Sísifo Educational Sciences Journal Educational Sciences R&D Unit of the University of Lisbon  Edited by Rui Canário and Jorge Ramos do Ó ISSN: 1646-6500

As far as Portugal is concerned, the preoccupation with renewing and opening perspectives in medical education has always been a central concern for teaching-doctors and has been the theme of several meetings. In this context, the Sociedade Portuguesa de Educação Médica (SPEM) [Portuguese Society of Medical Education] was established in 1967 (becoming active in 1971), as a site for joint reflection, presided by Professor José Pinto Correia.

The editorial of the first issue of Cadernos de Educação Médica [Medical Education Booklets] by SPEM announced the organization of six medical education congresses between 1982 and 1990, the year the journal “Medical Education” was launched, under the direction of Professor Joaquim Pinto Machado. Since then, another four medical education congresses have been held, with the participation of teachers and students from all the faculties of medicine.

With respect to the degree course curriculum, the faculties of medicine have been attentive to innovation concerns and have introduced more subjects and modules geared towards clinical practice (Fernandes & Fernandes, 1998) and experimented innovative pedagogical strategies, such as “learning through problems” (Rendas et al., 1993, 1997a, 1997b,1998,1999), using information technology in the teaching of different subjects (Garcia & Costa, 1991), reformulating the 6th year of the course and making it professionally- orientated (SPEM, 1998), updating “classical” curriculum content and even creating new, apparently more innovative curricula in the new medical schools in Beira Interior (Lopez de Macedo & Craveiro Sousa, 2003) and Minho (Pinto Machado, 2003).

So, a lot has been done by the faculties of medicine and the entire process fits into the current legislation framework. This is the case of the Council of Ministers Resolution No.140/98 which, acknowledging the need to increase the supply of quality in the area of health care, has adopted a set of measures including: the systemic monitorization of the implementation of two medical education units (in the Universities of Beira Interior and Minho), the monitorization of the re-structuring of the medicine degree course curriculum in the five faculties of medicine throughout the country (Faculties of Medicine of the Universities of Oporto, Coimbra and Lisbon, Institute of Biomedical Sciences Abel Salazar in Oporto and the Faculty of Medical Sciences of the Universidade Nova, Lisbon), the promotion of co-operation among the ministries involved, namely Science, Higher Education and Health, improved articulation between higher education institutions in the health sector and health care provision units ( with a view to achieving articulation and the suitability of training to the realities of the National Health Service) and the nomination of a Monitoring Group in 1998, presided by Professor Alberto Amaral. Much of the reflection created has derived from the effort of this group, both in terms of its characterization of needs on a national level (national distribution of the needs of doctors, nurses and other health technicians) and its “Strategic Plan for Training in the Health Sector”.

It is also in this sector that the faculties of medicine are subject to internal and external evaluations carried out both by national and international commissions. The following are examples: the evaluation of degree courses in Medicine and Dentistry, beginning in the academic year 1995-1996, following the Agreement among the Ministry of Education, the Conselho de Reitores das Universidades Portuguesas [Council of Deans of the Portuguese Universities] and the Fundação das Universidades Portuguesas [Portuguese University Foundation]; Evaluation, carried out by the Grupo de Missão para a Saúde [Health Mission Group] (from which recommendations mainly regarding curriculum have emerged) in 2000; evaluation carried out by the Conselho de Reitores da Europa [European Council of Deans] and within the context of the European University Association (EUA) in 2002, where the effort to implement change on the part of the faculties was acknowledged and recommendations were made in relation to their articulation with the health services; evaluation carried out by the Conselho Nacional de Avaliação do Ensino Superior (CNAVES [National Higher Education Evaluation Council]) in 2004, recommending greater emphasis on “research training”, improvement of the pedagogical and evaluation processes, the integration of basic and clinical training, the reinforcement of multidisciplinarity, with permission being given to non-doctor candidates to take a PhD in the faculties of medicine, students’ early contact with the health system, regular and systematised pedagogical training of teachers and the monitoring of teaching, the implementation of a professional teaching system in clinical subjects, quality control and the promotion of a self-evaluation routine and, finally, the establishment of long-term institutional plans of action.