RESUMO
BACKGROUND AND OBJECTIVES: In Venezuela, family medicine is taught and practiced almost exclusively in ambulatory care settings. This article describes the evolution of the educational strategies that emphasize family and community aspects of clinical practice within one residency program in the country of Venezuela. METHODS: Three distinct phases of development are depicted, beginning with a biomedical and individual-centered approach. Subsequent efforts to involve residents in the community provoked criticism. Resident-faculty dialogue led to modifications and to the success of the current program. Some of the specific educational strategies are: a structured weekly five-hour community afternoon, a 40-hour course titled "Family Dynamics and Counseling," use of the family-oriented home visit to introduce residents to the community aspects of health care, and completion of a community-based and health-related project. RESULTS: A sample of residents and graduates noted an improved doctor-patient relationship, improved ability to work with groups, and improved skills for incorporating preventive medicine with a community focus into their clinical practice. CONCLUSIONS: The community involvement is enthusiastically supported by the residents, as it is perceived as useful for clinical practice. The program prepares family physicians to become more responsive to the health needs and the reality of Venezuelan society.
Assuntos
Serviços de Saúde Comunitária , Medicina de Família e Comunidade/educação , Internato e Residência/métodos , Currículo , VenezuelaRESUMO
Family practice residency training in Venezuela is designed to prepare physicians to meet the health needs of the nation at a time of increasing societal concerns for the quality and cost of care. Since 1982, nine residency programs have been created throughout the country. Each two-year program is based in an ambulatory care setting. Entering physicians have completed an internship and have a minimum of two years practice experience. Graduates have been prepared to continue a socially active role to promote the new specialty. Training emphasizes community aspects of clinical practice, similar to the hopes of community-oriented primary care in the United States. Additional emphases include exposure to clinicians from other specialties, family aspects of patient care, working with a health care team, completion of a research project, and structured courses of theory in areas such as public health, behavioral medicine, and research methodology. Although hampered by economic constraints, the movement's intensely committed leaders have successfully captured political and public support.
Assuntos
Educação Médica , Medicina de Família e Comunidade/educação , Internato e Residência , Currículo , VenezuelaRESUMO
Los sistemas de atencion medica con pago anticipado tropiezan en todo el hemisferio con diversos problemas especificos. En este articulo se decriben los conceptos basicos, la estrategia y un modelo experimental existente que pueden ayudar a resolver los problemas que esos sistemas presentan para prestar servicios a grupos predeterminados de la poblacion