She was nervous and anxious at the same time. For the first time she was holding a five-month-old baby for a physical exam. There were maneuvers that were not entirely clear. Lucia was taking the pediatric exam at an ASSE polyclinic and had never before examined a baby. He knew the procedure because he had seen videos in that regard, but when he tried it on the exam he did it wrong. He looked at the teacher and asked for help: “Be the procedure but I’m not sure how to do it,” he was sincere.
From the fourth year, students of the Faculty of Medicine (Fmed) begin clinical internships in educational hospitals, public and ASSE polyclinics. Due to the pandemic, the fourth generation in 2020 had their clinical care suspended: the students did not step on a hospital or a polyclinic between March and September last year.
the Dean of Medicine, Miguel Martínez, He said the pandemic involved suspending the clinical part and to this day this remains a “big problem”. As he explained to the Observer all the theoretical could be moved to the Zoom, but the challenge was the practical part.
“There is a clinical sector that is lagging far enough to know that still working all this year that we have and even reaching February of the year 2022 without any kind of interruption will be complicated to fulfill the program,” he admitted. These are the fifth and sixth year generations.
Martinez has stated that his idea is getting students to be able to learn in six months what they should have done again, without lowering quality and demand. “We are following the students closely so that we can say precisely when the course is coming to an end,” he said.
The dean has assured that it is a commitment to do things in such a way that the contents, information and training are not affected and said: “It is necessary to minimize the risks because ultimately we are training the doctors who will take care of us all in the future”.
The return to hospitals and polyclinics
The member of the UdelaR Doctor of Medicine career committee Maria Noel Álvarez he explained that when classes that had been solely virtual during 2020 were resumed, “contact with patients was prioritized as there was a theoretical foundation”.
Upon returning to internships, students took seven weeks of pediatric and seven gynecology clinics, he reported. The two fourth-year practical subjects are semester-long and add to medicine in the first level of care, which is annual.
“It’s as if they’ve done in separate modules the theoretical of the practical that are normally linked to each other at the same time,” Alvarez added. That’s how pediatric practitioners started in September, but the return was slow. Instead of having the corresponding four hours from Monday to Friday, they had class once a week. Lucia explained that “this depended on each polyclinic. We were offered two options: go two days two hours or one day four hours. My group decided on the second option.”
The faculty also decided that all quarterly practical subjects would have compulsory examination. The pediatric exam in which Lucia had to examine the baby was set for last February but she ended up giving it in March due to outbreaks of active cases in the country.
The dean explained that measures to return to internships in hospitals “were taken with great care”. He assured that 80% of the internships they do in hospitals are in the non-university ASSE -Maciel, Pereira Rossell, Pasteur and inland hospitals-. “Each admission we had to agree with ASSE to give maximum guarantees to the patients, the ASSE authorities themselves and the students,” he said.
Martinez has stated that the coordination work that was achieved was very good since in fact there was no outbreak of covid-19 caused by university activities taken to hospitals.
no holidays
The dean argued that to recoup practical classes losses plan to use students ’rest and vacation time. He also assured that students follow closely per “To be able to say precisely when the course is over” and added, “The idea is for the faculty to maintain quality standards so that they don’t go down, which will mean cutting their vacation.”
the teacher grade 4 Laura Llambí is in charge of one of the fifth-year subjects that is one of the most practical in the career, and opined that it is not possible to sacrifice the quality of what is learned because they will receive nothing more and nothing less than doctors. “The decision was for these students to resume the practical part in the summer of 2022 so as not to waste hours of clinical teaching.”, He pointed out.
“Medical Clinic is a discipline that is learned from the foot of the patient’s bed,” said the teacher to explain that future doctors must interrogate hospital patients, do the physical examination, make the diagnosis and then establish what additional examinations, tests or studies would require, in order to direct a treatment .
Llambí explained that during 2020 to advance in knowledge they made recordings of the theorists who uploaded to the online platform of the faculty, forums and seminars via Zoom. They discussed real cases across the screen but the students had no way to interrogate and examine them. They also did mock interviews where the teacher had a script about certain symptoms. The seminar involved students questioning the teacher as a patient.
Beyond the fact that they already had pandemic experience this year, uncertainty remained. The teacher pointed out that between the doubt of ending one generation and starting with the other was that the start of classes was delayed.. Online theory classes began in June (should have been in March) and internships on July 19th.
Lucía, who is now in 5th grade, said that the method they used in their class is that the group is divided into two and while half is a week of practical class (from 8 to 12 hours, Monday to Friday ), going to polyclinics and hospitals, the other has theoretical class online and they exchange. With this system Cusan half of the 80 practical hours per month they should have according to the Medicine program.
The position of the guild of the Faculty of Medicine
He assured that from the guild they worked in together with the Central Board of Directors to find a solution to clinical practices. “While the faculty cannot get involved in matters of ASSE and the Ministry of Public Health, it can reach certain agreements,” he expressed. Robalez explained that the stance maintained by the faculty was to take care of the health of the students and not to generate agglomerations, So virtuality became a tool that helped at this time. However, he said that “Teaching at the virtual level is not the same as in practice: medicine at the clinical level is the most important thing.”
Robalez said that “it will affect having lost practical classes,” but said that Medicine “is one of the faculties in Latin America that generates more specialized resources, we have tools to strengthen and train us every day.” , he said.