(Expansion) – The last two years have shown us that health should always have been a priority. Physicians are a fundamental piece in a robust health system and their clinical performance must be the result of a medical education that is flexible, adaptable to new needs, more technological, patient-centered and community-based with a predictive-preventive approach, besides being profoundly humanistic.
Today reality is other. Medical education is focused on curing the disease, on creating specialists and super specialists that saturate the large urban centers due to the few places and the lack of adequate infrastructure in intermediate and small cities.
And although there are great efforts to standardize medical practice, the truth is that the general practitioner market -more than 200,000 in Mexico- is riddled with inconsistencies since, with the notable exceptions of public and private educational institutions, thousands graduate year after year. of doctors without proper exposure to patients and without incentives to develop a life and career plan in the place where the best health systems in the world recharge their success: first contact medicine . There are doctors, but abandoned by the health system.
The characteristics of the population and the circumstances of today’s world, in short, are not the same as they were a couple of decades ago. We are facing an increasing life expectancy, which confronts us with more prolonged chronic-degenerative diseases; Bad lifestyle habits have notably affected global health, with obesity, diabetes, cardiovascular diseases and cancer as threats today.
The high mobility of people between countries, as well as migratory phenomena have exposed us -COVID-19 is proof of this- to a new panorama in the prevalence of diseases, at the same time that the population growth that the UN anticipates will pass from 7.8 to 9.7 billion people by 2050, will have Africa and Asia as its epicenter, thus influencing a new genetic footprint.
With these circumstances in mind, in addition to the advancement of science and the exponential amount of information that is generated daily, today there is no way for doctors to obtain and analyze it other than through databases and systematic filters. Therefore, educational systems should expose students to medicine based on scientific evidence that is based on the best knowledge available at the moment and supported for analysis with artificial intelligence.
Knowledge in the health sector requires that the doctor critically interpret what he knows instead of just remembering what he learned, and for this he must be trained in the analysis of complex systems and critical thinking. Genomics, biostatistics, global and urban health, coding and predictive analysis, in addition to the classic subjects of anatomy, physiology and applied biochemistry, are the subjects that the curricula of medicine and health sciences careers should have in order to train doctors for the next 30 years.
On the other hand, the humanistic sense in medical sciences becomes very relevant. The doctor must be educated considering the patient the epicenter of his actions, but with a population approach. A deep education in values, human rights, inclusion and diversity should have a more relevant role since the human sense is not an attribute that can be replaced with technology.
It is also a priority to understand who the new medical student is. Today he is a highly social, digital and hyperconnected person, with needs for feedback and the creation of learning communities, who will be used to collaboration between disciplines and very alien to traditional systems of teaching and learning models.
The solitary, guru and almighty doctor has remained in the past: we teachers must take off the robe of the traditional doctor and also adapt to the changes that the progress of science and the new reality of the world impose on us.
However, there is no educational model in health that replaces the deep inefficiencies and inequalities generated by anachronistic public health systems installed in premises that are more than 50 years old. The change to have a better health system in the future lies in the education and preparation of those who make public policy decisions. There, with a few exceptions, our expectations really go down.
what the doctor meant
More than 20 years as a medical teacher and 30 years in daily clinical practice give Fernando the necessary authority to issue an objective and supported opinion on the training of doctors that future patients will need, so I would not add anything in that sense, except for the need to add to the study programs a greater understanding of pathologies such as cancer, which continues to be largely absent in almost all the academic programs of the Bachelor of Medicine.
But, and how should we be the patients of the future? As Dr. Germán Fajardo, Director of the UNAM School of Medicine, said in his interview for Health Café, we should be patients who are more responsible for our own health.
Understanding that health is transversal and that -as the pandemic demonstrated- affects all human activities, then implies thinking that in all educational programs and at all levels, we should train the population in a healthy life: knowing how to feed ourselves better and why avoid junk food, the importance and benefits of regular physical activity, consistent and repeated content on addiction prevention, as well as regular medical check-up routines and early detection of signs that could herald a disease .
If this is not the case, even if the medical schools provide us with super doctors of first contact, they will continue to be insufficient in the face of the needs of a population that only cares about its health when it gets sick.
This column is part of the ‘The Future of Health’ serial .
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Fernando Castilleja is an internist and an expert in lifestyle medicine and health innovation. Professor at the Tec de Monterrey School of Medicine for 20 years. Co-founder of NuupHealth and CEO of Genethic Services. Mentor Endeavor, McCombs Business School at UT Austin, HealthIDS and CONACYT Binational Innovation Nodes. Follow him on and/or on .
Juana Ramírez is founder, CEO and Chairwoman of Grupo SOHIN. President of the Warriors Foundation. Entrepreneur Endeavor. President of the Board of Directors of the Association of Entrepreneurs of Mexico. Author of the initiative “Medicine with M for Women”. University professor at UP and IPADE Business School. Follow her on and/or on .