The case for patient involvement in medical curriculum development

Dear Editor:

Many years have passed since the introduction of the educational system for training medical professionals and too little has changed in the career history of medical schools in Latin American countries. Although the state university continues to be a powerful and costly educational monument, the social moment we live in shows us that its daily activity does not adjust well to the new dynamics of the contemporary world. The educational system in those countries does not fit the new era of the noosphere and digital electronic networks. With the arrival of new information and communication technologies; the widespread use of computers, and now cell phones; the massive use of new electronic resources for searching, compilation, and analysis of information; the arrival of robotics; the exponential increase in the use of the world wide web; the processes of internetization between communities located geographically anywhere in the physical world ... all this requires the training of new professionals, with other skills, new knowledge, and with more communicative skills, more capacity for self-learning, leadership, and personnel management, more ability to analyze and interpret the information that appears on the monitors of the new electronic physical resources.

Although the activity of medical educational institutions occupies an important place in processes leading to the prevention of disease, the promotion and protection of public health, and the development of medical science and technology, the programs and curricula of Latin American medical schools are not helping to solve the great health needs of those people, nor do they meet the necessary standards to keep up with the current state of medical research. There is a very rigorous organization of a system of courses by semesters, where teachers are the main protagonists in the organization of teaching, with many subjects that are developed independently, by a methodology where workshops, experimental activities in laboratories, and discussions are carried out, whose objectives, most of the time do not fit the real health needs of the population. The compulsory sequence of the subjects is absurd and there is no interconnection between the topics. All this has led the students to be more behavior-oriented towards obtaining an academic degree than helping to solve the health problems of the region where they live. All the time they learn things by heart to try to answer correctly to the knowledge tests periodically established in each semester.

It is time to change. The study of contemporary social dynamics requires the creation of a modular educational system, without subjects, but with patients, for the meaningful learning of medicine, based on the relevant and priority health problems of a delimited geographical region and with an operational methodology that turns mainly around preventive healthcare work and observational research. It is urgent and indispensable in Latin America to make the transition from the obsolete traditional teaching-learning model of medicine to a new interdisciplinary modular system of learning and research, with activities aimed at comprehensive and operational training with the participation of many people and where students and patients are the main protagonists, with a strategy always aimed at contributing to solving, operationally and functionally, the very serious problems of the health sector in all regions of Latin America.

In the educational system of integral learning by modules, the student learns any medical discipline from the knowledge of real health problems, discovering the true social, biological, physical, and chemical relationships of all the related phenomena.