The fact that the previous Board did a remarkable work in the administrative modernization of the Faculty of Medicine of the University of Lisbon greatly facilitated the possibility to move forward in 2005 with the idea to initiate a strategic process that could lead to the modernization of medical education and, consequently, create the conditions for more and better scientific research. In any case, the goal was to attain “excellence”. The idea was to have a five-year overall plan, and some important changes were introduced during that period.
Several unanticipated factors external to the school came up during this period, namely the Regulamento Jurídico das Instituições do Ensino Superior (RJIES) – Legal Regulations of Higher Education Institutions, which imposed statutory changes and alterations in the structure and accountability of governing bodies and partly blurred the initial objectives.

The White Paper of the Harvard University Medical School reveals that the main weakness of its Medical School, which also happens at our school, is the lack of “communication” between basic sciences and clinical sciences, i.e. between the foundations of scientific training and their application. The Paper referred to the absence of “communication” between lecturers of the same and different levels. Despite having made some progress in this direction, the Coordinating Committee of the Scientific Council is far from fulfilling this task, due to the multiple jobs they need to perform. There are insufficient informal discussion forums in the school that can act as incubators of new ideas and implement the practical aspects.

Several areas to strengthen FMUL were identified, namely:

1) The need to introduce changes in the curricula to enable students, as they learn the scientific core foundations of their medical training, to establish an early connection with patients, based on the idea that medicine is learned by the bedside of patients (“Medicine is learned by the bedside and not in the classroom ... See and then research, compare and control. But see first.” – William Osler, the first chief of medicine at The Johns Hopkins Hospital and the founder of the institution’s residency program), which then encourages them to reflect and find explanations in the lessons from lecturers and in their scientific readings. The underlying principle is that medical students have maturity and are highly motivated to learn, for which reason they need guidance and encouragement, rather than ‘compulsoriness’ and competition. Thus, students must take responsibility for their own learning and have the freedom to decide how they will fulfill the requisites to become a doctor. Memorizing facts should be a lot less important than having an education based on learning research methods that enable them to have a scientific approach when analyzing medical issues at all times of their activity as doctors.

2) The need to create opportunities to encourage the approximation of biomedical science to clinical science: GAPIC has made an exemplary effort to this effect.

3) The need to reduce institutional barriers as much as possible, allowing more effective and less bureaucratic collaboration. Through the Academic Medical Centre of Lisbon (CAML), a joint project involving FMUL, IMM and Santa Maria Hospital, FMUL has actively contributed to give a context to the institutional conditions that could be modernised in the areas of medical education and health sciences. Under and postgraduate training and continuing medical education, both in biomedical sciences and in health sciences, have amplified the academic dimension of scientific research in the various fields transversal to medical training and the practice of clinical medicine. Everyone should look at the new challenges as opportunities to cement cohesion and a sense of responsibility.

4) The need to invest in structures that can give a dimension to development strategic projects and make them operational, which is ongoing with the construction of the Câmara Pestana Building so that, together with the Egas Moniz Building, which is now at “normal” operating speed, we can significantly improve the physical areas of the School. Moreover, there is also the need to set up new groups and areas for biomedical research, namely in the cardiovascular, nephrology, and gastroenterology fields, among others, associated with the need to identify and encourage the emergence of new scientific leaders.

During this period, FMUL expanded its level of external intervention in biomedical sciences through the Faculties of Pharmacy, Sciences, Psychology and Dental Medicine, improving the cross-sectional and the multidisciplinary nature of opportunities and projects in under and postgraduate training and in scientific research. The same was achieved with regard to the social sciences (Institute of Social Sciences of the University of Lisbon), in order to understand and respond to the factors that influence social and economic behaviour in health, illness and medical care.

Despite the economic crisis, reduced funding and the increase in student numbers, my brief “look” at FMUL, a school with a long and prestigious story and which has shown to have strong collective power, I see a community of lecturers, students and non-academic staff who are committed, intelligent, creative, and generous. This strengthens the school’s inspiration to fulfil its mission: train doctors, good doctors, the best doctors; foster basic and clinical scientific research; link basic research to clinical research and serve the community.

In short, this mission is to stimulate the intellectual curiosity of both students and lecturers to acquire new knowledge and endow them with the appropriate tools necessary to “refined” medical practice. Contributing to significantly expand the scientific foundations of medical knowledge will unquestionably continue to be the main reason for the existence of our school and our utmost responsibility.

J Alexandre Ribeiro