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 (http://www.fulbright.org.br/content/view/68/97/). 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
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 5th or 6th 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.
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 1951. 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.
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)
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 Hours
Year 1
RCG0115 -‐ Biochemistry 120
RCG0116 -‐ Molecular, Cellular, Tissue and Developmental Biology 165
RCG0117 – Human Genetics 90
RCG0118 -‐ General Anatomy and Anatomy of the Locomotor Apparatus 75
RCG0122 -‐ Community Health I 60
RCG0131 – Bioethics and Training in the Humanities I 30
RCG0145 -‐ Morphology of the Thorax 90
RCG0146 -‐ Morphology of the Abdomen and Pelvis 135
RCG0147 -‐ Morphology of the Head and Neck 90
RCG0247 -‐ First Aid and Pre-‐hospital Care 30
Year 2
RCG0212 -‐ Structure and Function of the Nervous System 180
RCG0213 -‐ Physiology and Medical Biochemistry 330
RCG0243 -‐ Immunology 90
RCG0244 -‐ General Pathology 45
RCG0245 -‐ Microbiology and Parasitology 225
RCG0248 -‐ Bioethics and Training in the Humanities II 75
RCG0249 -‐ Community Health II 60
RCG0250 -‐ Basic Pharmacology 150
RCG0285 -‐ Cancer Biology 45
RCG0286 -‐ Introduction to Patient-‐Doctor communication 60 RCG0312 -‐ Introduction to Hospital Infection Control 15
Year 3
RCG0314 -‐ Introduction to Clinical Skills 180
RCG0321 -‐ Introduction to Surgical Technique/Anesthesia 75
RCG0323 -‐ Respiratory System 120
RCG0327 -‐ Disorders of the Genitourinary Tract 90
RCG0350 -‐ Clinical Skills in Neurology 30
RCG0379 -‐ Bioethics and Training in the Humanities III 30
RCG0381 -‐ Basic requisites in medical imaging 30
RCG0382 -‐ Medical Psychology 60
RCG0383 -‐ Clinical Skills and Health of Children and Adolescents 90
RCG0384 – Epidemiology 45
RCG0148 -‐ Introduction to Biostatistics
RCG0432 -‐ Digestive System 195
RCG0452 -‐ Organization and Administration in Health 45
Year 4
RCG0431 -‐ Pediatrics 135
RCG0433 -‐ Cardiovascular System 150
RCG0434 -‐ Infectious and Tropical Diseases 75
RCG0436 -‐ Preventive Medicine 45
RCG0439 -‐ Endocrine System and Metabolism 60
RCG0440 -‐ Medical Nutrition 30
RCG0441 -‐ Medical Genetics 30
RCG0442 -‐ Hands-‐on Training I 120
RCG0446 -‐ Clinical Immunology 60
RCG0447 -‐ General Dermatology 45
RCG0448 -‐ Hematology 45
RCG0453 -‐ Musculoskeletal System 75
RCG0454 -‐ Women's Health 135
RCG0455 -‐ Geriatric Medicine 30
RCG0456 -‐ Clinical Oncology 30
RCG0457 -‐ Clinical Applications of Diagnostic Imaging 30
RCG0458 -‐ Emergency Medicine 30
RCG0459 -‐ Ophthalmology, Otorhinolaryngology and Head and Neck
Surgery skills applied to general practice 90
RCG0460 -‐ Bioethics and Training in the Humanities IV 30 RCG0460 -‐ Bioethics and Training in the Humanities IV -‐ Deontology
and Medical Law 30
RCG0461 -‐ Hands-‐on Training II 60
RCG0511 -‐ Diseases of the Nervous System 75
RCG0515 -‐ Psychiatry 105
RCG0516 -‐ Forensic Medicine 30
Year 5
RCG0504 -‐ Supervised training in -‐ Women's Health I 420 RCG0508 -‐ Supervised training in Surgical Clinic I 225 RCG0509 -‐ Supervised training in Internal Medicine I 450 RCG0510 -‐ Supervised training in Integrated Health Care in Community
Health Centers 450
RCG0512 -‐ Supervised training in Pediatrics-‐I
450 RCG0513 -‐ Supervised training in Emergency and Traumatology 450 RCG0607 -‐ Supervised training in Neurology and Psychiatry 225
Year 6
RCG0601 -‐ Supervised training in Surgical Clinic II 255 RCG0602 -‐ Supervised training in Internal Medicine II 255
RCG0603 -‐ Supervised training in Traumatology
RCG0604 -‐ Supervised training in -‐ Women's Health II 360 RCG0605 -‐ Supervised training in Community Medicine II 240
RCG0606 -‐ Supervised training in Pediatrics II 240
RCG0608 -‐ Supervised training in Ophthalmology and
Otorhinolaryngology 105
RCG0612 -‐ -‐ Supervised training in Anesthesiology
105 RCG0613 -‐ Supervised training in Intensive Care
105
FIGURE 1
SOURECE: (http://www.fulbright.org.br/content/view/68/97/).
Medicin e
