EDITORIAL

The responsibility to develop an educational continuum in the training of doctors

La responsabilidad del continuum educativo en la formación de los médicos

Arcadi Gual

Secretario de SEDEM. Director de la Fundación Educación Médica.

Among the various activities which took place as part of the XVIII Congress of the Spanish Society for Medical Education (SEDEM), particular attention should be paid to a round table on the responsibility to develop an educational continuum, especially between the undergraduate training offered by the universities and the specialist training received within the health service.

If it is true that we reap what we sow then it should come as no surprise that there is currently a poor link between the two periods of training that doctors are obliged to complete: their medical degree and their specialist training. Prior to the current MIR system for medical interns, specialist training was offered by the universities, the result being that it did not meet minimum requirements. Although it proved to be an upheaval at the time, the decision to shift specialist training from the universities to the health service has borne such abundant fruit that the wisdom of that decision is now accepted by everyone. Nevertheless, not even the best of decisions are free of problems, and in this case the problem has been the loss of a clear link between two successive periods of training.

How many times has it been said that the weak point in the training of specialists is that the MIR exam overshadows and has an undue influence on undergraduate studies? However, if undergraduate studies were coordinated with specialist training then this criticism would become the basis of a strength. All those participating in the round table - medical students, interns, medical faculties, the National Council Health Sciences Specilaties (CNE), and representatives of the health and education ministries - agreed on the need to build a permanent and sturdy bridge that would provide a coordinated link between undergraduate and specialist training.

From the academic world represented by the Spanish Society for Medical Education and the Foundation for Medical Education, what remains to be asked is: what is the completion date for this sturdy bridge, one built on responsibilities and duties and able to link the undergraduate and specialist training of doctors? Unfortunately, we are unable to provide an answer as the response lies in the hands of politicians. Thus, all we can do is hope that somebody, somewhere, someday will make the necessary decisions.