People´s aging: a new challenge for the study plan of the Medicine career
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People´s aging: a new challenge for the study plan of the Medicine career

 

Envejecimiento poblacional: nuevo reto para el plan de estudio de la carrera de Medicina

 

 

Ana Isis Arias Gallardo1, Néstor Moré Hernández2, Ivón Felicia Alfonso Alfonso3

1 Medical Doctor. Master of Science. Associate Professor. Villa Clara University of Medical Sciences. Cuba. E-mail: anaag@ucm.vcl.sld.cu
2 Medical Doctor. Instructor Professor. Teaching Clinic "Chiqui Gómez Lubián". Santa Clara. Villa Clara. Cuba. E-mail: anaag@ucm.vcl.sld.cu
3 Medical Doctor. Master of Science. Assistan Professor. Teaching Clinic "XX Aniversario". Santa Clara. Villa Clara. Cuba. E-mail: anaag@ucm.vcl.sld.cu

 

 

ABSTRACT

The pertinence of the medical formation can be considered as the adjustment of the contents from the curricula to the social necessities of health. Cuba occupies the second place among the countries with a more aged population in Latin America and in 10 years ahead one of each four Cubans will be an elderly people. The study plan of the Medicine career projects in an insufficient way the management of elderly people, even when it includes elderly homes as educational scenarios for the teaching of the comprehensive General Medicine and some other disciplines of the clinical cycle only a minimum percent of students have rotations by these institutions. The current article presents the analysis carried out about the contents related to this topic that General Practitioners receive during the career and in what subjects they are imparted, what will serve as base for later proposals of actions.

MeSH: Demographic aging, programs of study, education, medical.

RESUMEN

La pertinencia de la formación médica puede verse como el ajuste de los contenidos de los currículos a las necesidades sociales de salud. Cuba ocupa el segundo lugar entre los países con una población más envejecida de América Latina y dentro de solo 10 años uno de cada cuatro cubanos será un anciano. El plan de estudio de la carrera de Medicina proyecta de manera insuficiente el manejo del paciente adulto mayor, y aún cuando incluye los hogares de ancianos como escenarios docentes para la enseñanza de la Medicina General Integral y algunas otras disciplinas del ciclo clínico, solo un porciento mínimo de estudiantes rota por esas instituciones. El presente artículo pretende significar el análisis realizado acerca de cuáles son los contenidos relacionados con este tema que recibe el futuro médico durante su carrera y en qué asignaturas se imparten, lo que servirá de base para posteriores propuestas de acciones.

DeCS: Envejecimiento de la población, programas de estudio, educación médica.

 

 

According to Álvarez de Zayas,1 the pertinence and the relevance of the curriculum rely on the extent it expresses, in a pedagogic language, the social expectation in regard to the capacities that are necessary to develop in the students to form competitive professionals in a market of constant changes, keeping in mind the social, political, cultural and economic values of the developing society, where they should perform a social function.

The pertinence of the medical education should be considered according to its correspondence with the necessities of people's health, the families and the communities in its social and natural environment, but it must also take into account what is derived from the level of current and perspective development of the context and its demands to the higher education.

It is understood by the pertinence of the medical formation as the adjustment of the contents from the curricula to the social necessities of health.2

The composition of society is changing. Cuba is a developing country that shows a life expectancy of 78,97 years for men and 80 years for women. It is expected by 2025 that the Cuban population will be the most aged in Latin America, and by 2050 it is expected that Cubans will have one of the most advanced age averages in the planet.3

This reality shows a steady increment of this age group. Other data refer that the demographic projections for 2030 indicate that 3,4 million Cubans will be senile for that date, with the population's 31 % in that condition that will be the oldest in Latin America; it is calculated that this figure rises to 38 % according to UN calculations, and it will be located in the 11th place among the most aged States in the planet.4

In the authors' opinion, the study plan of the Medicine career projects in an insufficient way the management of elderly patients; in spite of including elderly homes as educational scenarios for the teaching of comprehensive General Medicine and some other disciplines of the clinical cycle, only a minimum percent of students have rotations in these institutions. When the complexity of General Practitioners´ functions are analyzed, lacks of knowledge, habits, abilities and procedures to assist with efficiency to this age group are identified.5,6

Of all the problems to be solved by General Practitioners (GPs) and their performance level, they are only approached in an explicit way the osteoarticular ones in adults and the management of senile osteoporosis. Complications in woman and children are described but those in elderly people are not taken into acount.7

In a detailed revision of the study programs it can be observed that an approaching to the topics related to elderly people appear in around 20 % of the subjects according to semesters of the Medicine career:8,9

  • First semester

Subject: Introduction to Comprehensive General Medicine.

In the thematic unit VI: National health system.

It is mentioned inside the prioritized programs of health for the Attention to elderly people.

  • Second semester

Subject: Morpho-physiology IV.

In topic II: Regulation of growth and development.

It is imparted: Dynamic thyroid of the human development. Factors that intervene in the growth and normal development. The endocrine system in the childhood, the puberty, the adolescence, the adulthood and in the elderly. Alterations. Aging. Basic mechanism of the molecular aging. The aging of the organism. Aging as a natural stage of the development of the human beings. Peculiar characteristic of the elderly with medical importance.

Subject: Health Promotion.

In the thematic unit I: Community, family and promotion.

The contraction and breakup stages of the family are approached. Growth and the adult's comprehensive development and their involution with aging. Elderly people. Education for health. Sexuality. Hygienic-dietary habits. Characterization of growth and development in: youth, adulthood and the elderly.

  • Third semester

Subject: Physical education III.

In topic I: The physical exercise in the procedure and particularities in elderly people. Consolidation of the physical capacities. Auxiliary sport activity.

  • Fourth semester

Subject: Physical education IV.

One of their general objectives consists on explaining the pertinent therapeutic procedures for the differentiated attention to pregnant women, elderly and disable people and inside its system of abilities it includes the selection and dosage of specific physical exercises for the treatment of people in the third age.

Subject: Medical genetics.

In topic VIII: the updating about the illness in question is indicated, its natural history, treatments, the possibilities of early detection and the limitations of technical actions and its results, the severity of the defect, its prenatal beginning, neonatal, youth and elderly people.

Subject: Medical psychology I.

In topic II: Personality.

Involution and senility are approached. Essential characteristics of senility. Sexuality in this stage. Age responsibility with the elderly.

  • Eighth semester

Subject: Surgery.

In topic I: General principles of treatment.

Surgical risk. Concept. In third age patients, children, obese. Concepts, cardiovascular and undernourished affections.

  • Ninth semester

Subject: Public health.

In topic II: Analysis of the situation of the population's health.

Growth and Development: Physical development. Fundamental indicators. Influencing factors. Stages of physical development and growth. Childhood. Low weight at birth. Adulthood. Elderly. Ancientness.

Subject: Comprehensive General Medicine.

It contemplates in the system of abilities the physical exam ( children, adolescent, pregnant, adult and elderly people).

  • Internship

Rotation: Comprehensive General Medicine.

In the seminars of therapeutic updating.

Title of the topic: Alterations of growth and development in the different stages of the vital cycle.

Selection suggestion: Preconceptional risks. Low weight at birth. Alterations of growth and development since birth up to adolescence. Climacterics and menopause. Deviations of normality in the development and the elderly´s involution.

Subjects like Pathological Anatomy and Ophthalmology refer to the management of elderly people as part of the curricular strategy of public health and environmental formation; Clinical Propedeutics and Internal Medicine contemplate the possibility of using elderly homes as educational scenarios, but not the teaching of the particularities of elderly people.

As it had been mentioned, by 2025, only 10 years ahead, one of each four Cubans will be an elderly people, that´s why in the authors' opinion, it is necessary an careful preparation of the doctors in this sense to face the problem, in such a way that it becomes indispensable to carry out the revision of the curriculum and to make the necessary adaptations to match the study programs to the approaching time.

IT´s been proposed to impart the topics that doctors need to know in the form of a curricular strategy to alleviate the situation. Will this be a satisfactory solution? Villa Clara has the most aged population in the country. Will the answer be in the next Plan D?

 

BIBLIOGRAPHIC REFERENCES

1. Álvarez de Zayas C. Diseño curricular en la educación superior cubana. Rev Pedal Univ [Internet]. 1996 [citado 19 Feb 2015];1(1):[aprox. 15 p.]. Disponible en: http://cvi.mes.edu.cu/peduniv/index.php/peduniv/article/viewFile/103/102

2. Pernas Gómez M, Sierra Figueredo S, Fernández Sacasas JA, Miralles Aguilera E, Diego Cobelo JM. Principios estratégicos de la educación en Ciencias de la salud en Cuba (II): la pertinencia. Educ Med Super [Internet]. 2009 [citado 19 Feb 2014];23(2):[aprox. 10 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412009000200006&lng=es

3. Otaño Álvarez M, Núñez López MB, Amechazurra Oliva M, Triana Alonso PG. Proyecto de intervención para prevenir enfermedades cerebrovasculares en adultos mayores vinculados a una casa de abuelos. Rev Cubana Med Gen Integr [Internet]. 2014 [citado 19 Mar 2014];30(3):[aprox. 5 p.]. Disponible en: http://www.bvs.sld.cu/revistas/mgi/vol30_3_14/mgi01314.htm

4. Baster Moro JC. Adultos mayores en funciones de cuidadores de ancianos. Rev Cubana Salud Pública [Internet]. 2012 [citado 19 Feb 2013];38(1):[aprox. 5 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662012000100016&lng=es&nrm=iso&tlng=es

5. Reyes Mediaceja R, Bastart Ortiz EA, Reyes Mediaceja M. Evolución histórica sobre la formación del estudiante de Medicina en la atención al adulto mayor. EDUMECENTRO [Internet]. 2014 [citado 26 May 2014];6(1):[aprox. 12 p.]. Disponible en: http://www.revedumecentro.sld.cu/index.php/edumc/article/view/337/html

6. García Adianez A, Mejías Alcázar A. Necesidades de aprendizajes del personal de salud que atiende al adulto mayor. Educ Med Super [Internet]. 2009 [citado 26 May 2014];23(4):[aprox. 10 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412009000400005&lng=es

7. Reyes Mediaceja R, Bastart Ortiz EA, Mercaderes Ferrer MÁ, Pérez Miró F, Plasencia Asorey C. Necesidad de una competencia en los médicos generales básicos para la atención al adulto mayor. MEDISAN [Internet]. 2012 [citado 26 May 2014];16(1):[aprox. 8 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192012000100010&lng=es

8. Universidad de Ciencias Médicas de La Habana. Problemas a resolver por el médico general y su nivel de actuación. La Habana: MINSAP; 2010.

9. Universidad de Ciencias Médicas de La Habana. Programas de estudio. Carrera Medicina. La Habana: MINSAP; 2010.

 

 

Received: May, 27 2014.
Approved: January, 9 2015.

 

 

Ana Isis Arias Gallardo. Villa Clara University of Medical Sciences. Cuba. E-mail: anaag@ucm.vcl.sld.cu

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