History of the creation and first developments of the Social Medical Notebooks. From the Chair of Preventive Medicine to Social Medical Training in Chile. Sixties and seventies

Abstract

At the end of 1958, the Department of Public Health of the Medical College reported in its minutes that it had received approval from the General Council to carry out a Seminar on Medical Training. After listening to various reports of the visit of its members and other doctors to the main educational centers in the United States and Europe, they reported on the efforts of those schools to adjust to the changes that reality was demanding of them. Something similar to what happened in the debate that the Department itself had on the guidelines that needed to be introduced in the training of health professionals, in accordance with what the national scenario demanded within the framework of a series of transformations of the medical work and the National Health System.

In order to carry out the meeting, the search for bibliography was carried out, at a global and national level, and, at the same time, the creation of the “Cuadernos Médico Sociales”, where these documents and the discussions that were held were published. were given in the country on this topic.

Meanwhile, the country was shaking off the second government of Carlos Ibáñez del Campo, which ended with a severe social, economic and political crisis, with the rise of union mobilization under the leadership of a Single Central of Workers and the strengthening of political parties. politicians, who were the representation of those same sectors, and who demanded better public services, including health.

The Seminar had the support of three key actors: the Medical College itself, through its Department of Public Health, the three universities that taught medicine and other health careers, and the National Health Service. This triad was fundamental so that the discussions that resonated in the care centers, the cloisters and the health institutions were more than a rhetorical exercise and were translated into programs and policies that gave new life to training and the care model. Likewise, in the trajectory of these actors we can find the bases for the changes that were subsequently introduced and that allowed significantly better health outcomes for the country, particularly in the two governments that collected these lessons and made them part of their health policies, with Eduardo Frei Montalva and Salvador Allende as presidents.

For its part, the “Cuadernos Médico Sociales”, where these same actors also converged, was the space for the compilation of national and international reflection, in addition to the transmission of the experiences of the conceptual and interdisciplinary amalgamation of the teams of professionals with the desire of a social medicine that would contribute to justice and the redistribution of resources.

This article wishes to rescue from historical memory the story of current actors of that epic, primary and other secondary sources of the time, to answer the question about what were the conditions that made possible the transformations that medical training and the healthcare system underwent. health, something that today, from the same interest, is greatly needed. Go beyond the rhetorical and declarative, to achieve effective changes, both in the graduation profile of professionals and in the health system, in order to achieve better health results.

The hypothesis proposed here is that by achieving the synergy of the three aforementioned actors; health professionals, academia and the health system, their history could be collected and new practices made effective. That was the key to success.