[Medical residency and graduation].
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Biomedical subjects
Publications and source records attributed to E Marcondes.
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To verify whether there is a state of phosphate depletion in dehydrated infants with diarrhea and whether phosphate administration affects recovery from metabolic acidosis, two groups of infants were studied. All were males, from 1 to 7 months old, and in good nutritional state. The control group was treated with a standard regimen of I.V. fluids initially, followed by feedings of a diluted milk formula starting on the 2nd day of treatment. The study group, in addition to this standard regimen, received sodium phosphate (Na2HPO4/Na2HPO4, 4:1, pH 7.4), initially by the I.V. route and thereafter orally with the feedings, at the dose of 2mM/kg/day. During the first 6 days of treatment, daily electrolyte (Na, K, Ca, Mg. Cl and P) and nitrogen balances were recorded. Hydrogen ion excretion (NH4 + TA--HCO3) was determined daily. Clinical findings and course were similar in the two groups. No untoward effects were observed with phosphate administration. In the control group, P balance was negative during all the periods and losses were in excess of those expected from nitrogen losses, thus suggesting a state of depletion. In the P-treated group however, P retention was not demonstrated in the first 2 days, finding a not suggestive of a P depleted state. Linear regressions between both daily and cumulative balances of P-nitrogen-free and Ca indicated a close correlation, thus suggesting that these two ions are mobilized concommitantly.
The authors discuss the usefulness of giving to the students of the Department of Pediatrics of the University of São Paulo instructions regarding the educational objectives of the graduation course. An inquiry was carried out with the collaboration of: 1) members of the Departmental Council and of the Commission for Graduation; 2) teachers responsible for the course, and 3) the students. Only 32.9% of the consulted students affirmed that the knowledge of educational objectives had a positive influence on their study.
Graduate courses of medical pedagogy and special didactics at S. Paulo University Medical School are analysed. The authors present objectives, subject matters and methodologies of both courses, as well as their evaluation by the graduate students. After an initial rejection, the evaluation became very positive (67% in medical pedagogy and 82% in special didactics). Some future perspectives are discussed.
The authors present results of an inquiry involving 3,309 physicians graduated at the University of S. Paulo School of Medicine in the 1958-1989 period. Concerning sex, there were 79% male and 21% female students (6% female in 1958-1963 period and 38% in 1958-1989). Medical residence (1-4 years) were done by 91% of all inquired physicians. Postgraduate education was performed by 26% of the graduates in master degree and by 29% in doctorate degree. In reference to professional work, 26% exert surgical specialties, 20% clinical specialties, 13% pediatric specialties, 9% gynecology and obstetrics, 9% psychiatry and 5% neurology. Eighty por cent of them perform their activity as non employed professionals, sometimes associated with some other form of work; of those, 40% earn more than 60% of their total income as non employed professionals. Three different curricular structures were analyzed in this inquiry. In the period 1958-1980 (traditional curriculum), the areas considered more attractive and important were: medical and surgical clinics, pediatrics, anatomy, physiology and pathological anatomy. The less motivating were: legal medicine, psychiatry, phthisiology. In the experimental curriculum (1974-1980) the more attractive areas were: biochemistry, pediatrics, surgical and pediatric internship, general pathology and medical clinics. The less motivating areas were: mathematics, statistics, medical deontology, preventive medicine, ophthalmology and psychiatry. In the unified curriculum (1980-1989), the preferred areas were: general pathology, medical and surgical propedeutics, infantile-maternal, clinical and surgical internship. The less motivating ones were: preventive medicine, otorhynolaringology, anesthesiology, genetics and statistics.
The authors present a feed-back evaluation of the curriculum of the University of São Paulo Medical School, made by the students that attended the course. History, methodology, implantation and illustrative results are presented.
The authors present an educational investigation performed with students of the 6th year of the University of São Paulo Medical School. The results of the diagnostic evaluation employed with the fifth grade students in 1984 defining the target-population of the future course; the results of the questionnaire used with the assistants of, the teaching body of the course. The formulation of the terminal objectives of the course and the results of its operation during 1985, are presented. To proceed to the analysis of the results, tests on the program syllabus were applied at the beginning and end of the training period, which are compared in the global sense and according to subjects of the program. A statistical analysis was carried out, by non-parametric tests of Wilcoxon and Mann-Whitney to check the significance of the percentual yield (difference in performance before and after the training period). The result was that at the end of the course most of the students had achieved a satisfactory degree of improvement (higher than 75%). However, the percentual yield was contrariwise proportional to the performance of the students in the pre-evaluation, showing a homogenization of the students at the end of the training period. Among the subjects evaluated, the hydroelectrolytic balance was the one to present a smaller percentual profit for most of the students, without the occurrence of a significative variation of the performance, when compared before and after the course. No difference either was noticed among the groups of students stratified by area of option for medical residence.
After some considerations about the particular situation of pediatric departments within the global context of the medical education, the authors discuss the graduate teaching of Social and Preventive Pediatrics (primary care), as carried out by the Department of Pediatrics, University of São Paulo Medical School. The following aspects are emphasized: locals or areas of training, academic programs, human resources, duration of training and it's time schedule, number of students and evaluation of the related social and preventive pediatric courses. They conclude pointing to the importance of these courses having in view the terminal performance of the undergraduate students after 1.155 hours of apprenticeship under the supervision of the Department of Pediatrics.
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The growth of 209 children with moderate and severe bronchial asthma seen at two different Health Care Centers for Bronchial Asthma Patients: (ICr and USP) was studied. The two groups differ mainly in socioeconomic level. Age at the onset of the disease, as well as duration and severity of the illness were considered. The first manifestations of the disease occurred before two years of age in 68.4% of the children. There was a predominance of males over females, with an almost 2:1 ratio in severe cases. The relationship between socioeconomic level and severity of the disease was highly significant (p less than 0.002). Weight and height were predominantly in the 50 percentile or below. This predominance was more evident for height. The height percentiles were significantly lower for the ICr group (p less than 0.01). Only 5.7% of the population studied had been submitted to prolonged (more than 3 months) corticoid treatment.
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