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The Medical Intern after the National Curricular Guidelines of 2014: a Study in Medical School of Rio de Janeiro State

ABSTRACT

Established in 2014, the National Curricular Guidelines (NCG) for the Undergraduate Medical Course contain several recommendations, especially for Medical Internship. Despite the recognition of the need for changes, in terms of professional training to meet the demands of the community, instituting these NCG was considered by many to be rather undemocratic. Yet, few studies have investigataed the implementation process. The objective was to analyze the Medical Internship in Medical Schools of the State of Rio de Janeiro, after institution of the NCG of 2014, according to the Course and Internship Coordinators. In 2016, the State of Rio de Janeiro had 19 medical courses, in 15 Medical Schools. Of these, nine courses participated in the research. The study population was represented by 13 participants, nine Course Coordinators and four Internship Coordinators. It is thus a sample of the universe of schools, with no intention of generalizing the results to represent the whole State. Qualitative and quantitative approaches were used. The answers of the open-ended questions were submitted to content analysis, the scale was evaluated by statistical analysis. In the view of the Coordinators participating in the research, all Medical Schools are in the process of adapting to the NGC’s determinations of 2014. The majority agrees with the mandatory inclusion of Urgency and Emergency, Primary Care and Mental Health in the Internship areas. Many difficulties were encountered in the process of implantation and/or restructuring of these activities in Internship: scarcity of practical scenarios; precariousness of existing scenarios in emergency care of the Unified Health System; lack of teachers/preceptors; and the deadline established for the implementation of the Guidelines. However, some strategies have been planned, such as the diversification of practice scenarios, the creation of elective internships, the establishment of agreements and partnerships, development of integrated activities with other Internships areas and the use of realistic simulation laboratories. The Medical Schools live a moment of curricular transformation, driven by the NCG. We must see this moment as an opportunity to revisit the Medical Internship and, possibly, to find strategies for the improvement of medical training in this privileged undergraduate space. It is believed that dissemination of the results of this research can help Medical Schools in their appropriation and implementation of the NCGs of 2014.

–Medical Education; –Medical Schools; –Curriculum; –Internship and Residency

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