A study led by Dr. Giuston Mendoza-Chuctaya revealed that, between 2009 and 2019, 42.8% of the students in the last cycle of Human Medicine who took their SERUM failed to pass the National Medicine Examination (ENAM), a 200-question multiple-choice and clinical reasoning test designed to measure foundational knowledge of the future general practitioner.
The study, recently published in the Acta Médica Peruanashowed that the incidence of failure was higher in Peruvian graduates from private universities and from abroad, where 34% and 79% of students did not reach the minimum score, respectively. In the case of public universities, the number of disapproved is 31%.
It is also indicated that, of these universities, only three registered less than 20% of disapproved: the National University of San Marcos (7%), the National University of Piura (17%) and the Pedro Ruiz Gallo University (19%). The others reach up to 55% disapproved, as is the case of the National University of the Amazon of Peru; 49% at the San Luis de Gonzaga National University in Ica; 48% at the National University of the Altiplano in Puno and 42% at the Federico Villarreal National University in Lima.
In the case of private universities, the highest level of disapproval is that reached by the César Vallejo University, where 70% of medical students fail this exam; at the San Juan Bautista Private University, 63% disapprove; the University of Chiclayo and the Peruvian University of the Andes 62%, and the Antenor Orrego Private University and the Ricardo Palma University 42%.
Weakening of Sunedu puts training quality at risk
The study also warns of an accelerated growth of medical schools: from the 24 that offered the degree in 1998, they increased to 52 in 2016. The National Superintendence of Higher University Education (SUNEDU), to date, has only approved the programs of seven of these universities. The report highlights that, although this increase in supply might cover the deficit of health personnel, not only quantity is required, but also competent and quality professionals.
One of the reasons that explains these results is that the universities do not have the appropriate instruments, suggests Dr. Jesús Valverde, an intensivist doctor at Hospital 2 de Mayo. “There is no what we call teaching doctors for the training of doctors. Most hospitals are already saturated, but the number of students has increased significantly. They are going to hospitals or posts outside the city, where there is no teacher training”, he points out.
Along these lines, according to figures from the Medical College of Peru, at the Federico Villarreal National University the six medicine residents have only one teacher; while at the Universidad Nacional Mayor de San Marcos there is only one medical tutor for the 15 residents.
“Sunedu has demanded that teaching doctors be on the payroll, have a schedule, have a master’s degree and specialization. Our concern is that, in the future, when Sunedu backs down, there will be no control and they will be abandoned.. Seeing care with an unqualified professional, especially in health, would be very unfortunate”, emphasized Dr. Raúl Urquizo, dean of the Medical College of Peru.
For him it is essential strengthen universities in their training for our future medical staff. He pointed out that there are currently top-level health professionals leaving the country and he fears that the situation will worsen. He considers that increasing the teaching budget, better managing the number of places and giving opportunity to appointed doctors, this complicated scenario can be reversed.
The failure of this exam has not been a factor that prevents doctors from practicing their profession. In the program News Extension Dr. Elmer HuertaRPP’s medical adviser, warned that Indecopi calls the request of the Medical Association of Peru a “bureaucratic barrier” to consider the ENAM results as a requirement to enter the labor field.
“The big question is: What are these universities forming? This is an exam that a medical student has to answer. Doctors at these universities are practicing medicine [tal vez] in the poorest neighborhoods of Peru, giving a lousy medical service to the residents, while those who have money go to private clinics where the most qualified are. That is called inequality,” he stated.