What became of the rotating internship?
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An experiment in the teaching of public health for interns in the sixth year of medical training was launched in 1978 on the basis of the clinical practice of health services in Botucatu and neighboring municipalities. The course was designed to promote the practice of primary medical care, contacts with the different health professionals, analysis of the relations between health and the social structure, and an understanding of the organization of medical care in Brazil through discussions of day-to-day activities in health services, and of the role of medicine and medical care in the present capitalistic production structure of Brazil. The paper reports on the teaching experiment in 1978 and 1979, when the supervised training was taken by 85 and 95 interns, respectively, in groups of seven or eight for periods of 18 working days at the Botucatu Health Center-School (CSE) and the Anhembi and Itatinga Health Services. A comparison of the answers to tests given before and after the training and the opinions recorded by the students on the activities carried on show an improvement in their perceptions of team-work and of health education in the role of medicine and medical care in society. Most of the students expressed open approval of the training as a whole.
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Explore the source record for details and available documents.
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BACKGROUND: The quality of physicians who have undergone resident official training (MIR) should logically be better than that of the remaining physicians who were not able to enter into this official training. The present study was designed with the aim of verifying this hypothesis. METHODS: A sample of physicians who underwent the MIR examination in 1982 and who upon passing the same were permitted to initiate the MIR training in 1983 was selected. The group was subdivided into MIR and no MIR and according to the specialty followed. When the physicians were practicing as specialists two types of surveys were carried out with one being by telephone and the other personal in which the personal characteristics, preparation for the MIR test, professional satisfaction and personal motivation were analyzed. The pharmaceutic prescriptions of both groups were analyzed according to indicators of the Servei Català de la Salut (Catalonian Health Service) and the opinion of colleagues of each of the members of each group was evaluated with another questionnaire. The written resolution of hypothetical clinical cases were given to each of the individuals included. A level of global competence defined as a percentage for the following components was identified using: curricular evaluation (10%), professional satisfaction (20%), personal motivation (10%), hypothetical case resolution (35%) and peer opinion (25%). RESULTS: The global competence of the physicians trained under the MIR system was greater than that of the no MIR group (p < 0.01). On analysis by sections the differences of greatest note were observed in the resolution of hypothetical cases (p < 0.0001), curricular evaluation (p < 0.0001) and the quality of pharmaceutical prescription (p < 0.0001). The differences were less of note in comparison of personal motivation (p < 0.02) and professional satisfaction (p < 0.02). No differences were observed in peer opinion. CONCLUSIONS: The professional quality of physicians trained by MIR who presented for the 1982 examination in Catalonia and practiced in medical specialties is greater than that of a comparable group with regard to professional practice.
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