Insinuations about placements of medical students in hospital internships outside the Algarve region have appeared in the media, in anonymous letters of obscure origin and in opinion articles. A clarification on such insinuations is due.
I was the first Director of the Medicine Course at the University of Algarve, created in 2008 and known as the Integrated Master in Medicine (MIM), taught at the Faculty of Medicine and Biomedical Sciences of the University of Algarve (FMCB-UAlg). I report here facts arising from my experience as Director until 2013, when I retired, and later as Professor Emeritus.
Student placements in clinical hospital internships began in 2011, when students from the first edition of the course reached the 5th year. These placements always followed criteria defined by the FMCB and were subject to assessments of the quality of hospital services.
Since 2011, FMCB has placed 5th and 6th year students in hospitals outside the Algarve region, in Almada, Setúbal, Santiago do Cacém, Évora, Beja, Loures and Lisbon. These placements outside the region have been essential to ensuring the quality of training and have varied over the years as a result of ongoing assessments, in part contributed by the students themselves.
Contrary to what has been suggested in the media, the placements projected for the 2022-23 school year never excluded CHUA, in fact an adjustment resulting from substantial changes in the quality of some services, and not only in CHUA.
If more students are going to be placed in hospitals outside the Algarve, it is because there are no hospital services accredited to meet the quality criteria in the region. Hospital units in Portugal, with particular emphasis on University Hospitals, must submit to one of the recognized Quality Accreditation Agencies (the ACSA/DGS: King's Fund or Jci), which evaluates and believes, or not, each clinical service.
The criteria that the FMCB established, since its foundation, to evaluate hospital clinical services, were, on the one hand, inspired by the requirements of the Agency for Assessment and Accreditation of Higher Education (A3ES) and, on the other hand, informed by the current legislation ( DL 61/18) for University Hospitals, which include factors such as accreditation recognized by the aforementioned competent authorities.
It happens that CHUA, at the moment, only has one accredited service (Physical Medicine and Rehabilitation), having not, in the last two years, implemented the Quality Accreditation Plan that was approved and initiated by the previous Board of Directors, in response to the needs identified by the FMCB and by the fact that it is designated as “University Hospital”.
Recently, some services no longer have the minimum quality for FMCB student internships. There has clearly been a deterioration from previous years, the cause of which is the responsibility of the CHUA CA and Clinical Director to investigate.
It should be noted that, when the representative member of the University was removed from the Board, the University was no longer able to contribute to operational decisions, such as the implementation of the Quality Accreditation Plan.
It is only due to the deterioration in the quality of services that more placements were made for FMCB students outside the region. The aim of the FMCB is to ensure a quality of learning that cannot be affected by the personal conveniences of students who know from entering the course that they can be placed outside the region in grades 5 and 6. There are no “obscure manoeuvres”.
Author José Ponte is Emeritus Professor at the University of Algarve
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