Vázquez RJA, Vázquez GAL

Language: Spanish
References: 8
Page: 95-99
PDF size: 73.98 Kb.

ABSTRACT

The history of the current surgical residency system has its origin with William S. Halsted, who introduced it to the Johns Hopkins University. Whole generations were trained under the “militarized” system of general surgery, with low pay and heavy work loads. During the last century, the system experienced a transformation toward a more flexible life style for the residents; although working hours remained long and the work load heavy. The reference frame for residents’ training is the end-product: an ideal general surgeon, defined as a specialized physician possessing an integrated medical formation, who knows the anatomy and physiology of the patient in response to the surgical trauma and who will always act for the benefit of his/her patients, with deference for the patient’s dignity and autonomy, with honesty and mutual respect. Surgery programs must prepare the resident to respond to the needs of patients in his/her practice as graduated surgeon. In our country, the change has been slow and gradual; but, in the USA, the change has been swift, starting in 1984, when the death of a young woman in a teaching hospital prompted a change in the medical and surgical residencies program, as no other event since the changes introduced by William Halsted. In Mexico, the Official Mexican Standard (NOM, for its initials in Spanish) establishes general guidelines on the performance and organization of the residency: flexibility in the working hours, better pays, improved conditions. Educational models are being implemented to compensate for the less amount of time invested in the hospital, to be able to comply with the standards regarding the on-call shifts length without deteriorating the quality of training. In approaching the creation of alternative models, the challenge goes beyond just the working hours and the time allotted to the diverse rotations, it must lead to the construction of a curricula with well-defined goals and ways to assess them. It is certainly a difficult task,but we owe its attainment to our profession and to the well-being of our patients.

REFERENCES

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