A BRIEF DESCRIPTON OF THE MEDICAL SCHOOL CURRICULA IN BRAZIL

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1 A BRIEF DESCRIPTON OF THE MEDICAL SCHOOL CURRICULA IN BRAZIL 1. The Brazilian Educational System Primary and secondary schooling in Brazil and the United States are similar in terms of student age and grade level. However, considerable differences exist between the Brazilian and American systems regarding university education. This applies to medical education and training: in Brazil, students are eligible to enter medical school after completion of high school, i.e. graduate training Is not required, as it is in the United States. Thus, from an US perspective, Brazilian medical students are undergraduates, whereas American medical students are graduate students. Figure 1 shows a comparison of the Brazilian and US educational systems, as depicted in the website of the Fulbright Commission ( The position of the medical schools in the two systems are highlighted. 2. Admission to medical schools in Brazil Most Federal and State universities in Brazil accept medical students based on their performance at the ENEM, a national exam coordinated by the Ministry of Education, which is offered once yearly. Some medical schools in public or private universities, select students based on their results in independent exams (vestibulares, in Portuguese) or by combined results in the ENEM and the independent exams. 3. Medical school curricula in Brazil All Brazilian medical schools have a six-year (12 semesters) curriculum, which comprises necessarily two years (semesters 9, 10, 11 and 12) of clerkship rotations. In broad terms, the curriculum of most Brazilian medical schools may be described as comprising: Two years (semesters 1-4) of studies of fundamentals in biomedical sciences and introduction to patient-doctor communication. In some 1

2 schools (e.g. Universidade Federal do Rio de Janeiro), the fundamental disciplines are combined into integrated programs per system (e.g. cardiovascular, gastrointestinal, nervous, respiratory, etc), but in most schools each discipline is covered in a separate program. Two years (semesters 5 8) of further education in patient-doctor communication, clinical and surgical learning; Two years (semesters 9 12) of clerkship rotations. It follows from this general description, that after the 5 th or 6 th semester, depending on the specific medical school, the students are prepared to examine/assess patients. 4. A representative example of a medical school curriculum in Brazil The description of the medical school curricula presented above summarizes the contributions provided by the following members of the Capes mission to CRWU last October: Prof. Claudia Henrique da Costa, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ; Prof. Guilherme Suarez-Kurtz, re. Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ; Prof. João Pereira Leite, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP; Prof. Lucia Klieman, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS. The curriculum of the Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (Appendix 1) provides a representative example of the medical school curricula in Brazilian universities. 2

3 5. MSc and PhD in medical disciplines After successful completion of the medical school curriculum, the individual obtains his/her MD and is eligible for MSc and PhD programs. In Brazil these are termed post-graduate programs, and the students are therefore considered post-graduates. In contrast, they are graduate students in the US. All MSc and PhD programs in Brazil are supervised by Capes, an agency of the Ministry of Education, created in Capes evaluates each program every three years and attributes a grade (0 5 for MSc and 0 7 for PhD), based on a number of criteria, specific for each area of knowledge. The Capes grade is a major determinant of the number of scholarships allotted to each course, and impacts significantly the assessment of grant proposals submitted to federal and state research funding agencies. 3

4 APPENDIX 1 UNIVERSITY OF SÃO PAULO RIBEIRÃO PRETO MEDICAL SCHOOL FACULTY OF MEDICINE Year 1 Fundamentals in Biomedical Sciences. Biochemistry, Molecular and Cellular Biology, Human Genetics, Morphology (Histology, Anatomy), Embriology. Year 2: Fundamentals in Biomedical Sciences and Patient- Doctor Communication Physiology and Neurophysiology, Metabolism, Pharmacology, Basic Immunology, Microbiology and Parasitology and General Pathology. Introduction to Patient- Doctor communication. Year 3 and 4: Patient- doctor communication and clinical skills (history- taking and physical examination). Medical Psychology. Pathology. Introduction to Surgical Technique. Medical Imaging. Clinical and Surgical learning: Internal Medicine, Ageing, Pediatrics, Women s Health, Neurology, Psychiatry, Surgery, Oncology, Musculoskeletal System, Emergency Medicine. Year 5 and 6: Clerkship Rotations. Internal Medicine I and II. Pediatrics I and II. Surgery I and II. Womem's Health I and II. Neurology and Psychiatry. Community Medicine I and II. Emergency Medicine I and II. Anesthesiology. Intensive Care. Students attend each rotation of 4 to 8 weeks at year 5 (Appendix 1) and Year 6 (Appendix 2) in different settings: community base, primary care, countryside areas, secondary and tertiary hospital. LONGITUDINAL CONTENTS THROUGHOUT THE COURSE: Primary and Community Health: Community Health I (Year 1) Community Health I (Year 2) Organization and Administration in Health (Year 3) Introduction to Biostatistics and Epidemiology (Year 3) Preventive Medicine (Year 4) Supervised training in Integrated Health Care in Community Health Centers (Year 5) Supervised training in Community Medicine II (Year 6) 4

5 Bioethics and Humanities: Bioethics and Training in the Humanities I (Year 1) Bioethics and Training in the Humanities II (Year 2) Bioethics and Training in the Humanities III (Year 3) Bioethics and Training in the Humanities IV (Year 4) Bioethics and Training in the Humanities IV - Deontology and Medical Law (Year 4) Emergency Medicine: First Aid and Pre- hospital Care (Year 1) Emergency Medicine (Year 4) Hands- on Training II (Year 4) Supervised training in Emergency and Traumatology I (Year 5) (8 weeks) Supervised training in Emergency and Traumatology II (Year6) (8 weeks) Women Health: Women's Health (Year 4) Hands- on Training I (Year 4) Supervised training in Women's Health I (Year 5) Supervised training in Women's Health II (Year 6) PROGRAM STRUCTURE Disciplines Year 1 Hours RCG Biochemistry RCG Molecular, Cellular, Tissue and Developmental Biology RCG0117 Human Genetics RCG General Anatomy and Anatomy of the Locomotor Apparatus RCG Community Health I RCG0131 Bioethics and Training in the Humanities I RCG01 - Morphology of the Thorax RCG Morphology of the Abdomen and Pelvis RCG Morphology of the Head and Neck RCG First Aid and Pre- hospital Care

6 Year 2 RCG Structure and Function of the Nervous System RCG Physiology and Medical Biochemistry RCG Immunology RCG General Pathology RCG02 - Microbiology and Parasitology RCG Bioethics and Training in the Humanities II RCG Community Health II RCG Basic Pharmacology RCG Cancer Biology RCG Introduction to Patient- Doctor communication RCG Introduction to Hospital Infection Control Year RCG Introduction to Clinical Skills RCG Introduction to Surgical Technique/Anesthesia RCG Respiratory System RCG Disorders of the Genitourinary Tract RCG Clinical Skills in Neurology RCG Bioethics and Training in the Humanities III RCG Basic requisites in medical imaging RCG Medical Psychology RCG Clinical Skills and Health of Children and Adolescents RCG0384 Epidemiology RCG Introduction to Biostatistics RCG Digestive System RCG02 - Organization and Administration in Health

7 Year 4 RCG Pediatrics RCG Cardiovascular System RCG Infectious and Tropical Diseases RCG Preventive Medicine RCG Endocrine System and Metabolism RCG Medical Nutrition RCG Medical Genetics RCG Hands- on Training I RCG Clinical Immunology RCG General Dermatology RCG Hematology RCG03 - Musculoskeletal System RCG04 - Women's Health RCG05 - Geriatric Medicine RCG06 - Clinical Oncology RCG07 - Clinical Applications of Diagnostic Imaging RCG08 - Emergency Medicine RCG09 - Ophthalmology, Otorhinolaryngology and Head and Neck Surgery skills applied to general practice RCG04 - Bioethics and Training in the Humanities IV RCG04 - Bioethics and Training in the Humanities IV - Deontology and Medical Law RCG Hands- on Training II RCG Diseases of the Nervous System RCG Psychiatry RCG Forensic Medicine

8 Year 5 RCG Supervised training in - Women's Health I RCG Supervised training in Surgical Clinic I RCG Supervised training in Internal Medicine I RCG Supervised training in Integrated Health Care in Community Health Centers RCG Supervised training in Pediatrics- I RCG Supervised training in Emergency and Traumatology RCG07 - Supervised training in Neurology and Psychiatry Year RCG01 - Supervised training in Surgical Clinic II RCG02 - Supervised training in Internal Medicine II RCG03 - Supervised training in Traumatology RCG04 - Supervised training in - Women's Health II RCG05 - Supervised training in Community Medicine II RCG06 - Supervised training in Pediatrics II RCG08 - Supervised training in Ophthalmology and Otorhinolaryngology RCG Supervised training in Anesthesiology RCG Supervised training in Intensive Care

9 FIGURE 1 Medicin e SOURECE: ( 9