Here is an email I received from a reader in Brazil describing the way surgeons are trained there. You may notice some remarkable similarities and a few differences. My comments are in italics.
After finishing high school, usually at 17 years of
age, to enter med school one must pass the tests. At public universities, the
tuition is entirely funded by the state. These are the most difficult ones to
enter, so the students are generally better. Then there are the private
universities, and they are expensive.
Med school is organized into two years of basics,
two years of clinics and two years of internship (internal medicine, family
medicine, surgery, ob-gyn and pediatrics). Notice—no
college. I also have a feeling that students aren't studying that much
nowadays, but it's also impossible to fail.
Sounds quite familiar. See "Medical
school grading and T-ball: Everyone gets a trophy."
As med school goes on and they meet with the awful
parts of medicine, they tend to focus on quality of life and moneymaking.
Therefore, the most difficult specialties to enter are dermatology, radiology,
anesthesia. Also sounds familiar. Although
some exams are unified, each hospital establishes its own residency exam and
interview. Very different from the US.
General surgery is a two year residency. Different. In the past, general surgery
was more general, but each subspecialty grabbed its cases and now what is
mostly done are cholecystectomy, appendectomy and hernia. Similar in some ways to the US model. So there is another exam to
enter the subspecialty residency: urology, plastic surgery (again, due to
quality of life issues, no inpatients, income, status, the most popular Similar), coloproctology, vascular,
thoracic surgery, surgical oncology, head and neck surgery. Orthopedics,
neurosurgery, ENT don't need general surgery.
I finished general surgery last year, and this year
I've been operating by myself. I've done cholecystectomy, appendectomy,
hernioplasty, Hartmann procedure, skin lesions, abscesses, etc. Of course, at
the beginning, I was not completely confident (which is good in some ways), but
I have had nice results.
I can relate with a lot you posted, your blog makes
me remember residency and my teachers.
I'm out of time now, in the future I'll catch on
some other things. I hope my English isn't too bad, but reading the comments
I've seen that even USA citizens have trouble typing. :D
Of
course, this is just one doctor's perspective, but it's thought-provoking.
What
do you think about the Brazilian system of training surgeons?
