Decentralization in the Training of Pediatricians at the School of Medicine, University of the Republic, Uruguay

Abstract

Introduction: Centralizing higher education studies in Montevideo entails economic expenses, family uprooting, and loss of human resources for families living in the interior of Uruguay. The training of pediatric specialists outside the capital city began in the 1980s.  In recent years, this innovations has been reinforced by adding learning scenarios, teachers, didactic resources, and evaluations.
Objective: to describe the experience of decentralizing the teaching of pediatric specialists between 2007 and 2021 in Maldonado, Paysandú, Rivera, and Salto.
Method: Descriptive study, including postgraduate students of pediatris who completed their training in Maldonado, Paysandú, Rivera, and Salto between 2007 and 2021. The study describes the number of specialists trained, personal or family characteristics that influenced the decision to take the course in the interior, academic performance, place of professional practice, and available teaching staff.
Results: during the study period, 88 students undertook postgraduate studies in the evaluated cities,  33 of which studied in a residency program. Of these, 78 were native to or residents of the area.  Fifty six pediatricians graduated, 18 were still enrolled, and 4 dropped out. A variable percentage of the course’s mandatory components were conducted in the interior. Average time to complete all mandatory activities was 3.3 years.   Sixty graduates practice in the place of training or in nearby cities.  Paysandú and Salto have 34 hours of teaching per week; Maldonado has 6 hours per week and honorary teachers.  Rivera has honorary teachers/tutors.
Conclusions: the decentralization of pediatric teaching is a significant achievement for inland cities in the interior of the country, as it allows them to train their own human resources, enabling them to settle in these cities. There is a need to improve the offer of curricular activities and teaching hours.