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Introducción. La educación médica en cirugía se encuentra en transformación, producto de la incorporación de estrategias pedagógicas en sus procesos docente-asistenciales. Sin embargo, existe una limitación de los docentes para responder a las necesidades educativas actuales propias de un programa de especialización en cirugía. Estudios sobre el tema han identificado puntos de intervención en las competencias docentes, con una nueva concepción de un profesor de cirugía. Métodos. Se analizó, con una posición crítica y desde la perspectiva del residente, los atributos esperados en un profesor de cirugía de alta calidad. Discusión. Se caracterizaron los roles de un profesor de cirugía, acorde con la actividad clínica y quirúrgica habitual, sus cualidades e impacto esperado como generador de un cambio en las competencias, técnicas y no técnicas, de un profesional médico en especialización. Asimismo, se efectuó una aproximación teórica al proceso de enseñanza-aprendizaje de la cirugía, así como de la construcción de su identidad docente, y los alcances pedagógicos de un profesor de cirugía en la actualidad. Conclusiones. El perfil del cirujano general ha cambiado y los profesores de cirugía deben estar a la altura de este reto. Los nuevos modelos educativos favorecen un impacto positivo en los postgrados y en la percepción del residente sobre su proceso formativo. Sin embargo, es necesario una reconfiguración del docente, dentro de un contexto propio del ejercicio de la cirugía y su responsabilidad social. Los programas académicos están obligados a propiciar el desarrollo profesoral en pro de elevar el nivel del futuro cirujano.

Introduction. Medical education in surgery is undergoing transformation as a result of the incorporation of pedagogical strategies in its teaching-assistance processes. However, there is a limitation of the professors to respond to the current educational needs of a specialization program in surgery. Studies on the subject have identified points of intervention in teaching skills, with a new conception of a professor of surgery.Methods. The expected attributes in a high-quality professor of surgery were analyzed from a critical point of view and from the resident's perspective. Discussion. The roles of a professor of surgery were characterized, in accordance with the usual clinical and surgical activity, their qualities, and expected impact as a generator of a change in technical and non-technical skills of a medical professional in specialization. Likewise, a theoretical approach to the teaching-learning process of surgery was carried out, as well as the construction of its teaching identity, and the pedagogical scope of a professor of surgery today. Conclusions. The profile of the general surgeon has changed and professors of surgery must rise to this challenge. The new educational models favor a positive impact on postgraduate courses and on the resident's perception of their training process. However, a reconfiguration of the teacher is necessary, within a context of the exercise of surgery and its social responsibility. The academic programs are required to promote teacher development in order to raise the level of the future surgeon.

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Introduction: The consequences of the Covid-19 epidemic have been catastrophic for Latin America in 2021. This study explores experiences, lessons learned, and practice changes during this critical time in post-graduate medical education in Latin America. Me-thods: A panel of 53 post-graduate medical education leaders from 8 Latin American countries and Canada was invited to participate in the 2021 Latin American Medical Education Leaders Forum to share their experiences, lessons learned, and main educational practice changes given the Covid-19 pandemic scenario. Participants were selected following a snowball technique with the goal of obtaining a diverse group of experts. Small group discussions were conducted by bilingual facilitators based on a semi-structured questionnaire. The plenary session with the main conclusions of each group was recorded and fully transcribed for a thematic analysis using a framework methods approach. Results: Participants ́ profiles included 13 experienced clinician-educators, 19 program directors, and 23 deans or organizational representatives. Seven specific themes emerged. They followed a pattern that went from an initial emotional reaction of surprise to a complex collective response. The responses highlighted the value of adaptability, the application of new digital skills, a renovated residents' protagonism, the strengthening of humanism in medicine, the openness of new perspectives in wellness, and finally, an unresolved challenge of assessment in medical education in a virtual post-pandemic scenario. Conclusion: A diverse panel of medical educators from Latin America and Canada identified changes triggered by the Covid-19 pandemic that could transform postgraduate medical education in the region.

Introducción: la pandemia de Covid-19 ha tenido consecuencias catastróficas para América Latina en el año 2021. Este estudio explora las experiencias, lecciones aprendidas y nuevas prácticas surgidas durante este crítico período en la educación médica de postgrado en América Latina. Métodos: un panel de 53 líderes de 8 países de América Latina y Canadá fue invitado a participar en el Foro Latinoame-ricano de Líderes en Educación Médica 2021 para compartir sus experiencias, lecciones aprendidas y cambios de prácticas educativas en el escenario de pandemia. Los participantes fueron seleccionados mediante la técnica de bola de nieve con el objetivo de obtener un grupo diverso de expertos. El Foro incluyó discusiones de pequeños grupos conducidos por facilitadores bilingües basadas en un cuestionario semiestructurado. La sesión plenaria con las principales conclusiones de los grupos fue grabada y transcrita para el análisis temático posterior utilizando la metodología de marco analítico. Resultados: el perfil de participantes incluyó 13 experimentados edu-cadores, 19 directores de programa y 23 decanos o representantes institucionales. Siete tópicos emergieron durante la discusión. Ellos siguieron un patrón que transitó desde una reacción emocional de sorpresa por la pandemia hasta una respuesta colectiva compleja. Las respuestas enfatizaron el valor de la adaptabilidad, la aplicación de nuevas habilidades digitales, un renovado protagonismo de los residentes, el fortalecimiento del humanismo en medicina, la apertura a nuevas perspectivas de bienestar y, finalmente, un desafío no resuelto respecto de la evaluación en educación médica en escenarios de pandemia. Conclusión: un panel diverso de educadores médicos latinoamericanos y canadienses identificó cambios claves gatillados por la pandemia de Covid-19 que pueden transformar la educación médica de postgrado en la región.

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Introducción: A pesar de considerarse el estándar de oro para la evaluación de competencias en posgrado, el Examen Clínico Objetivo Estructurado (ECOE) es escasamente aplicado en América Latina. El Gobierno de la Ciudad de Buenos Aires (GCBA) posee un sistema de residencia de Pediatría con cerca de 400 residentes, distribuidos en 13 hospitales, que comparten examen de ingreso y programa de formación. Nuestro objetivo es describir la experiencia de aplicación del ECOE a todos los residentes de Pediatría del GCBA, y comparar el desempeño según el tipo de hospital. Sujetos y método: Estudio descriptivo, incluyendo a todos los residentes de Pediatría del GCBA que finalizaban primer año, pertenecientes a 13 hospitales (2 pediátricos y 11 generales). El ECOE incluyó 10 estaciones. Resultados: Participaron 85 residentes; el 88,2% (IC 95% 79,7-93,5) aprobó la evaluación. No se encontraron diferencias significativas en la proporción de residentes que aprobó la evaluación entre los que provenían de hospitales pediátricos y los de hospitales generales (89,5 vs. 85,7%; OR = 1,4; IC 95% 0,4-5,5; p = 0,8). Conclusiones: En 2015 por primera vez se desarrolló un ECOE como evaluación unificada para todos los residentes de Pediatría del GCBA. La experiencia permitió identificar debilidades de cada evaluado y del sistema, estableciendo estrategias para superarlas.

Introduction: The Objective Structured Clinical Examination (OSCE) is considered the reference standard for competence evaluation, but its use in Latin America is limited. The City of Buenos Aires Government (CBAG) administers a Paediatric residency system that includes 400 residents distributed in 13 hospitals, sharing an admission system and education program. We aim to describe the experience of administering an OSCE for evaluating all the Paediatric residents of the CBAG. Subjects and method: Descriptive study, including all paediatric residents of the CBAG, belonging to 13 hospitals (2 paediatric and 11 general), ending their first year of training. The OSCE included 10 stations. Results: Eighty-five residents participated in the OSCE, and 88.2% (95% CI 79.7-93.5) passed the examination. There were no significant differences in the pass rate between residents from paediatric hospitals and from general hospitals (89.5 vs. 85.7%; OR = 1.4; 95% CI 0.4-5.5; P = .8). Conclusions: In 2015, the OSCE was administered to all paediatric residents of the CBAG for the first time. This experience allowed identifying weaknesses in the education system, in order to develop strategies to overcome them.

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INTRODUCTION: The Objective Structured Clinical Examination (OSCE) is considered the reference standard for competence evaluation, but its use in Latin America is limited. The City of Buenos Aires Government (CBAG) administers a Paediatric residency system that includes 400 residents distributed in 13 hospitals, sharing an admission system and education program. We aim to describe the experience of administering an OSCE for evaluating all the Paediatric residents of the CBAG. SUBJECTS AND METHOD: Descriptive study, including all paediatric residents of the CBAG, belonging to 13 hospitals (2 paediatric and 11 general), ending their first year of training. The OSCE included 10 stations. RESULTS: Eighty-five residents participated in the OSCE, and 88.2% (95% CI 79.7-93.5) passed the examination. There were no significant differences in the pass rate between residents from paediatric hospitals and from general hospitals (89.5 vs. 85.7%; OR=1.4; 95% CI 0.4-5.5; P=.8). CONCLUSIONS: In 2015, the OSCE was administered to all paediatric residents of the CBAG for the first time. This experience allowed identifying weaknesses in the education system, in order to develop strategies to overcome them.

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A presente tese tem por objetivos: identificar concepções sobre Medicina Convencional e Acupuntura que contribuem para o entendimento dos motivos que levam médicos a procurarem conhecer ou se especializar em medicina chinesa, identificar expectativas dos médicos investigados com relação ao exercício da Acupuntura e desvelar o significado dos discursos sobre prática médica e sobre mudança de especialidade médica. Com a hipótese de que os médicos que buscam especialização em Medicina Chinesa - Acupuntura objetivam exercer Acupuntura de forma integrada à Medicina Convencional, o que se dá a partir de uma nova visão de mundo, tendo por referência o contexto de uma prática médica mais abrangente e com relação médico-paciente mais humanista. O tema estudado é de relevância, visto que atualmente é crescente a procura de médicos por especialização em práticas médicas não convencionais, mais freqüentemente, Acupuntura. Também porque tem aumentado o afluxo de pacientes para estas especialidades e, finalmente, porque a discussão do humanismo na medicina é bastante presente na atualidade. Neste contexto, interessa-nos estudar o médico que tem formação na medicina convencional e busca se especializar-se em Acupuntura. Dada a natureza do problema, a pesquisa realizada é quanti-qualitativa. Foram pesquisados 175 médicos do 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' do Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM, com questionários composto por perguntas abertas e fechadas. Os dados obtidos foram analisados estatisticamente com metodologia que se aplicou no caso específico do presente estudo, bem como, com técnica de coleta de material denominada do tipo temática, baseada nas respostas dos médicos. As respostas foram analisadas com a técnica de análise de conteúdo, buscando desvelar unidades de significado, e a partir daí, estabelecemos categorias gerais e específicas, que passaram a dar significado aos discursos. Dessa forma obtivemos três grupos categoriais: "Aprimoramento profissional", "Ampliar seu próprio horizonte de vida" e "Compreender o paciente em uma dimensão mais abrangente". Nossos dados revelaram que médicos de especialidades médicas cognitivas e intermediárias são mais atraídos para a especialização em Acupuntura. Também revelaram que os médicos de nosso estudo pretendem exercer Acupuntura em diversos espaços de prática como consultório e outros espaços da medicina privada, SUS, hospitais, pesquisa e docência, entre outros, de forma integrada à Medicina Convencional, no bojo da qual a Acupuntura se firma como especialidade médica.(AU)

The main goal of the thesis is to identify conceptions relating to Conventional Medicine and Acupuncture that contributes to the understanding of reasons why doctors search for or specialize in Chinese medicine, identify expectations of the doctors researched in connection with the practice of Acupuncture and reveal the meaning of speeches about medical practice and changes of medical specialization. Assuming as a hypothesis that doctors specialize in Chinese medicine aims to practice Acupuncture integrated with Conventional Medicine, which comes from a new view of the world, having as base a more broaden medical practice in view of a more humanistic doctor-patient relationship. The subject is relevant in view of the current growth in number of doctors searching for specialization in unconventional medical practices, most frequently, Acupuncture. In addition to that, the number of patients of such practices is increasing and, finally, since the discussion of humanistic values in medicine is a current matter. In view of the above, it is important to study the doctor who has as a base the conventional medicine and who searches for specialization in Acupuncture. Due to the nature of the problematic a quantitative-qualitative research was carried on. 175 doctors from 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' of Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM- São Paulo, was researched and subjected to a questionnaire of open and closed questions. The obtained data was statistically analyzed with the methodology applicable to the concrete case of the present study, in addition to the applicable collection of material denominated thematic, based on the doctor's answers. Such answers were analyzed in face of the "content analysis" method, seeking to reveal significance units, and from than on, establishing general and specific categories, which leads to the meaning of speeches. In face of that, 3 categories were established: "Professional Improvement", "Broaden self life horizon" and "Understand patients in a more broaden dimension". The data collected reveals that doctors who specialize in cognitive and intermediary medical practices are more drawn to Acupuncture specialization. The data also revealed that doctors subject to the present study aim to practice Acupuncture in several environments, such as private offices and clinics, public hospitals (SUS), academic research, among others, in an integrated way with Conventional Medicine, which establishes Acupuncture as a medical specialization.(AU)

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