Director Gulbenkian Programme in Advanced Medical Training

On the 6th of October last, at the FMUL/ Institute of Molecular Medicine (IMM) the educational component of the first edition of the Gulbenkian Programme in Advanced Medical Training (PGFMA) began, a PhD programme specifically aimed at clinical doctors. The PGFMA is a Gulbenkian initiative which has been joined by the Champalimaud Foundation and will be open for three consecutive years, accepting 10 clinical doctors (specialists and specialty interns) per year, 5 full-time and 5 part-time. The programme offers the candidates admitted an excellent scientific training in biomedical and clinical sciences, as well as financial support to attend the programme and research activities (all information on www.gulbenkian.pt).

The Reasons:
The extraordinary progress of biology over the last decades today offers medicine unprecedented opportunities for a better understanding of the normal and of the pathological, new approaches to the physiology of complex systems and powerful instruments for prevention and therapeutics. Contemporary biomedicine has also brought with it the bases of a new taxonomy of illness, with an intrinsically predictive character, in which specific molecular signatures promise pre-symptomatic identification of the individual at risk, and desirably, prevention of the illness. An admirable promise, but difficult to move into reality if clinical doctors are outside the process of the production of knowledge. Indeed, the research carried out by a clinical doctor is marked out by two characteristics that are as unique as they are indelible: his personal experience of caring for the sick human being and a training guided by a view “centred on the organism”. If the first one explains that the clinical doctor-researcher has always embodied eagerness to bring to the patient the benefits of scientific progress, the second aspect, in contributing his holistic viewpoint to a somewhat reductionist biomedicine, today emerges as an indispensable factor in the very progress of fundamental biomedical research.
However, over the last decades there has been a progressive decline in doctor involvement in the practice of research. This phenomenon, observed in all the developed countries, is mainly due to the difficulty felt by the practitioner in allying a long and complex professional training, as well as health assistance activity dealing with strong economic restrictions, with the acquisition of skills that allow them to accompany the steps of contemporary biomedical science. This deep divorce between the practitioner and science runs the risk of turning the doctor into a passive executor of products derived from an agenda that he himself has not determined and to which he has not contributed. The corollary will be, in the final analysis, a serious threat to the development of medical research that is truly useful for the patient.

The Aims:
The programme’s main aim is to contribute towards allowing doctors interested in allying their health care practice with research into clinically relevant problems to acquire solid scientific bases and to be able to develop quality research projects in their specific areas of interest.
Who the programme is for:
Doctors, Interns or Specialists, highly motivated for clinical research activities or of transfer, who:
• are convinced that a solid scientific training is the basis for excellent medical research and of better clinical practice,
• wish, in the future, to become involved in multidisciplinary and cooperative projects as a complement to their health care activity.

What characterises the programme
Although it is specifically designed for clinical practitioners, the PGFMA shares the same principles as all the Gulbenkian PhD Programmes: 1. Strict selection of the candidates through a nationwide competition; 2. Exposition of the students to an excellent and mainly international teaching body; 3. Great diversity and flexibility of the educational programmes; 4. Strong stimulus to creativity and intellectual independence by the students as well as to the development of their leadership qualities.

In its current structure, the training component takes place over six months in high level Portuguese institutions of biomedical research, followed by a period of thirty months of research activity (full-time students) in Portugal or abroad.

Given the nature of the students for which it is aimed, the programme’s educational component differs from other PhD programmes in one essential aspect. It does not aim at training professional scientists but rather scientifically informed clinical practitioners. It specifically aims at making the clinical practitioner familiar with the concepts, language and technologies of contemporary biomedical science, granting them the capacity to critically assess the respective contributions to clinical medicine and providing them with new horizons of research.

Additionally, the programme aims at motivating permanent contact between student-doctors and non-medical PhD students, for this purpose allowing non-medical PhD students from the different institutions associated to the programme to attend all of the tutorial modules on the course.

The First Edition of PGFMA
Ninety-eight clinical practitioners, 27 specialists and 71 Interns competed to enter the first edition of the PGFMA, coming from a total of 30 health units in Portugal (Table 1a,b).

The 10 candidates admitted were selected by a commission made up of Professors João Lobo Antunes (FMUL/IMM), António Coutinho (Gulbenkian Institute of Science /FMUL), Ricardo Brentani (University of Sao Paulo/Champalimaud Foundation), Manuel Rodrigues Gomes (Gulbenkian Foundation), Isabel Palmeirim (University of Minho), Miguel Castelo Branco (University of Coimbra) and Leonor Parreira (FMUL/Programme Director) (Table 2).

In 2008-2009, the six months of the educational component of the programme (Figure 1) will take place at the IMM/FMUL, at the Gulbenkian Institute of Science, at the Oporto Faculty of Medicine and at the IPATIMUP (Institute of Pathology and Molecular Immunology of the University of Oporto), with the participation of a mainly international teaching staff coming from the best European and American centres of medical and biomedical research (Table 3).

The organization of 7 of the 15 educational modules in the first edition of the programme will be the responsibility of teachers/researchers from the FMUL/IMM, who will decide upon the programme contents and choose the respective Portuguese and international teachers. The tutorial classes in the IMM/FMUL modules benefit from the support of the Institute of Advanced Training and the Management Unit of the IMM, and will take place in the post-graduation rooms in the Egas Moniz Building, a space which has recently been increased by a new study area for FMUL PhD and Masters students, with the computer equipment having been financed by the Gulbenkian Foundation.

It should be stressed that all the seminars and conferences on the programme are open to all concerned.