Abstract
BackgroundThe Mexican mandatory year of social service following medical school, or pasantía, is designed to provide a safety net for the underserved. However, social service physicians (pasantes) are typically unpracticed, unsupervised, and unsupported. Significant demotivation, absenteeism, and underperformance typically plague the social service year.ObjectiveCompañeros en Salud (CES) aimed to create an education-support package to turn the pasantía into a transformative learning experience.DesignCES recruited pasantes to complete their pasantía in CES-supported Ministry of Health clinics in rural Chiapas. The program aims to: 1) train pasantes to more effectively deliver primary care, 2) expose pasantes to central concepts of global health and social medicine, and 3) foster career development of pasantes. Program components include supportive supervision, on-site mentorship, clinical information resources, monthly interactive seminars, and improved clinic function. We report quantitative and qualitative pasante survey data collected from February 2012 to August 2013 to discuss strengths and weaknesses of this program and its implications for the pasante workforce in Mexico.ResultsPasantes reported that their medical knowledge, and clinical and leadership skills all improved during the CES education-support program. Most pasantes felt the program had an overall positive effect on their career goals and plans, although their self-report of preparedness for the Mexican residency entrance exam (ENARM) decreased during the social service year. One hundred percent reported they were satisfied with the CES-supported pasantía experience and wished to help the poor and underserved in their careers.ConclusionsEducation-support programs similar to the CES program may encourage graduating medical students to complete their social service in underserved areas, improve the quality of care provided by pasantes, and address many of the known shortcomings of the pasantía. Additional efforts should focus on developing a strategy to expand this education-support model so that more pasantes throughout Mexico can experience a transformative, career-building, social service year.
Highlights
The Mexican mandatory year of social service following medical school, or pasantıa, is designed to provide a safety net for the underserved
The six pasantes who completed the study ranged in age from 22 to 26 years, included three men and three women, had all completed required coursework at an accredited medical school in Mexico making them eligible to complete their social service requirement, and all had completed the pasantıa as part of the Companeros en Salud (CES) educationsupport program in Chiapas
Knowledge and skills Overall, pasantes reported that their medical knowledge and clinical skills improved while completing the education-support program during their social service year in Chiapas
Summary
The Mexican mandatory year of social service following medical school, or pasantıa, is designed to provide a safety net for the underserved. Results: Pasantes reported that their medical knowledge, and clinical and leadership skills all improved during the CES education-support program. One hundred percent reported they were satisfied with the CES-supported pasantıa experience and wished to help the poor and underserved in their careers. Conclusions: Education-support programs similar to the CES program may encourage graduating medical students to complete their social service in underserved areas, improve the quality of care provided by pasantes, and address many of the known shortcomings of the pasantıa. Additional efforts should focus on developing a strategy to expand this education-support model so that more pasantes throughout Mexico can experience a transformative, career-building, social service year
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