She is a neurologist at Santa Maria Hospital and two of her areas of interest are the study of headaches and cognitive functions. She teaches Neurology at the Faculty of Medicine of the University of Lisbon and directs the Language Laboratory, which studies language as well as other mental functions, focusing, in particular, on brain lesions.

In the Department of Medical Education (DEM), she is also responsible for teacher training. She tells us she has a long way to go ahead of her. Her ambition is to foster greater openness and the internationalization of the Faculty.

For three years she was president of the Pedagogical Council of the Faculty of Medicine. On 11 December she passed on this role to Professor Joaquim Ferreira.

With tolerant bright blue eyes, she has a generous rigorous stance. In a brief conversation, between agendas that do not always reconcile themselves, Isabel Pavão Martins assessed the core aspects of her mandate. She has a natural wisdom that is only achieved with time and experience.

What is the role of the Pedagogical Council?

It is the only academic council that has absolute parity between students and lecturers, there were 6 – 6 of us with voting rights, with situations in which, if lecturers do not vote, the students win. There has to be dialogue and consensus.

In these three years and looking back, what stands out, what prompts you to say “mission accomplished”?

It was mainly to change a little and make more visible the faculty’s ideas with regard to teaching. Often doctors, and I think this was happening in most faculties, thought that it was enough to be a doctor and have a specialty, or be a researcher and that was that, they could teach. And I believe that increasingly, teaching is also a form of training. Education is changing around the world, suffice to look at the Teaching Commission of the European Union. Everything changed with the new information and communication techniques. Students no longer study in books and this is changing the way in which medicine is taught. The great change in teaching has been led by Harvard University, but also by Canada, and I wanted to convey this to our lecturers. We strongly insisted on the Pedagogical News (they released weekly pedagogical news that could be read on mobile phones, about announcements, events and prizes, among other ideas) and the Pedagogy Textbook, with the introduction of the Pedagogy Day, which this year had 250 participants, mostly people from the faculty. And then came the Medical Education Department. When we started it, it did not exist, that is, it was not operational, and it improved pedagogical practices. Involving students in the practice of Medical Education is a requirement for excellence in the practice of medical schools.

Did you feel resistance on the part of the lecturers regarding our approaches to teaching?

There is a little bit of resistance. Nobody likes to change, to leave their comfort zone. Sometimes you see this through a derogatory way, “what is this about medical teaching and what does it matter?” And yet, as everything is changing, we must also change so that we do not become obsolete. Within the University of Lisbon, the best example is provided by Instituto Superior Técnico (IST), which is always conducting training sessions for lecturers. They have semi-annual questionnaires and assessment to see how the teaching is being provided, listening to the students’ opinions and integrating them into the evaluation of lecturers.

The Faculty had never had this type of questionnaires?

It had, but they were conducted by the Students’ Association. And now they are here and lecturers will have to accept them as an integral part of their routine. This is a breakdown of the mentality. It is no longer just the lecturer who decides, we will listen to the students and they may have a say. There must be, however, established limits, suddenly the students will not teach us what should be taught. We want to train quality doctors and those doctors who have already received training have, obviously, much more experience, much more knowledge. But students are important too. Nowadays they can access everything on the Internet, attend classes at an American University, and they are no longer the same students as 20 years ago. One of the criticisms that still arises is that we have few answers on the part of our students. We started with 15% and we have now reached 40% of adhesion. But to be representative, one has to take responsibility and this involves both sides: the student who should be serious in his assessment and the lecturer who looks at that assessment and incorporates the suggestions of the students in his practice. An example of this was the two lecturers who were elected as the best this year: Professor Carmo Fonseca and Professor Luis Costa – oncobiology – regularly listen to the opinions of their students and incorporate new ideas and new forms of teaching. They are demanding, but they please students because they involve them.

Beyond Med, (the former Pedagogy and Medical Education Day, is an annual event that promotes teacher and student reflection on the current reality of teaching in medical schools in Portugal, and it is the day when lecturers are elected) is one of the great events for them, due to their involvement and the proposals that they make in the subjects under debate.

I noticed that when they received the Professor João Gomes Pedro Prize (a prize that wants to reward excellence in education), one of the characteristics that the students most emphasized was precisely rigor.

Students do not like to have it easy. Bear in mind that the medical students who come here are the top students in secondary education. As the current director of the Higher Technical Institute says interestingly: in the schools they come from, students are used to having marks of 18 and suddenly they need to compete with the best, they will be the best with the best, and they will go down from having 18 marks to having 14 marks. This destabilizes them. Adaptation in the first year is very difficult, but it forces them to be rigorous and to study in a different way. And the faculty has to organize things for them so that they can be good. Because exceptional students are exceptional everywhere, but we have to train almost 400 physicians a year and not just a fringe of geniuses. Our concern should be this higher average of students.

We look at the relationship between lecturer and student in this Faculty and we feel that there is mutual respect and that lecturers look upon students as faithful followers of their teachings. You see that, too?

Yes, perhaps, Medicine is taught in a somewhat tutorial way. Of course, with almost 400 students per year, one cannot get such a direct relationship with all the students. But the relationship has very much this idea of the apprentice as the person who is directly in touch with the tutor, and perhaps this attributes special characteristics to Medicine. First he is our student, then our helper, then our partner. It does not happen with all students, of course.

Now that your mandate comes to an end, will you miss it?

I shall miss it because it was a time of learning at the faculty, and even of personal learning, but it is important to change and know new departments. I will carry on, but this time in Neuroscience and Neurology, which is my area. I will now go to the Medical Education Department, where, by the way, I am already part of. This department focuses on teaching techniques, teacher training, on creating the best teaching conditions. Professor Madalena Patrício is the Director of the Medical Education Department. We shall continue the training sessions. Professor Richard Fuller (Director of Educational Programmes in England at the Leeds Institute of Medical Education) has recently been here to give a workshop on multiple choice tests. I attended that training session and it was very interesting. He also participated in Beyond Med, advancing new assessment techniques and showing how students can use their own cell phones to obtain information. We have students who, today, know that they will need lifelong training. That idea that one takes the degree and, upon completion, closes the books and goes straight to doing clinical practice, is over. Three years later there are new things, the medication has changed, the diagnosis criteria are different. Therefore, the Faculty should train students to continue their education throughout their lives, hence the techniques to increasingly use their own smartphones. Nowadays there is so much information that sometimes the excess of it can be useless because we deal with a different kind of patient who also saw everything on the Internet. That is, we, doctors, have an authority that is based on solid scientific knowledge and not on all those things that anyone can read.

When we make a goals’ plan we know that, along the way, we give up some of them. Was it the case?

I think the training of some lecturers was not complete, we could have done more, but as the Medical Education Department came along, we thought it was an area that was not ours, so we delegated the role.

Joana Sousa

Editorial Team