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Once you face flesh-and-blood patients you realize that nothing is black and white and that no one gives you options to choose from

DR. MARIO SUTIL VEGA

Consultant cardiologist at the Parc Taulí Hospital in Sabadell, Catalonia (Spain)

Mario Sutil Vega is a consultant cardiologist at the Parc Taulí Hospital in Sabadell, Catalonia (Spain). He completed his residency at the Hospital de la Santa Creu i Sant Pau and obtained his title from Bellvitge. Cardiac imaging is his passion, and even though he only became a medical specialist three years ago, he speaks enthusiastically about it. He has more than 12 published studies and is a member of the Spanish Society of Cardiology and the European Society of Cardiology. According to Dr. Vega, "The diagnostic and therapeutic reality is more complex than a 'true or false;' it is necessary to integrate multiple data and be aware of the specificities of each of them."

Madrid, April 16, 2019. Have you found these 30 Practicum Script cases useful in your medical specialty?

Yes. The cases present clinical scenarios found in clinical practice and, as PS shows, there are different points of view on how to address them. It is enriching to see how other colleagues assess the cases and discuss the pros and cons of each diagnosis or treatment.

Debate and controversy are the basis of our approach. How do you deal with dilemmatic situations?

I tend to be independent in my clinical practice, but it is true that some cases require an experience in specific areas that I do not have.  In these situations, I have no problem in asking for a second opinion and learning from my colleagues.

Uncertainty is inherent to human nature. Is it difficult to get rid of the format of the “unique correct answer,” so much required in medical school and in the MIR?

No. Once you see flesh-and-blood patients in real life you see that nothing is black and white and that nobody gives you five options to choose from. What is important is to integrate dozens of data, inputs, signs, and symptoms and analyze which diagnosis fits into all that. For this, it is essential to have the theoretical knowledge firmly established, but also, to have handled many cases. The first years of residency are complicated, but eventually, we all overcome it.

The meaningful learning theory is based on the concept that the student already has the knowledge and emphasizes the importance of constructing conceptual networks. Do you consider Practicum Script useful in this task?

As I said in my previous answer, the diagnostic and therapeutic reality is more complicated than "true or false" or "choose between these 5 options." It requires the integration of multiple data and to be aware of the sensitivity and specificity of each one of them to approach our diagnosis; in this sense, the more reliable our conceptual network is, the better our diagnostic approach will be. I believe that Practicum Script is an interesting method for professionals who are just starting to have a more realistic view of the complexity of medicine. It is a step beyond the theoretical dogmas that we use to simplify things.

You are young and have an original perspective. Why do you think that a study plan that does not contemplate seeing patients until the final stage is still maintained? How does “controlled simulation” contribute to real patients?

It is possibly a matter of resources, since medical professionals have a heavy healthcare burden in their daily practice, and it would not be feasible to add another significant burden of learning in situ. More hours a week without the burden of healthcare would be necessary to learn with a certain quality and, at the moment, this seems complicated.  As I said before, controlled simulations allow students to access real clinical scenarios, with all their nuances and with the pros and cons of each decision; this would be difficult to understand only with theory.

You did your residency at Hospital Sant Pau, a pioneer in the field of teaching and research, and right now, you are associated with the [Hospital] Parc Taulí de Sabadell. Tell us about your lines of research.
I specialized in cardiac imaging. I have collaborated in several research studies during medical residency, such as tissue characterization of the atherosclerosis plaque by coronary CT and evaluation of graft rejection by myocardial strain using echocardiography in patients undergoing cardiac transplant. Currently, as an assistant, my field of research is based on echocardiography, specifically, myocardial strain, in collaboration with colleagues from the Heart Failure and Cardiomyopathy Unit.

Testimonies

For me, the program is very interesting, since it allows me to sharpen my interrogation and direct it more towards a specific pathology and to have more knowledge of laboratory and cabinet exams. I think it is very important that we keep our medical sagacity throughout our practice and that in the few minutes it takes to answer any of the cases that Practicum Script presents, you acquire more knowledge.

Dr. Miguel Olivares Alcocer

Pediatrician in Guanajuato (Mexico)

I would like to express my gratitude to the Practicum Institute of Health Sciences Research for the opportunity given to Latin American physicians  to access and take different courses of our specialty for the benefit of our dear patients, in my case in Mexico. It has encouraged me to improve myself and keep abreast of the advances in Pediatrics and put into practice the knowledge acquired in the hospital where I work. Thanks friends and congratulations to this valuable team of Practicum Script Education.

Dr. Heriberto Fuentes García

Pediatrician in Sonora (Mexico)

I am grateful for this study tool that, through Nestlé and with this method, allows us to review different issues with cases that confront us in decision-making and serve us in the daily consultation.

Dr. Josué Refugio de León Padilla

Pediatrician in Jalisco (Mexico)

It is an excellent educational support platform for the pediatrician, offers very specific clinical challenges with alternatives for diagnosis and differential diagnoses, with the support of experts, a bibliography and a forum to share opinions. It's easy to navigate and it's fun, a tool that's worth using and making the most of it.

Dr. Guillermo Yanowsky-Reyes

Surgery Pediatrician in Guadalajara (Mexico)
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