It started back in 1995. It was completely innovative in this country, and an initial idea of Prof. Gomes-Pedro, further developed by other people, until it became the icon of the medical degree. It was the subject that lit the first sparkle in freshers and made them have the ambition of “becoming doctors”. I started my medical degree in 1999.

The subject “Introduction to Medicine” was a way of saying to first-year students: “Come to the Medical Degree! Come and learn everything you need to learn to be a Doctor and not just a mere medical scientist”

This subject involved a lot of face-to-face contact, and required a lot of work, but at the end of the day, it added a lot of value to the process of mental transformation high schools students had to undergo to be able to become future doctors.

The subject changed from year to year, but, generally speaking, it included 4 core areas and a few electives.

Relational and Communication Psychology showed us how important psychological analysis is to establish a good relationship between doctor and patient. This was a first approach to Relational Medicine, carried out with the collaboration of the Psychiatry University Clinic: Prof. Maria Luísa Figueira, Prof. António Barbosa, Prof. Marco Paulino and Carlos Gois (MsC). The classes were interactive, resorting to role-playing and behaviour analysis, and reflection were heavily encouraged. Students loved it!

Life Basic Support offered basic training on cardiorespiratory resuscitation, and it was only possible thanks to the generous collaboration of a team of Santa Maria Hospital’s Anaesthetics Team: Prof. J Figueiredo Lima, Doctors Idalina Rodrigues and Helena Gomes Santos, besides Interns and Nurses. There was a handbook to study and practical classes involving the use of dummies lying on the floor. Students loved it!

The strand Health Practice in the Community enabled students to share the life of Family Doctors at Health Centres in Lisbon and outskirts for a few hours, under the supervision of Prof. Luís Rebelo. This offered direct contact with medicine in the field. Students were thus confronted with the reality of peoples’ lives in their own surroundings, neighbourhoods, poverty, habits, addictions, strengths and weaknesses of families, children’s specific problems, women asking for a sick leave certificate out of sheer tiredness, pregnant adolescents, those who could not afford to buy medicines, those who do not have the time to cook specific diets, the elderly who have no-one else to talk to…

Standing by the doctor’s side in their white coats, students were able to see the multiplicity of clinical, human, and social problems unfolding before their eyes. Students loved it!

Human Development and Behaviour had the purpose of fostering students’ reflection on the role of circumstances in the evolution of human beings, raising their awareness to the need to understand and respect differences, admire resilience, and feel compassion for extreme cases. To this effect, students went, in groups, to social assistance institutions to see by themselves, as examples of professional behaviour, the hundreds of people who dedicate their lives looking after those whose health or life conditions keep away from a “normal” life: the blind, patients with brain paralysis, institutionalised children, the mentally impaired, inmates, the dumb, and the dumb and blind, refugees, the elderly, etc. We paid a lot of attention to the fact that they should have direct contact with users, to enable students to directly hear the messages they inevitably heard: “when you become a doctor, don’t forget…”. Of course students loved it!

The elective areas were varied and interesting, all related to the practice and requirements of the profession: History of Medicine was taught by Prof. João Frada, Introduction to Scientific Research was taught by com Prof. Carlota Saldanha, whereas Information and Communication Technologies was taught by Prof. Mário Lopes, etc.

Classes were interspeded with passages from films. Throughout the subject, which was taught over one year, students were instilled the pleasure of reflection. Memorisation was left for handbooks and for the “rote learning” of other subjects. Here, encouragement was given to feeling, understanding, and emotional involvement.

The very close contact with first year students that the subject provided, and its actual characteristics, which focused on empathy, experienced sharing, and teamwork, offered a sort of Introduction … to the Faculty of Medicine. The work groups, formed at random, became the embryos of many a friendship (even some romance). The moment when work was submitted extended well beyond the mere “ it is handed in, you may go”. A simple request for a timetable change could lead to confiding a secret. Uncommitted students who affected the work of the group they formed part of, were told off. Spelling mistakes were highlighted, and the authors were confronted with the requirement to acquire the excellent writing skills the profession imposes. And amid this convivial environment with students, a feeling of belonging and of tenderness grew among us lecturers and students.

I believe, and I have reasons for doing so, that Introduction to Medicine and the personal involvement with the subject has had a strong impact on generations of young doctors, who then embarked on their degree and profession fully convinced of the power of kindness and good atmosphere, aware of the absurdity of arrogance, and with their minds open to tolerance and resilience.

Any young student who complains that the degree “is very difficult” will change when he realises that what is really difficult is for a blind person to succeed to have lunch without spilling the food, or for a patient with brain paralysis to turn a page on a book. A young person who dreams of becoming a doctor and, to some extent, is influenced by the “sexy side” of the profession, as television series portray, will change when he understands the professional abnegation of family doctors, navigating, from their desks, against the tide of risk behaviours, the often antagonist attitude of patients or their families, or bureaucracy.

The subject Introduction to Medicine came to an end in 2007, as a result of the syllabus reform. Nevertheless, its “historical” areas continue to be part of the Degree, namely in Module III.I “The Doctor, the Person, and the Patient “.

“IntroMed” was the best achievement of my entire professional life. Ever since I started to work when I was 18, no other work has given me so many positive returns: compliments, caricatures, opportunities to be useful, contact with persons of outstanding merit, extravagant awards (I am a “Big Grande FMelic”!), lively crowds, standing ovations in the amphitheatre (and at the Coliseum…), and, above all, the first embrace of a new graduate, the kisses given by young doctors missing the times spent at college who recognizes me at the supermarket or at the ER of São José Hospital. These moments are part of me, will be part of me forever, and one of the best parts of me.

October 2010
Maria Manuela Nunes
ajuda@fm.ul.pt