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Revista Colombia Médica
Universidad del Valle - Facultad de Salud
ISSN: 0120-8322 EISSN: 1657-9534
Vol. 41, Num. 4, 2010, pp. 304-305
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THE TEACHING OF MEDICINE AT UNIVERSIDAD DEL VALLE
Colombia Médica, Vol. 41, No. 4, October-December, 2010, pp. 304-305
EDITORIAL
THE TEACHING OF MEDICINE AT
UNIVERSIDAD DEL VALLE
Rodrigo Guerrero, MD, DrPH
, Pedro Rovetto, MD
Honorary Professor, Universidad del Valle
Cali, Colombia, e-mail: guerrerr@yahoo.com
Full Professor and Head of the Department of Pathology,
School of Medicine, Faculty of Health,
Universidad del Valle, Cali, Colombia
e-mail: rovettos@gmail.com
Code Number: rc10043
The first formal
attempt for medical education in Valle del Cauca was in the Faculty of Medicine
and Surgery in Buga, which was part of the Colegio Académico between
1866 and 1871. It only had one graduating class of ten physicians in 1871. Its
foundation was contemporaneous with the faculties of medicine at Universidad de
Antioquia and Universidad del Cauca; the reasons for its prompt disappearance
are unknown.
The professional
training concerns of the región were maintained through the creation of the Sociedad
de Medicina del Cauca (Cauca Medical Society) in 1887, which gave rise to
the Boletín de Medicina del Cauca (Cauca Medical Newsletter) (1887-1910)
which published the works of Evaristo García and his partners Daniel Quijano
Wallis, Pedro Pablo Scarpetta, Agustín Escobar, Enrique Garcés, Adolfo Tenorio,
and Pablo García Aguilera, among others.
The need to
create a school of medicine in Cali was aired since the 1940s among trade
groups at the Colegio Médico del Valle (Valle Medical School), although
some thought that the warm climate in Cali was not suitable for intellectual
development because such required cold environments like those in the
Cundinamarca and Boyacá plateau. History managed to reveal how wrong these
believers of geographical determinism were.
The Humphreys
Mission, commissioned by the National Government in 1948, delivered a bleak
report (1950) on medical education in Colombia suggesting the creation of new
medical faculties, among them one in Valle del Cauca.
Guillermo
Orozco, a physician from Anserma and living in Cali, with support from the Colegio
Médico del Valle, managed to get the Governor, physician Antonio Lizarazo,
to expedite Decree 641 of 1950, ordering the creation of a faculty of medicine
affiliated to the recently created Universidad del Valle. The University had
been founded in 1945 with the name of Universidad Industrial del Valle del
Cauca; the name was changed in 1954 to Universidad del Valle when the Dean
of Medicine, Dr. Velásquez, was designated Departmental Secretary of Education.
With support
from Carlos Arturo Cabal, then Rector of the University, in November 1950, the
Governor named Dr. Gabriel Velásquez Palau, a physician from Cali, as Dean of
Medicine.
Classes began on
the 12th of October of 1951 with fifty students at the former convent of San
Agustín already converted to Colegio de Santa Librada, located in Carrera 4
with calle 13; the medical practices took place at the San Juan de Dios
Hospital.
Excited by the
collective dream of accomplishing a change in medical education, prestigious
professors started arriving in Cali from many latitudes like Jorge Araújo Grau,
Luis María Borrero, Plutarco Naranjo, Pelayo Correa, Carlos Restrepo, Jorge
Escobar Soto, Miguel Gracián, Jaime Korgi, Carlos León, Lupi Sergio Mendoza,
Santiago Rengifo, Vicente Rojo, and Carlos Sanmartín, among others. This group
of adopted «Caleños» joined prestigious local physicians, many of them
trained abroad with support from the Kellogg and Rockefeller Foundations, until
forming a critical mass, a sort of athenaeum of the enlightened, which would
change the Colombian and Latin American educational model, and even influence
on the global educational model.
The influence
from Universidad del Valle may be synthesized through various contributions
that became reference points. For didactic purposes, they are presented in
isolated manner, but in practice these accomplishments were closely linked to
each other.
- The initial educational proposal was inspired by the
recommendations of the Flexner Report for medical education in the USA: neglect
of eminently theoretical education, with great emphasis on anatomy and based on
the authority of big figures or clinical chiefs, to develop another one based
on the emphasis of basic sciences and learning next to the patient, along with
a more democratic relationship between the professor and the student. This learning
process close to the patient and to the disciple required a closeness of the
professor with the faculty, which in Hopkins since 1914 was reflected in
teaching with «exclusive dedication». At Universidad del Valle, this model was
adapted as «geographic» time of exclusive dedication: professors were paid to
teach while conducting their private practice where they were teaching.
- But the classical Flexner model was son modified, improved, we
could day, with the addition of the social dimension. Community medicine was
added to the departments of basic and clinical sciences, which son evolved into
the Department of Preventive Medicine and Public Health, years later called
Social Medicine. The idea was that students would become familiarized with the
diseases from the social context in which they were developed so they could
better understand the diseases and the patients. The department’s teaching
purposes were joined by the need to conduct research and offer consultancy to
government entities. Siloé, was the first neighborhood where the students
carried out their medical practices. Santiago Renjifo Salcedo, professor of
parasitology, was the heart and soul of this novel focus, adopted then by the
rest of the medical faculties in Colombia, which until then could only timidly
show hygiene cathedra.
- Obligatory Social Service, approved since 1948, was only complied
with when it was changed to Compulsory Rural Medicature. Universidad del Valle
responded by signing an agreement with the Departmental Government for the
Health Care Center-Hospital of the municipality of Candelaria to be outfitted
for the Rural Medicature practices and, thus, offer a physical space in the
rural setting, where the young professionals could comply with the legal
requirements, acting as a group and supported by the University.
Soon, Candelaria
turned into a research hub for the whole University. A novel housing
improvement program was conducted with the Faculty of Architecture. The
Department of Nutrition, headed by Leonardo Sinisterra, established a Home for
nutritional recovery. An innovative health care volunteer program was begun who
focused on home visits to detect pregnant women and malnourished children. These
experiences, exposed by Gabriel Velázquez at the World Health Organization,
became the base for the World Program on Primary Health Care Service, approved
years later at the Alma Ata meeting.
An aspect in the
evolution of the Faculty of Medicine at Universidad del Valle has gone
unnoticed and has not received the importance it merits. It is the
reorganization of the diverse faculties, to create the Division of Health,
registered in Agreement 04 of 1969 by the Directive Council, signed by Alfonso
Ocampo Londoño, Rector. In addition to placing the faculties of medicine,
nursing, medical laboratory, and physical therapy under the academic authority
of the Division of Health, conceptual definitions were made that would
thoroughly transform the educational model in effect at the time.
Numeral 5 of the
3rd article of the
aforementioned Agreement defines as an objective of the new division to prepare
the professional and para-professional personnel required… for the health care
system. Personnel had to be at the sufficient level, number, and quality to
decrease morbidity and mortality in the Colombian south western area. It was
not enough to train the best professionals as they had so far been trying to
do, but rather it was necessary to train all the human resources necessary and
sufficient to help improve health conditions, especially in the Colombian south
west.
Numeral 2 of the
same 3rd Article ordered to design, experiment, and promote ways of improving
the productivity of the Colombian health care system. The University had to
investigate the reality of its environs and the ways of improving the systems
and factors affecting health care services. Therein, emerged the revolutionary
System of Simplified Surgery, directed by Adolfo Vélez Gil; the renowned
University Center of Population Research (CUIP for its name in Spanish)
directed by Ramiro Delgado; the Research Program on Operational Health Care
Models of Rural Development (CIMDER for its name in Spanish). The Department of
Stomatology, with Gustavo Ulloa and Fernando Barreto, began to train Odontology
Aides (following a very successful model developed in New Zealand).
As a corollary
of the prior considerations it was decided that the University should always be
willing to collaborate with municipal and departmental administrations and make
it possible for its professors to hold public office.
This change in
paradigm of the educational model placed the University in front of its reality
and admonished it to comply with its high purpose of academic formation while
helping to solve health problems.
The projection of
all these innovations of the new educational paradigm at Universidad del Valle
had begun with the First Congress on Medical Education held in Cali in 1955,
which was attended by representatives from all the faculties in existence in
the nation and then with the creation of the Association of Medical Faculties
in 1959, promoted by Gabriel Velázquez and José Félix Patiño. Then through the
Pan American Federation of Medical Faculties, the innovations were projected
throughout the continent.
We sought to create
a narrative memory of these events during this year when we are celebrating 60
years of the foundation of our Faculty. And to summarize, it may be said that
the Faculty of Medicine at Universidad del Valle was not so much the «gardenia
in the swamp» as defined in somewhat pessimist manner at one point by Santiago
Renjifo, but rather the flower that transformed the swamp into a lake, and the
stone that upon falling on the quiet lake of medical education in Colombia,
produced important concentric waves that are still felt to this day.
Copyright 2010 - Colombia Médica
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