20 July 2023
The format of this course, aimed at researchers and created in partnership by the Champalimaud Foundation and the Faculty of Medicine & Biomedical Sciences of the University of Algarve, aims at "simplifying the objectives and reducing the workload of the course".
Interview with Isabel Palmeirim, Director of Education at the Champalimaud Foundation.
Isabel Palmeirim, who was until recently the director of the Faculty of Medicine & Biomedical Sciences and of the Medicine Course at the University of Algarve, was appointed, in June, Director of Education of the Champalimaud Foundation (CF).
Since 2020, Isabel Palmeirim has already organised and directed, two editions of the Fundamentals of Medicine course at the CF. This is a pioneering initiative, aimed at researchers interested in familiarising themselves with the terminology and the anatomical, physiological, pathological and pharmacological issues of the different organic and functional systems of the human body, in order to be able to establish bridges between research and clinical practice – the two main branches of activity of the institution.
From a more general perspective, the challenge ahead for this 57-year-old physician-scientist is to integrate and structure the various teaching initiatives that already exist at the CF, as well as to encourage the creation of new initiatives involving researchers, doctors or both. One of the first steps will be reworking the original idea of the Fundamentals of Medicine course.
It is a postgraduate course that was born as a collaboration between the Champalimaud Foundation and the Faculty of Medicine of the University of Algarve. And, given its success, we intend to maintain it.
The idea came from João Silveira Botelho, administrator of the Champalimaud Foundation. As director of the Medicine course at the University of Algarve, I was giving a presentation on our Medicine course and talking about our concern to train doctors to be able of interacting with scientists, and I was asked if there was any effort in the opposite direction: training researchers to be able to listen/talk about medicine with a doctor.
And indeed, I was unaware that there was anything of the sort. I was then challenged, in 2018, to create a training programme that would familiarise researchers with medical terminology and issues, in order to foster the emergence of so-called translational projects.
Translational [research] projects are those in which basic science is "translated" into science applied to medical practice (the English expression to describe the translational process is "from the bench to the bedside"). Scientific research has increased biological knowledge in an astonishing way, but there is a significant lag between this increase in knowledge and its application to medical diagnosis and treatment.
There is a real difficulty in research translation, because researchers and doctors belong to two different worlds that do not interact much. Researchers don't know what the needs of doctors in the field are, and doctors don't know how to approach researchers to present their clinical problems. We believe that the most interesting projects come from the frontiers between these domains, and that it is necessary to be able to "jump" from one to the other. That's why I thought it was so interesting to try to endow top researchers with the language and medical knowledge they need to be able to imagine applications of their research areas to medical care. And it was a first. I still don't know anything like this, in Portugal or abroad.
In its initial phase, Fundamentals of Medicine (FoM) was identical to a curricular unit (CU) that exists at the Algarve Medical School: the UC Basic and Clinical Sciences I (CU CBC I). The idea was that if FoM appealed to researchers from the Champalimaud Foundation, inciting them to apply to the Algarve Medicine Course, and if they were selected in the access tests to the university’s course, an equivalence would be granted to them between the CU CBC I and the FoM course carried out at the Champalimaud Foundation.
The initial idea, proposed by João Silveira Botelho, was therefore implemented in a very demanding format. However, the essential goal remained that, without necessarily wanting to go to Medical School, the CF course’s research students could acquire a different contact with medical practice.
The course proved to be very interesting for the students, but very "heavy" in terms of workload. The first edition lasted one year and was very intensive. The second edition maintained the same contents but lasted 18 months, to reduce the workload.
Now, we will partially abandon this format. We are going to "detach" Fundamentals of Medicine from the UC given at the Algarve Medicine Course. In other words, this postgraduate programme will no longer grant equivalence to UC CBC I, which will allow FoM to be substantially simplified.
In fact, there is no need for researchers to reach the degree of knowledge that we were providing at the beginning. So what I intend to do now is to relaunch FoM in a format that is more suited to the needs and interests of the researchers of the Champalimaud Foundation.
Scientific studies have shown that our brain retains knowledge better when learning is an active, problem-solving activity, that is, with clear application in everyday life. This is the basic idea of PBL. This type of learning has already been implemented at the University of Algarve.
First of all, it has to be said that PBL is already applied in other parts of the world: Canada and the Netherlands, for example, have been doing PBL for more than 40 years in medical courses.
In our Medicine course at the University of Algarve, PBL is the basis of the first two years of the course since 2009 and its application was completely new and pioneering in Portugal. Taking into account that the PBL methodology is totally different from the classical teaching method, the idea was to create a small medical course (initially only 32 students/year) that would work as a kind of test tube, where we could try out these new active learning methodologies in medical training in Portugal.
The problems that the FoM students have to solve are clinical cases, organised in sets of five or six cases that seek to develop medical knowledge in given areas: the cardiovascular system, the immune system, the central nervous system, etc. A "tutor" guides the discussion of the clinical case by the students.
The classes ideally have between six and ten students, so that the discussion can be lively. And after the students have worked on a topic/case, there are one or two seminars given by experts, which allow the students to complete their knowledge on that topic. (More details at: https://fchampalimaud.org/news/learning-see-world-through-physicians-eyes)
Until now, students had to go through all the areas required for equivalence with UC CBC I, as I have already mentioned. As this will no longer be necessary, certain topics that will be eliminated, leaving only the most interesting ones for the researchers of the Champalimaud Foundation. Maternal and Child care, for example, is not an area of particular interest to the scientists of this house – but the whole part about the nervous system is, obviously, because it is linked to the research in neuroscience being done here. The new format means a simplification of the objectives and a reduction in the course’s workload.
On the other hand, in view of the large number of requests that we have received from outside the CF, the Board of Directors has decided to open the Fundamentals of Medicine course to researchers from other institutions. A very generous attitude, given the sums involved.
I also think that, now that I am here, I will be able to get to know the Champalimaud Foundation community much better, and invite in-house doctors to give seminars on the course. This will make the CF’s researchers and doctors get to know each other better and communicate more, potentially favouring opportunities for translational research to emerge.
There are already many collaborations within the Foundation. But not in every unit, nor in every research group. Collaboration is part of the culture of this house and we want it to become widespread.
Yes, some ideas are already starting to emerge, but essentially what I am doing at the moment is meeting with as many people as possible (researchers, doctors, technicians, students) to learn about their needs and about what they feel is working, or could be improved, in terms of education at the Foundation.
Yes. One of the ideas is to create a Fundamentals of Medicine type of programme, but for doctors - a “Fundamentals of Research” course, so to speak. PBL is a very interesting way of learning and it is very well suited to adults, who no longer have the patience to sit in a classroom listening to a teacher.
