This is an interesting video, makes me think about the possibility of using Virtual Reality for Medical Education in General Practice.

Tiago Villanueva wrote in Medical Education (a forum created by Deirde Bonnycastle) about the Family Medicine curriculum in Portugal, explaining how a medical student becomes a family doctor.

I’m already preparing myself for the Final Examination in July… almost there!

Family Medicine Residency Program in Portugal

Portugal is a Southwestern European country which has been a member of the European Union since 1986, and a founding member of the Euro Zone since 1999. In 2008, Portugal was ranked the 33rd most developed country in the World according to Human Development Index. There are seven medical schools in Portugal (two in the capital city, Lisbon, two in Porto, one in Coimbra, Braga and Covilhã). Studying Medicine in Portugal takes six years, and afterwards, the newly qualified doctors must take a 100 questions MCQ national examination (whose questions are based on the American textbook ”Harrisson’s Principles of Internal Medicine”), which ranks candidates all over the country. Then, newly qualified doctors choose the specialty and training institution based on the order of choice provided by that ranking, that is, the highest ranked candidate in the country chooses the specialty and training institution of his/her choice, while the lowest ranked candidate has to contend with the leftovers. After graduation and before residency, young doctors must undergo a one-year internship called the common year, in which they rotate through Internal Medicine, Family Medicine and Public Health, Paediatrics, Obstetrics, and General Surgery.

Even though Family Medicine is not considered a specialty in all European Countries, in Portugal it is considered a medical specialty on par with all the other medical and surgical specialties. There is a three year Residency Program in place, which varies slightly according to the region of the country (North, Centre or South Family Medicine Residency Program Coordination Centre). Residents are assessed on a yearly basis (or after each rotation in the Centre region) according to the following methods:

Performance Assessment: this is subjective, and carried out by the tutor of the resident in the end of a specific rotation. This could be the resident’s tutor at the practice, or a tutor at the hospital, in the case of hospital rotations. It covers criteria such as

Knowledge Assessment: this is an oral examination at the end of each year, and covers all the rotations done by the trainee in that year. The jury of the exam consists of two family physicians, and one of them is the tutor of the resident at the practice. Questions are more or less open or closed, for example “What are the referral criteria for Community Acquired Pneumonia”, or “A patient collapses in front of you at the practice. What do you do?”

Rotation Report: residents must submit an extensive report describing all the activities carried out in each rotation. They are compiled in one single document each year, read by the jury carrying out the yearly examination and criticized. This is more of an actual preparation for the submission of the final CV in the Final Examination (see below).

Video Recordings of the resident’s consultations: this is not done in every Coordination Centre, for example, in the Centre.

Final Examination: this is done in the end of the Residency Program, is spread out across several days, and includes a CV discussion, which is submitted previously, a knowledge and practical assessment, the latter implying a real patient encounter, and revolved around history taking skills, physical examination skills, and the ability to integrate information in order to devise a management plan for the patient.

Tiago Villanueva, M.D.
GP/Family Medicine trainee, Lisbon, Portugal
http://www.virtualcongressgpfm.com/