Since the beginning of the teaching process in modern medical schools, the evolution of medicine has created the need for medical education to evolve as well. We have passed through the ages of theaters where surgeries and lectures were performed, and teachers were the primary source of knowledge until today with technology, simulation learning, and evidence-based medicine when information came from. multiple sources, so it is important to filter to reach reliable conclusions.1-3
The evolution of medicine has also enabled us to confirm and refute hypotheses, to discover new drugs and technologies, to better understand the pathophysiology and therefore to adequately treat many diseases. Thus, knowledge has been increased in all medical fields, and this has compelled doctors to study more specific subjects to better understand its implications. In this way, the traditionally recognized fields of medicine have given rise to sub-fields of knowledge capable of generating more hypotheses and developing better quality evidence.4, 5
Thus, referral of patients to physicians specializing in subfields of medicine has become the gold standard of patient care. However, most of the time, the same patient needs an approach from different specialist doctors who, unfortunately, do not exchange their expertise to individualize his treatment and therefore do not provide the best patient care.6
In addition, globalization has strongly affected the medical and health systems. While in past centuries it could take almost a year for an infectious disease to spread across continents, as seen in the flu epidemic, we have recently seen the epidemic coronavirus disease 2019 (COVID-19) degenerate into a pandemic within 5 months. more than 212 countries.4 Suddenly, many medical specialists found themselves in a situation they had not been confronted with for a long time: having to treat patients outside their area of expertise. The opportunities for teaching and learning through the webinar modality – due to the imperative of social distancing – have brought to the present day the urgent need for teamwork and an interdisciplinary approach to patient care. patients, leveraging multiple areas of knowledge.7, 8
The question is: Did we do everything wrong when we became “super-specialists”? We think no! With the exponential increase in the amount of information available and the speed at which data can be viewed and analyzed, it is impossible to be aware of every new content in all medical fields.
The lesson the COVID-19 pandemic brought us was the urgent need for an interdisciplinary approach to better treat our patients, and not just each individual disease they present. Although this concept is not new, in the current era it has become difficult to find teamwork in medicine. The heart team (multidisciplinary approach for patients with cardiovascular disease) is an excellent example in this regard. Experts have proposed teamwork as the gold standard for establishing a better strategy for treating patients with complex cardiovascular disease, however, effectively establishing a heart team around the world remains a challenge.9, 10
Ahmed et al described the example of the process of rapid transition to digital platforms seen in rheumatology education over the past year, with the cancellation of face-to-face events and the limitation of hours of work. training, which required interns to continue their education online. Important resources, such as virtual libraries, social media for knowledge sharing, and mentoring programs dedicated to research activities have helped overcome existing barriers for medical education in this current scenario.11
From the perspective of medical students, a qualitative study also showed that the unplanned shift to digital learning due to the sudden shutdown of educational activities across the world was welcomed, with the agreement that sessions in online have saved time and helped optimize time management and learning of theoretical subjects, improved by the ease of recording lessons and reducing distractions on campus. On the other hand, some challenges have been reported regarding individual behavioral characteristics, limited non-verbal communication, various technological barriers and issues in ensuring the quality of the content delivered.12
Telemedicine in the COVID-19 era has taught us so much. We need to rethink our traditional approach to medical students, residents, colleagues and patients in which we have found ourselves stuck in barriers of distance and time. We need to use technology on our behalf to spread knowledge among colleagues and provide the best treatment and follow-up to patients. We are now living in the age of 4.0 medicine.13 As Darwin proved long ago: we have to evolve!
The authors have declared no conflict of interest.