<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902024000401501</article-id>
<article-id pub-id-type="doi">10.29193/rmu.40.4.8</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cambiar o resignarse al inexorable deterioro formativo de especialistas]]></article-title>
<article-title xml:lang="en"><![CDATA[Change or resign oneself to the inexorable decline in the training of specialists]]></article-title>
<article-title xml:lang="pt"><![CDATA[Mudar ou resignar-se ao inexorável deterioro da formação de especialistas]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Trostchansky]]></surname>
<given-names><![CDATA[Julio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bruno]]></surname>
<given-names><![CDATA[Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Cátedra de Cirugía de Tórax ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Hospital Maciel ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>40</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902024000401501&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902024000401501&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902024000401501&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Se abordan los desafíos actuales en la formación de médicos especialistas en Uruguay desde la perspectiva de los autores, subrayando la necesidad de reformar el sistema de residencias médicas para adaptarlo a las demandas del contexto demográfico y sanitario del país. A pesar de los avances recientes, como la implementación de una prueba única para el ingreso a residencias, persisten importantes desafíos en cuanto a la centralización, la gestión profesionalizada, la acreditación de centros de formación y la equidad en las condiciones laborales y de financiamiento. El artículo propone un debate abierto y colaborativo entre todos los actores del sistema de salud, incluyendo autoridades, instituciones académicas, y profesionales de la medicina, con el fin de fortalecer el Sistema Nacional Integrado de Salud (SNIS) y garantizar una formación médica de alta calidad. Se aboga por la creación de un programa nacional de residencias único y descentralizado, con un enfoque en la equidad, la adaptabilidad, y el compromiso con la excelencia formativa, aspectos fundamentales para asegurar la sostenibilidad y la calidad del sistema de salud uruguayo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary Current challenges in the training of medical specialists in Uruguay are addressed from the authors&#8217; perspective, highlighting the need to reform the medical residency system to adapt it to the demands of the country&#8217;s demographic and health context. Despite recent advances, such as the implementation of a single-entry exam for residencies, significant challenges remain regarding centralization, professional management, the accreditation of training centers, and equity in labor conditions and funding. The article proposes an open and collaborative debate among all actors in the health system, including authorities, academic institutions, and medical professionals, in order to strengthen the National Integrated Health System (SNIS) and ensure high-quality medical training. It advocates for the creation of a unique and decentralized national residency program, focusing on equity, adaptability, and a commitment to training excellence, which are essential aspects to ensure the sustainability and quality of the Uruguayan health system.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Abordam-se os desafios atuais na formação de médicos especialistas no Uruguai sob a perspectiva dos autores, sublinhando a necessidade de reformar o sistema de residências médicas para adaptá-lo às demandas do contexto demográfico e sanitário do país. Apesar dos avanços recentes, como a implementação de um teste único para a entrada nas residências, persistem importantes desafios em relação à centralização, à gestão profissionalizada, à acreditação de centros de formação e à equidade nas condições de trabalho e financiamento. O artigo propõe um debate aberto e colaborativo entre todos os atores do sistema de saúde, incluindo autoridades, instituições acadêmicas e profissionais da medicina, com o objetivo de fortalecer o Sistema Nacional Integrado de Saúde (SNIS) e garantir uma formação médica de alta qualidade. Defende-se a criação de um programa nacional de residêncies único e descentralizado, com um foco na equidade, adaptabilidade e compromisso com a excelência formativa, aspectos fundamentais para assegurar a sustentabilidade e a qualidade do sistema de saúde uruguaio.]]></p></abstract>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bruno]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Palacios]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ruso Martínez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Residencias médicas: Una visión crítica a su proceso de acceso]]></article-title>
<source><![CDATA[Rev Med Urug]]></source>
<year>2021</year>
<volume>37</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e37414</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bruno]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Concretando los planteos de la 9a Convención Médica: Hacia el desarrollo y fortalecimiento de centros de referencia]]></article-title>
<source><![CDATA[Rev Med Urug]]></source>
<year>2016</year>
<volume>32</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>295-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anand]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Korndorffer Jr]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[We need to do better: A scoping review of wellness programs in surgery residency]]></article-title>
<source><![CDATA[J Surg Educ]]></source>
<year>2023</year>
<volume>80</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1618-40</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fortuna]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tobin]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Sobel]]></surname>
<given-names><![CDATA[HG]]></given-names>
</name>
<name>
<surname><![CDATA[Barrette]]></surname>
<given-names><![CDATA[EP]]></given-names>
</name>
<name>
<surname><![CDATA[Noroha]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Laufman]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perspectives of internal medicine residency clinics: A national survey of US medical directors]]></article-title>
<source><![CDATA[Educ Health]]></source>
<year>2022</year>
<volume>35</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>58-66</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[NP]]></given-names>
</name>
<name>
<surname><![CDATA[Boyd]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rapidly increasing number and cost of residency applications in surgery]]></article-title>
<source><![CDATA[Am Surg]]></source>
<year>2023</year>
<volume>89</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>5729-36</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brandão]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Bueno Motter]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Iaroseski]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Oliveira Trindade]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Mozzaquatro de Assis Brasil]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Severino Rodrigues]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Women in surgical residency programs in Brazil: A trend analysis]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2024</year>
<volume>293</volume>
<page-range>22-7</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silvariño]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Preve]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Minarrieta]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rebella]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Trostchansky]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recertificación médica en Uruguay: múltiples miradas de una obligación impostergable]]></article-title>
<source><![CDATA[Rev Med Urug]]></source>
<year>2021</year>
<volume>37</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e37412</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Trostchansky]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El desafío ético de la calidad académics]]></article-title>
<source><![CDATA[Rev Med Urug]]></source>
<year>2014</year>
<volume>30</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>85</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hall]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
<name>
<surname><![CDATA[Raker]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Hampton]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Variability in gynecologic case volume of obstetrician-gynecologist residents graduating from 2009 to 2017]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2020</year>
<volume>222</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>617.e1-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spencer]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Krumm]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Izadi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hirschl]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Modi]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
<name>
<surname><![CDATA[Ehrlich]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How many operative performance ratings does a pediatric surgery fellow need to be deemed practice ready?]]></article-title>
<source><![CDATA[J Pediatr Surg]]></source>
<year>2024</year>
<volume>59</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>31-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
