education in rheumatology in latin america #acr14

Educación en Reumatología en América Latina

Education in Rheumatology in Latin America

Carlo V Caballero-Uribe MD-PhD (c)

Internist-Rheumatologist

Associated Profesor of Medicine

Universidad del Norte

Barranquilla-Colombia

Nothing to Disclose

Thanks to Drs. Loreto Massardo, Claudio Galarza, Carlos Pineda and PANLAR.

Education in Rheumatology . Trends to consider

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1. Burden of disease

2. Worldwide shortage of Rheumatologists

3. Inadequacies of Rheumatology Teaching

4. New learning methods

5. Needs of workforce in Rheumatology

Undergraduate Teaching of Rheumatology in Latin America . Outline

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Education for undergraduate students:A survey to Latin American Rheumatologists about pre grad medical education on Rheumatology

Seven points survey to Presidents of National Societies ( N° 10)

Individual Survey to members of National Societies sent from Panlar: N° 320

Survey to the Presidents of National Societies

MillionsHab.

(aprox.)

MDper 1

million h.

RheumatologistsPer 1 million h.

N º of medicalschools

N º teachingpregraduate

rheumatology (%)

Argentina 40 500 13 29 7 (24%)

Chile 17 170 9 21 9 (43%)

Colombia 48 160 3 57 NA

Costa Rica 4 260 6 6 3 (50%)

Ecuador 14 170 4 16 7 (44%)

El Salvador 5 254 33 4 1 (25%)

Dominican Rep. 10 300 2 9 NA

Mexico 112 180 6 85 35 (41%)

Uruguay 3 470 33 2 2 (100%)

Venezuela 30 200 6 8 5 (62%)

TOTAL 283 266.4 11.5 * 237 69 (29.1%)

Rheumatology teaching in pregrad med school

Survey to presidents of national societies*Ideal # 80 -100 /million h

Survey Questions

Survey using Survey Monkey via e-mail sent to Rheumatologists

through their National Societies38 questions

320 answers to the survey

Who are the teachers?

Feature Most frequent answer Percentage

Speciality Rheumatologist 96 %

University affiliation YES 71 %

Academic position Professor (Any level) 64 %

Teaching in undergraduatestudents

YES 56 %

Payment as a professor YES 55 %

Teaching semiology Semiology in rheumatology 51%

Year of medical degreeprogram (Teaching).

3-4 year 50 %

PANLAR. Individual survey 2014

Relevant Survey Questions

En general ¿qué tan de acuerdo está con la siguiente afirmación? La mayoría de los médicos en América Latina tiene un déficit en su formación / pobre conocimiento de la historia clínica y examen articular o exploración en reumatología.

Answered: 316 Skipped: 4

In general, to what extent do you agree with the following statements? The majority of doctors in Latin America lack training or have a poor knowledge of the clinical history/background and articular tests or exploration in Rheumatology.

72. % Totally agree or agree with a lack of training o poor Knowledge

En general ¿qué tan de acuerdo está con la siguientes afirmación? La mayoría de los médicos egresados de mi universidad / escuela de medicina en América Latina tiene un déficit en su formación / pobre conocimiento de la historia clínica y examen articular o exploración en reumatología.


In general, to what extent do you agree with the following statements? A majority of doctors that studied at my university/Institution lack training or have a poor knowledge of the clinical history/background and articular tests or exploration in Rheumatology.

67.5 % agree with lack of training by their own institution

¿Reumatología se enseña en etapas? (es decir se reparte en distintos niveles en distintos cursos o años durantela formacion como médico)


¿Rheumatology is teached by steps? (Several courses across the years of pre-medical school)

61.57 % One course of rheumatology in the lifetime

¿Hay un Perfil de egresado de su institución que incluya elementos de la reumatología?


Does your institution have a Graduate Profile that includes elements of Rheumatology?

Not a clear profile that includes rheumatology elements (67%)

¿Do you participate choosing the rheumatology topics ?


48% Do not participate choosing the topics

¿Participa Ud. en las decisiones del temario que se enseña en reumatología?

En general ¿qué tan de acuerdo está Ud. con el temario de enseñanza de la reumatología en pregrado en suinstitución?


In general; to what extent do you agree with the subjects that are taught in Rheumatology for undergraduates at your institution?

71.4%. Agree with the subjects or topics

¿Are the topics focus in the reality of your country or institution?


63.3% agree with focus on the topics

¿El temario se encuentra enfocado a la realidad de los problemas de atención de reumatología de su región o país?

Are immunology and rheumatology teaching integrated in the curriculum?


Separate courses in 42.75%

La enseñanza de la inmunología en relación con la reumatología en su programa se encuentra integrada?

In your country. The education program its regulated by a national institution or organization regarding depth and extension of the courses?


In 50% there is a national organization

En su país ¿Existe una entidad nacional que regule los temas a enseñar en cuanto a profundidad y extensión entre la distintas instituciones educativas?

¿Cuál es la metodología que utiliza de preferencia su escuela de medicina y en particular reumatología? (puedemarcar varias respuestas)


What is the methodology of choice with regard to Rheumatology at your institution? (You may choose more than one answer)

73.8% use a traditional teaching methodology

¿Does you med school has interactive methods to teach rheumatology?


62% Does not have interactive methods to teach rheum

¿Cuenta su escuela de medicina con métodos interactivos para la

enseñanza de reumatología?

How many teaching hours does your Rheumatology course have annually?


38 % have 24 or more hours dedicated to rheumatology

¿Cuántas horas lectivas tiene el curso de Reumatologia

anualmente?

¿Los alumnos tienen acceso en forma sistematizada a la atención de pacientesambulatorios?


Do students have access to attend Rheumatology out-patient clinics in a systematic way?

59 % teach in settings with real patients

¿Qué barreras identifica Ud. para obtener una enseñanza efectiva de pregrado en reumatología? (puede marcar varias respuestas)


In your opinion, what are the main barriers to effective undergraduate teaching in Rheumatology? (You may choose more than one answer)

60% mention lack of motivation as a barrier to effective teaching

¿Identifica Ud. alguna de las siguientes barreras para la enseñanza y aprendizaje del examen del sistemamúsculo-esquelético en su institución? (puede marcar más de una respuesta)


Could you identified any of the barriers in relation to the teaching of MSK examination skills at your institution ? (You may choose more than one answer)

57.32 % lack of standarized approach to MSK examination skills

Acerca del sistema de exploración o examen del aparato locomotor "GALS" (Gait, Arms, Legs, Spine)


Are you familiar with "GALS" (Gait, Arms, Legs, Spine) examination?

31.62 % Doesn’t know about the GALS

Conclusions

• Very few rheumatologists per habitants and few schools teachingrheumatology

• Lack of training o poor Knowledge with more than a half with pre grad teaching by Non Rheumatologists.

• The curriculum It’s not standarized to teach reumathology.

• Only 1/3 knows, practice and teach the GALS.

Conclusions. What needs to be done • Set of recommendations for core content of a musculoskeletal

course through a task force on pregraduate education (i.ePANLAR Education Committee?

• Teach the GALS? . Students who had formal instruction in the GALS were proficient in examining the locomotor system

• A PANLAR basical course oriented to pregraduate using different methods to reach those students lacking of rheumatology education (i.e online text or course)