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U21 HEALTH SCIENCES GROUP MEETING MAJOR TRENDS AND KEY ISSUED IN MEDICAL EDUCATION AND MEDICAL SYSTEM IN MEXICO Prof. Jorge E. Valdez Dean

U21 n zmedicinevaldez

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Les comparto lo que presente en la reunion dell Health Science Group de Universsitas 21 en Auckland New Zealand. U21 HEALTH SCIENCES GROUP MEETING MAJOR TRENDS AND KEY ISSUED IN MEDICAL EDUCATION AND MEDICAL SYSTEM IN MEXICO

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U21 HEALTH SCIENCES GROUP MEETING MAJOR TRENDS AND KEY ISSUED IN MEDICAL

EDUCATION AND MEDICAL SYSTEM IN MEXICO

Prof. Jorge E. ValdezDean

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Summary• Objectives• Introduction• The Health System in Mexico.• The Health and Medical Education Structure.• Medical Education Organizations• Conclusions

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Objetives• Provide a short review of Mexico's Health

System and its relation with Medical Education.• Show the nations infrastructure related to

medical education.• Know how Medical Education is organized • Present the opportunities for medical schools to

contribute in the improvement of health care indicators

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Population: 103 million

More than 19,000 communities with less than 500 people

Scattered throughout the country and add up to over 5 million people

MEXICO

Introduction

Federated Republic32 States

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Life Expectancy

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Demographic Changes

-6,000,000 -4,000,000 -2,000,000 0 2,000,000 4,000,000 6,000,000

No. de Habitantes

0-4 años

10-14 años

20-24 años

30-34 años

40-44 años

50-54 años

60-64 años

70 años o más

Edad

Población a mitad de año por grupos de edad, 2025.

Hombres Mujeres

2,000,000 2,000,000 4,000,0004,000,000 6,000,0006,000,000 0

Fuente: CONAPO: Proyecciones de la población de México, 1996-2050

-6,000,000 -4,000,000 -2,000,000 0 2,000,000 4,000,000 6,000,000

No. de Habitantes

0-4 años

10-14 años

20-24 años

30-34 años

40-44 años

50-54 años

60-64 años

70 años o más

Edad

Población a mitad de año por grupos de edad, 2006.

Hombres Mujeres

2,000,000 2,000,000 4,000,0004,000,000 6,000,0006,000,000 0

Fuente: CONAPO: Proyecciones de la población de México, 1996-2050

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Health Expenditure (%GDP)

Año %2000 5.072001 5.452002 5.622003 5.782004 6.002005 5.902006 5.702007 5.762008 5.802009 6.402010 6.30

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Life expectancy vs. Health expenditure

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Changes in the cause of death in Mexico: 1955-2005

0

10

20

30

40

50

60

70

80

90

100

1955 1960 1970 1980 1990 2000 2006 2030

Per

cen

tt

Infectious diseases, nutrition and reproductive problems.Non infectious diseasesLesions

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Comments• The health indicators had being improving but

more spending of the nations income its needed to face the growth on health care that the country will face due to demographic changes.

• The country faces most of the challenges in health care of a developed country and still have the health inequalities that characterize a underdeveloped society.

• A well organized health system is needed.

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Challenges for the Health System

Level of health

Inequality in health

Responsiveness

Fairness of Finance

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Stewardship

Production ofResources

Funding

Protection

Promotion

Prevention

Medical care

1. Improving Health Status

2. Reduce health disparities.

3. Provide health care with high standards of quality and safety.

4. Avoid impoverishment through protecting population against health care cost.

5. Guarantee that the health contributes: a) in the fight against poverty and b) country's development.

Means and Ends of Health System

Functions

Objectives

Hea

lth C

are

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Coordinated Health System

Universal Coverage

FunctionalIntegration

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The Health Ministry regulates and coordinates the Nations Healthcare System

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Comments• The health system has been reformed and the

definition of functions has allowed a better organization.

• The federal government regulates and coordinate with the states the health care system.

• Health care Infrastructure has been growing in the last decade.

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Health Science Education System Framework Structure

Committee for Postgraduate and Continuous Medical Education

Inter-institutional Commission for the Formation of Healthcare Human Resources

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Practicing Physicians

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Medical Schools

1830-1899 1900-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990-1999 2000-20040

5

10

15

20

25

8

4

8

1

24

12 20 2 0 2

8

2

12

3

PúblicasPrivadas

50 public medical schools31 private medical schools

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Medical Students per State

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“National Exam For Medical Residencies

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

5000

10000

15000

20000

25000

Inscritos Seleccionados

• 33 years of experience with it.

• Only 6000 are selected

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Graduated Physicians vs. Medical Residencies spots in the last 20 years

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Comments• The Health education is coordinated by two

entities of the federal government through a collegiate process.

• Our figures of medical graduates are below of the developed countries.

• The private investment in medical education has higher grow rate than the public.

• Its is in an ongoing process of decentralization.• We need more medical residencies positions .

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Three generations of reforms

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Academic Health Centers

4. Public University Owned Hospitals with affiliated medical school.

5. Private University Owned Hospitals with affiliated private medical school.

1. Federal government owned affiliated to public or private university.

2. State government owned affiliated state public or private university.

3. Private owned affiliated to public or private university

In Mexico we have different types of academic health centers

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Medical Education Organizations

•Collegiate Model of Medical Schools (89/104).•Non regulatory.• Facilitates accreditation through education, knowledge transfer.•Provides opportunity for networking•Supports accreditation of its members•Affiliation is required in order to obtain accreditation.

•Non profit, autonomous, public-private institution.•Non Medical Schools organization• Integrated by : Academy of Medicine, Academy of Surgery, AMFEM, Health Ministry.•Main porpoise is accreditation of Medical Education Quality.•58/89 accredited schools

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Mexican Physician Competencies Model

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Medical Schools

Public Private Summary

Accredited 39 19 58

In process 1 2 3

Non accredited

7 5 12

New accredited

3 2 5

First Visit 0 1 1

New No accredited

2 0 2

No information

4 4 8

Total 56 33 89

•7 Categories•60 Standards•179 indicators•13 Tables

Accreditation is valid for 5 years

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Challenges for Health Education System

• Integration of all “players”, in particular non affiliated medical schools.

• “Catch up” with the educational innovations• Same level of quality among the different

medical schools.• Congruence with health system needs in

curricular structure.

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GraciasThank you

[email protected]