Summary: This week Professor Harden discusses his recent visits to Uruguay and Argentina as well as their overwhelmingly positive response to the Face-to-Face ESME course. Description: Pat Lilley and I have just returned from participating in conferences and ESME courses in Punta del Este in Uruguay and Buenos Aires in Argentina. At both sites we were hugely impressed by the interest and enthusiasm for exploring developments in medical education. In CLAEH University in Punta del Este the programme was coordinated by Giorgia Ganduglia and by Eduardo Durante at the University of Hospital Italiano de Buenos Aires. Our ESME courses usually have participants from medical schools in different countries and this has advantages in terms of sharing information and problems. As we found on this occasion, there are also great advantages in having all of the participants from the same medical school. The participants worked in groups of eight for the activities. They engaged in the discussions enthusiastically and indeed at times there was difficulty stopping the discussion. One of the take-home messages reported at the end of the courses was the value they found in spending time discussing medical education issues with their colleagues in the context of the problems presented in the course. The photograph shows the participants in one of the courses.


In Punta del Este it was a pleasure working with the current CLAEH Dean, Hugo Nunez Bernadet and the previous Dean, Humberto Correa who is Professor of Medical Humanism. He presented me with a signed copy of his book on this subject. Both attended the whole course and actively participated in the group work. This sent an important message to staff with regard to their commitment to teaching as a priority in the school.

The conference at Punta del Este was on the training of doctors in Uruguay. I was impressed by the wide range of stakeholders who attended and participated throughout the conference, bringing together governmental and non-governmental, academic and non-academic institutes, medical schools and institutions which employ physicians and institutions which control health in Uruguay. Even the ambulance service was represented. The Minister of Health participated actively throughout the day and gave a powerful presentation in which he highlighted the need for those who educate doctors to work with those who manage medical resources. The aim, he highlighted, was to achieve high quality care for the population throughout the country, even in remote areas. I have not previously attended a meeting with all of the stakeholders represented.

A student presented at the conference the results of a survey she had undertaken of 500 individuals, from the general population and healthcare professionals, addressing the question “What makes a good doctor?” What was interesting was not only the difference between the views of the healthcare professionals and the general public, which one might anticipate, but the different perceptions according to the age of the respondent. Keeping up to date was viewed as most important by those under 30 while good communication skills and empathy was considered more important in older groups. Health promotion was not seen as a key attribute to those under 30 and those over 70.

I was invited at the close of the conference to highlight the key messages from the discussions. I identified seven – the importance of involving all stakeholders, including students, in the planning and delivery of healthcare; the move from a doctor-centred to a patient-centred approach to care; a change from an emphasis on knowledge to other attributes including attitudes and teamworking; a move from emphasis on disease and cure to prevention and health promotion; a move from an emphasis on the hospital to the community; the importance of delivery of healthcare in the rural as well as the urban areas; and the need for professionalism in healthcare professionals recognising accountability and with each professional responsible for keeping themselves up to date. We would see, I believe a similar list of issues in other countries.

In Buenos Aires the conference was chaired by the Rector of the University Professor Marcelo Fernando Figari. The theme was developments in medical education. Carlos Brailovsky who is now in Canada contributed. Dr Figari and other senior teachers all attended and participated very actively throughout the ESME course, an important signal to staff of the importance of the teaching. Professor Figari is a surgeon with an interest in the thyroid gland. Given my own interest as an endocrinologist I was fascinated to have an update from him about the latest techniques for thyroidectomy using robotic surgery through the axilla with no scar left on the neck. I had not appreciated the huge advances that are being made in robotic surgery and the implications for training. At a ceremony at the beginning of the conference I was honoured to be presented by the Rector with an honorary Professorship at the university.

I was not aware previously that the traditional drink shared throughout the day in the workplace and at meetings in Uruguay and Argentina is mate. Having sampled the drink, I was given a mate cup, drinking tool, flask and infusion for use in Dundee.

During the trip we went through seven airports, two in the UK, two in Uruguay, two in Argentina and Madrid. With the exception of our final London-Edinburgh connection all the flights were on time or early and there was no problem with our baggage or exhibition material. On arriving in Uruguay in Montevideo I was impressed with the ease of the luggage retrieval and immigration. There was a large notice in the airport saying – “Montevideo – an easy airport”. At immigration, I asked what it meant by “an easy airport”. The immigration officer thought about it for a minute and then said “an easy airport is easy airport!” I suggested in Punta del Este while telling the story about the airport that perhaps we also needed “an easy curriculum”! The translator suggested that perhaps “easy” was a mistranslation for “user friendly” but I think “easy” is more effective.

These were fascinating countries to visit and I look forward to meeting many of the course and conference participants from Uruguay and Argentina at AMEE 2017 in Helsinki.