Adriana Cavalcanti de Aguiar

Novas competências profissionais em saúde e o envelhecimento populacional brasileiro: integralidade, interdisciplinaridade e intersetorialidade

Este trabalho discute as caracteristicas da formacao medica frente ao processo de envelhecimento e as especificidades da atencao a saude do idoso, de forma a sistematizar as competencias necessarias para profissionais de saude. A premissa e que existe uma distância marcante entre, por um lado, conteudos necessarios a boa pratica geriatrica e diretrizes das politicas de saude e educacao e, por outro lado, o curriculo atual da graduacao e da pos-graduacao. A transicao epidemiologica e demografica coloca a Geriatria e Gerontologia como uma especialidade com mercado em expansao, tanto no setor publico como privado, implicando a discussao da normatizacao da formacao e distribuicao de RH na saude. Porem, a pouca valorizacao da presenca de seus conteudos nos curriculos nao reflete apenas uma questao pedagogica. Ao que tudo indica, apesar da legislacao existente, ainda nao esta clara a importância destes conteudos para a sociedade. A inclusao do processo de envelhecimento como curso de vida e em todos os seus aspectos nos curriculos de graduacao e uma prioridade. E tambem necessario ampliar a discussao sobre o papel da pos-graduacao, da educacao permanente e da educacao continuada a fim de fazer frente ao desafio de envelhecer com qualidade.This paper discusses the challenges faced by medical education with regard to the aging Brazilian population as well as the specificities of senior health care services, aiming at systematizing the contents and practices needed to prepare health professionals. The assumption is based on a clear gap between appropriate contents for quality geriatric practices and health policy guidelines on the one hand, and current undergraduate and graduate level medical programs on the other. This epidemiological and demographic transition positions Geriatrics and Gerontology as fields of expertise in an expanding market, both in the public and private sectors, which raises the discussion on medical training standardization and health HR distribution. However, the little emphasis given to these fields in current curricula does not only reflect a mere pedagogical issue. In spite of the existing legislation, everything points to the fact that the importance of these contents to society is not yet clear. Including the aging process in undergraduate programs as part of the life course and in all of its aspects is a priority for the Brazilian population. A broad discussion on the role played by graduate, permanent, and continuing education is needed in order to face the challenge of quality aging.

An analysis of the medical specialty training system in Spain

In this paper, we analyse the medical specialty training system in Spain (the so-called “residency system”). In order to do so, we a) summarize its historical evolution; b) describe the five major architectural pillars on which the system is currently based; c) analyse the special contract of the specialist-in-training; d) discuss the three major challenges for the medical specialist training future: the evolution and expansion of the residency system to other health professions, the issue of grouping specialties with a common core trunk and the continuity of the learning process; and e) draw four conclusions that may be relevant for those who are in the process of developing or revising their own medical specialization systems.

Es necesaria una segunda reforma de la atención primaria en España

Created in 1986, the Spanish National Health System adopted Primary Health Care (PHC) as one of its building blocks. Since the beginning, the Spanish PHC model has been the subject of both praise and criticism. Nowadays, a crisis in public policy funding - including health funding policies - is resurrecting old debates and raising new ones. This paper analyzes the data available about the degree of acceptance of PHC from the perspective of Spanish citizens as well as data about the debate produced in the last five years by politicians, patients and health workers. At the end of the paper the authors seek to draw some conclusions based on the commonly acknowledged strengths and weakness of the PHC model, which decision-makers ought to take into consideration in order to avoid mistakes caused by improvised decisions elicited by the requirements of the moment.