desafíos en la formación de los futuros médicos / Challenges in the training of future doctors

En este artículo, el autor reflexiona sobre sobre el presente y el futuro de la educación médica en el contexto de las tecnologías de la información y de la convivencia de nuestro trabajo con los dispositivos de inteligencia artificial, de los nuevos contenidos de genética y neurociencias, del trabajo en equipo y de la necesaria resignifificación de los términos "cura" y "cuidado". Se pregunta además si estamos en condiciones de encarar dicho desafío y de estar a la altura de las necesidades educativas de las próximas (y la actual) generación/es de médicos. (AU)

In this article, the author reflects on the present and the future of medical education in the context of information technologies and the coexistence of our work with artificial intelligence devices, the new contents of genetics and neurosciences, about team work and the necessary resignification of the terms "cure" and "care". He also wonders if we are able to face this challenge and to deal with the educational needs of the next (and the current) generation/s of doctors. (AU)

Medical education in non-conventional therapeutics in the world (homeopathy and acupuncture)

Background: Used as complementary to, alternating or integrated with mainstream medicine, the population’s demand for non-conventional therapies has substantially increased in the past decades, requiring from doctors knowledge on the basic notions of such therapeutics to orient their patients regarding treatments different to the ones they usually prescribe. Among them, homeopathy and acupuncture are considered medical specialties in Brazil for various decades. Aim: To describe the current state of medical education in non-conventional therapies (homeopathy and acupuncture) around the world. Methods: We updated data resulting from studies and reviews published until 2013 through a review of more recent studies included in database PubMed. Results: In all countries the teaching of non-conventional therapies is considered a relevant topic for the training of doctors as a function of the increasing interest of the population in their use, with a broad range of approaches targeting undergraduate and graduate students, medical residents and doctors from other medical specialties. Conclusions: The Brazilian medical schools must provide undergraduate and graduate students and medical residents accurate knowledge on the theoretical assumptions and clinical-therapeutic approaches proper to homeopathy and acupuncture, among other non-conventional therapies.

Homeopatia na Graduação Médica: Trajetória da Universidade Federal Fluminense / Homeopathy in Medical Schools: Trajectory of the Universidade Federal Fluminense

RESUMO A medicina homeopática foi reconhecida pelo Conselho Federal de Medicina como especialidade médica em 1980 e desde então a presença de seu ensino na formação médica tem se ampliado no Brasil. Na graduação médica da Universidade Federal Fluminense (UFF), iniciou-se em 1994. Em estudo de caso com abordagem qualitativa, analisou-se a trajetória do ensino da Homeopatia no curso de Medicina da UFF utilizando-se análise documental, observação direta, entrevistas individuais de coordenadores e alunos, e grupo focal com ex-alunos das cinco disciplinas que abordam a medicina homeopática. Identificou-se uma trajetória de resistência e avanços, desencadeada no processo de reforma curricular em contexto de implantação do Sistema Único de Saúde (SUS) e ampliação da atenção primária. Apoiado na colaboração de profissionais externos à instituição, o ensino da Homeopatia na Medicina da UFF apresenta como principais desafios sua consolidação no currículo obrigatório, integração às demais clínicas, contratação de professores especialistas e recriação do ambulatório-escola em Homeopatia para prática supervisionada. A humanização da prática médica e a integralidade do cuidado foram suas contribuições mais mencionadas, numa perspectiva de integração e complementaridade da abordagem biomédica. Nas disciplinas obrigatórias, defende-se que os alunos possam desenvolver competências e habilidades para: (a) orientar e encaminhar pacientes à Homeopatia quando puderem ser beneficiados por esta medicina; (b) dialogar com colegas homeopatas no acompanhamento de pacientes comuns. As disciplinas optativas são importantes para alunos que queiram ampliar sua formação teórico-prática em Homeopatia, tendo em vista uma atuação profissional que inclua esta especialidade e lhes permita integrar os paradigmas vitalista e biomédico no cuidado em saúde. O ensino da Homeopatia na graduação médica da UFF é sustentado no compromisso de sua comunidade acadêmica com uma formação plural em saúde, capaz de propiciar aos futuros profissionais o uso de diferentes paradigmas para lidar com o processo de adoecimento, o corpo e as pessoas na sociedade contemporânea e, desta forma, contribuir para melhorar o relacionamento com pacientes, promover autonomia, diminuir abordagens invasivas e insensíveis, ampliar a integralidade do cuidado e a resolutividade do trabalho em saúde. O estudo crítico de sua trajetória oferece contribuições para uma reflexão sobre o ensino da Homeopatia também em outras escolas médicas, sejam as que já contemplem a Homeopatia em sua grade de disciplinas, sejam aquelas que estejam planejando inseri-la no currículo em resposta à demanda de alunos e professores.

ABSTRACT Homeopathic medicine was recognized by the Federal Council of Medicine as a medical specialty in 1980, and since then its teaching as part of medical training has grown in Brazil. Homeopathic medicine was first taight in Brazil in 1994 in the undergraduate medicine program of the Universidade Federal Fluminense (UFF). The history of teaching Homeopathy in the UFF medical course was analyzed in a qualitative-approach case study using documental analysis, direct observation, individual interviews with coordinators and students, and focus groups with alumni from five disciplines that address Homeopathy. The path identified involved resistance and progress, triggered by the curricular reform process in context of the implementation of the Brazilian Unified Health System (SUS) and the expansion of primary care. The teaching of Homeopathy in the UFF medical course was supported by the collaboration of external professionals. The major challenges included consolidating the discipline on the compulsory curriculum, acheiving integration with other clinics, hiring qualified teachers and recreating an outpatient Homeopathy school environment for supervised practice. From the perspective of integration and complementarity of the biomedical approach, humanized medical practice and comprehensive care were the most mentioned contributions. In the compulsory subjects it is argued that students can develop skills and abilities to: (a) guide and refer patients to Homeopathy whenever they might benefit from this medical practice; and (b) hold dialogues with homeopathy colleagues concerning the monitoring of common patients. The optional subjects are important for students who want to broaden their theoretical and practical training in Homeopathy, aimed at offering a professional practice that includes this specialty and permits the integration of the vitalist and biomedical paradigms in health care. The teaching of Homeopathy in the UFF undergraduate medical program is supported by its academic community's commitment to a plural health education that enables future professionals to use different paradigms for dealing with the disease process, the body and people in a contemporary society. This, in turn, contributes to improving relationships with patients, promotes autonomy, reduces invasive and insensitive approaches and expands comprehensive health care and resolute health work. This critical study of the trajectory of Homeopathy education in the UFF undergraduate medical course adds support to reflections on its teaching in other medical schools, including schools that already contemplate Homeopathy in their schedule or schools that are planning to include it in their curriculum in response to student and teacher demand.