Elmer Huerta | Peruvian medical education is going through a serious crisis: what is happening with the national medical exam | ENAM | Public and private universities | Health | COVID-19 | coronavirus | TECHNOLOGY

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a recent original articlepeer review, published in “Acta Médica Peruana”, whose main author is Dr. Giuston Mendoza-Chuctaya of the National University of San Antonio Abad in Cusco, has caused a huge stir in academic circles in the peruvian medicine.

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In this document, the results of the academic evaluation of the students of the last year of the medical schools of Peru, and, as incredible as it may seem, 43% of doctors who took the exam failed it.

The national exam Medication (ENAM) is a written test of 200 multiple-choice questions, Of which 30% general medicine, 15% general surgery, 18% paediatrics, 17% obstetrics and gynecology, 10% public health and management, and 10% basic sciences.

In the words of Dr. Raúl Urquizo, Dean of the Medical College of Peru (CMP), the exam is nothing to write home about and should be passed without too much effort by any student in the final year of Medication. This assumes that the medical school in which the student studied has properly trained him and that he has devoted himself to the study.

Although the comparisons are odious, a similar test in the United States. he is only disapproved of by 3.7% students. How to interpret then that such a high proportion of recently graduated doctors do not pass an exam that they are supposed to pass without great difficulty?

The study

The research was relatively simple and consisted of counting the marks obtained by 30,750 students in the last year of Medication, who took the exam between 2009 and 2019. The results were disaggregated by the type of medical school they came from: private, public and foreign schools. The examination is a requirement for access to a place in the marginal urban rural health service (serums).

The 30,750 PhDs came from 36 Peruvian universities (17 public and 19 private), including 9,087 from public universities, 17,607 from private universities and 4,056 graduates from abroad.

“Unlike many countries, in Peru the approval of a similar exam is not a mandatory condition to exercise the career.”

Results

Analysis of the average ratings revealed that 42.8% disapproved. According to the originating university, it was found that 31.3% of graduates from public universities disapproved, along with 33.9% of graduates from private universities. Among foreign graduates, 79% failed.

The least disapproved state university was San Marcos (6.6%). With more than 40% of disapproval are the national universities Federico Villarreal, Ucayali, San Luis Gonzaga and the Universidad del Altiplano. The National University of the Amazon had the worst record, with 55.1% disapproval.

For their part, the private universities with less than 10% disapproval were Católica Santo Toribio, Unión, UPC, Cayetano Heredia, Andina del Cusco and Continental.

Privateers with over 60% disapproval were Peruana Los Andes, from Chiclayo, San Juan Bautista and San Pedro. The highest percentage of disapproval was held by César Vallejo, with 70.5%. Among foreign graduates, it should be noted that, compared to Peruvians, those from Cuba were 845% more likely to fail the exam.

It is not compulsory to practice medicine.

Unlike many countries, In Peru, passing a similar exam is not a mandatory requirement to practice the degree. This means that all these young doctors – unable to pass a theoretical knowledge test – are currently seeing patients somewhere in Peru, which many observers believe puts the health of their patients at risk.

In 2019, the CMP introduced the obligation to approve ENAM for the exercise of Medication. This initiative was requested from Indecopi which, in the resolution 0555-2021/SEL-INDECOPIsigned by Gilmer Paredes Castro, ruled that “The obligation to justify a successful ENAM with a minimum score of eleven (11) for registration in the CMP Registration Register constitutes a bureaucratic barrier, the CMP having exceeded its powers.

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The United States experience

At the beginning of the 20th century, the pedagogue Abraham Flexner, with the Carnegie Foundation, published the Flexner Reporta document considered the germ of the high quality of the medical schools current United States

The report described turn-of-the-century medical education as comprised of for-profit corporations that produced a surplus of poorly trained physicians and concluded that because of low admissions standards, poor laboratories, and inadequate clinical teaching , most medical schools in the United States, they were considered insufficient.

The faculties of medicine have been classified into three groups: good, poor but salvageable, and so bad (30%) that they had to be shut down.

the medical education in Peru it is in crisis and the country urgently needs a “Flexner report”. The first provision should be that students who do not pass ENAM cannot work as doctors.

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