Les comparto lo que presente en la reunion dell Health Science Group de Universsitas 21 en Auckland New Zealand. U21 HEALTH SCIENCES GROUP MEETING MAJOR TRENDS AND KEY ISSUED IN MEDICAL EDUCATION AND MEDICAL SYSTEM IN MEXICO

1. U21 HEALTH SCIENCES GROUP MEETING
MAJOR TRENDS AND KEY ISSUED IN MEDICAL
EDUCATION AND MEDICAL SYSTEM IN MEXICO
Prof. Jorge E. Valdez
Dean

2. Summary
• Objectives
• Introduction
• The Health System in Mexico.
• The Health and Medical Education Structure.
• Medical Education Organizations
• Conclusions

3. Objetives
• Provide a short review of Mexico's Health
System and its relation with Medical Education.
• Show the nations infrastructure related to
medical education.
• Know how Medical Education is organized
• Present the opportunities for medical schools to
contribute in the improvement of health care
indicators

4. Introduction
Population: 103 million
More than 19,000 communities
with less than 500 people
Scattered throughout the country
and add up to over 5 million
people
MEXICO
Federated Republic
32 States

5. Life Expectancy

6. Demographic Changes
Población a mitad de año por grupos de edad, 2006.
70 años o más
60-64 años
50-54 años
40-44 años
Edad
30-34 años Población a mitad de año por grupos de edad, 2025.
20-24 años
70 años o más
10-14 años
60-64 años
0-4 años
50-54 años
-6,000,000
6,000,000 -4,000,000
4,000,000 -2,000,000
2,000,000 0 2,000,000
2,000,000 4,000,000
4,000,000 6,000,000
6,000,000
No. de Habitantes
40-44 años
Fuente: CONAPO: Proyecciones de la población de México, 1996-2050 Hombres Mujeres
Edad
30-34 años
20-24 años
10-14 años
0-4 años
-6,000,000
6,000,000 -4,000,000
4,000,000 -2,000,000
2,000,000 0
0 2,000,000
2,000,000 4,000,000
4,000,000 6,000,000
6,000,000
No. de Habitantes
Fuente: CONAPO: Proyecciones de la población de México, 1996-2050 Hombres Mujeres

7. Health Expenditure (%GDP)
Año %
2000 5.07
2001 5.45
2002 5.62
2003 5.78
2004 6.00
2005 5.90
2006 5.70
2007 5.76
2008 5.80
2009 6.40
2010 6.30

9. Life expectancy vs. Health expenditure

10. Changes in the cause of death in
Mexico: 1955-2005
100
90
80
70
Percentt
60
50
40
30
20
10
0
1955 1960 1970 1980 1990 2000 2006 2030
Infectious diseases, nutrition and reproductive problems.
Non infectious diseases
Lesions

11. Comments
• The health indicators had being improving but
more spending of the nations income its needed
to face the growth on health care that the
country will face due to demographic changes.
• The country faces most of the challenges in
health care of a developed country and still have
the health inequalities that characterize a
underdeveloped society.
• A well organized health system is needed.

12. Challenges for the Health System
Level of health
Inequality in health
Responsiveness
Fairness of Finance

13. Means and Ends of Health System
Functions
Stewardship Objectives
Protection 1. Improving Health Status
2. Reduce health disparities.
3. Provide health care with high
Promotion standards of quality and safety.
Production of
Resources 4. Avoid impoverishment through
Health Care
protecting population against
health care cost.
Prevention
5. Guarantee that the health
contributes: a) in the fight
Funding against poverty and b) country's
development.
Medical care

14. Coordinated Health System
Universal Coverage
Functional
Integration

15. The Health Ministry regulates and
coordinates the Nations Healthcare System

16. Comments
• The health system has been reformed and the
definition of functions has allowed a better
organization.
• The federal government regulates and
coordinate with the states the health care
system.
• Health care Infrastructure has been growing in
the last decade.

17. Health Science Education System
Framework Structure
Inter-institutional Commission for the Formation of
Healthcare Human Resources
Committee for Postgraduate and Continuous Medical Education

18. Practicing Physicians

19. Medical Schools
25
24
Públicas
20 Privadas
50 public medical schools
31 private medical schools
15
12
10
8
8 8
5
4
3
2 2 2 2 2
0 0 1
1
0
1830-1899 1900-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990-1999 2000-2004

20. Medical Students per State

21. “National Exam For Medical Residencies
• 33 years of experience with it.
• Only 6000 are selected
25000
20000
15000
10000
5000
0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Inscritos Seleccionados

22. Graduated Physicians vs. Medical
Residencies spots in the last 20 years

24. Comments
• The Health education is coordinated by two
entities of the federal government through a
collegiate process.
• Our figures of medical graduates are below of
the developed countries.
• The private investment in medical education
has higher grow rate than the public.
• Its is in an ongoing process of decentralization.
• We need more medical residencies positions .

25. Three generations of reforms

26. Academic Health Centers
In Mexico we have different types
of academic health centers
1. Federal government owned 4. Public University Owned
affiliated to public or private Hospitals with affiliated
university. medical school.
2. State government owned
5. Private University Owned
affiliated state public or
Hospitals with affiliated
private university.
private medical school.
3. Private owned affiliated to
public or private university

27. Medical Education Organizations
•Collegiate Model of Medical Schools •Non profit, autonomous, public-private
(89/104). institution.
•Non regulatory. •Non Medical Schools organization
• Facilitates accreditation through • Integrated by : Academy of
education, knowledge transfer. Medicine, Academy of
•Provides opportunity for networking Surgery, AMFEM, Health Ministry.
•Supports accreditation of its members •Main porpoise is accreditation of
•Affiliation is required in order to obtain Medical Education Quality.
accreditation. •58/89 accredited schools

28. Mexican Physician Competencies Model

29. Medical Public Private Summary
Schools
Accredited 39 19 58
In process 1 2 3
Non 7 5 12
accredited
New 3 2 5
accredited
•7 Categories
First Visit 0 1 1
•60 Standards
•179 indicators New No 2 0 2
accredited
•13 Tables
No 4 4 8
information
Total 56 33 89
Accreditation is valid for 5 years

30. Challenges for Health Education
System
• Integration of all “players”, in particular non
affiliated medical schools.
• “Catch up” with the educational innovations
• Same level of quality among the different
medical schools.
• Congruence with health system needs in
curricular structure.

31. Gracias
Thank you
Jorge.valdez@itesm.mx