Aspectos de la formación médica en Chile. Su relación con los conceptos de medicina integral y medicina familiar y con la planificación de recursos humanos para el sistema de salud

Abstract

The current year —1998— has seen the start of a new syllabus at the Medical School of the University of Chile. This is a based upon a comprehensive view of human beings and of the health care they need, and represents a new phase of a process that was quite advanced in the country soon affer the creation of the National Health Service —1953. At that time the principles of Comprehensive Health Care were made explicit, both at a National Seminar on Medical Education —1960— and in several teaching experiences. Today, some of those principles are mentioned in the context of a critical view of general practitioners and of their role in Primary Health care — However, this view is of a different nature in Chile as compared with the situation in Europe, where independent GPs are an essential component of the health system. This and other current problems in the definition, education and licensing of physicians in Chile call for a revival of human resources planning for health care: a responsibility of the Ministry of Health. This is related to the estimates of the staff needed —in quantity and quality— by the system. In this respect it is proposed that the urban general clinics of the public subsystem should have a sufficient number of teams of basic specialists. In relation to the present objectives of medical education some relevant teaching methods are mentioned. Reference is made to the coherence of the teaching process as a condition for the integration of the health care system. The family approach to medicine, which is to be considered a componer of the comprehensive health care concept, is discussed. It is argued that it should not be confused with the proposal of training an “specialist in family medicine”, which carries risks for the development of health care in Chile. A national debate should take place on the subject of the health care model and system appropriate to Chile. This should be carefully prepared and should consider as a starting point the notion of comprehensive health care.