POST-GRADUATE TROPICAL MEDICINE PROGRAM

The Post Graduate Program in Tropical Medicine (PPGMT), the Tropical Diseases and Infectious Diseases area of the State University of Amazonas (UEA), works in partnership with the Dr. Heitor Vieira Dourado Tropical Medicine Foundation (FMT-HVD). This program has an interdisciplinary and multi-professional character, and is an academic space for the formation of Master´s and Doctorate students. This is one of only two postgraduate programs in Tropical Medicine / Infectious Diseases in the Northern Region of Brazil.

CAPES: Triennial Evaluation 2013 Grade 5
Evaluation Period: 2013 a 2017
Area of Evaluation: Medicine II

History

The creation of the PPGMT in 2002 has met a significant suppressed demand for the qualification of health professionals in the Brazilian Amazon, and has been strengthened since 2006 with the implementation of the first PhD course in the major area of Health Sciences in the state of Amazonas.

As emphasized in the 2013-2016 Quadrennial Assessment, the PPGMT has a very relevant regional impact for the development of higher education and research activities, and its Program activities have contributed to the nucleation of 3 other Programs in the State of Amazonas. In the current quadrennium, the group’ s goal is to consolidate its internationalization, funding from different agencies and capacity for academic production and qualifications, especially for doctors. To this end, it is working on all the opportunities for improvement raised in the previous evaluation, with emphasis on the adequacy of its permanent teaching staff, by means of for more rigid rules for registration and re-registration of permanent teachers in relation to productivity and training capacity of Human Resources. In addition, currently the course is conducted almost exclusively by permanent teachers, with few exceptions from visiting and collaborating teachers who assist in classes and co-orientation of students. The group's goal is clear - to improve its grades in the next four-year evaluation, being the first Grade 6 course in the Amazon Region.

By the end of 2017, the PPGMT had enrolled a total of 306 students, of which 228 (74.5%) are Master’s students and 78 (25.5%) are PhDs. Of this total, 202 graduated from their course - 162 (83%) from the Master´s and 40 (17%) PhD´s. Currently, 59 students are enrolled, of which 39 (66.1%) are Master´s students and 20 (33.9%) are PhD students. A total of 44 students have desisted since the beginning of the course, demonstrating a relatively low dropout rate. One student migrated from the Master's degree to the doctoral degree in 2016. Last year, 21 Master’s students were selected to enroll in February and March of 2018. Among these, three Master´s students were selected by the Program of Alliances for Education and Training (PAEC-OEA-GCUB), under the Cooperation Agreement between the Organization of American States (OAS) and the Coimbra Group of Brazilian Universities (GCUB ) and 10 doctoral ones, among them 1 by the PAEC. In the case of the Doctorate degree, the selection is carried out continuously, with new registrations beginning in February and ending in September of each year, as the number of vacancies is dependent on the availability of counselors.

What is observed is that our graduates are well absorbed in the labor market, considering that the supply is still great, especially in higher education and research, whether in public or private institutions. To illustrate this fact, all 40 PhD graduates have been effectively affiliated with important public education and research institutes, including in the FMT-HVD, UEA, the two institutions (in double contracts), the Vigilance Foundation in Health of Amazonas, Federal University of Amazonas, Alfredo da Matta Foundation of Dermatology, Hematology and Hemotherapy Foundation of Amazonas, Federal University of Roraima and Fiocruz (INI-RJ). Two of the 40 are teachers in private HEIs. The PPGMT itself has eleven permanent professors who are graduates of the PhD course, inserted in this category to strengthen existing research lines, as well as creating other important lines for the program.

The permanent and effective participation of several teachers who have been in charge of coordinating the program since its inception has allowed for the renewal of ideas and diversity in management, with substantial administrative and academic improvements in each evaluation period in a harmonious process of progressive accumulation of positive experiences.

It should also be noted that 4 graduates are currently coordinators of stricto sensu postgraduate courses in Amazonas. The formation of a solid culture in the management of stricto sensu graduate programs in the North of the country is also a secondary objective of this strategy, in the hope that more and more programs will be opened, multiplying the training capacities to effectively contribute to overcoming regional inequalities in relation to the number of Masters and Doctors compared to the rest of the country.

In the year of the program's creation, there was no permanent professor from UEA among the professors, and the entire doctorate group belonged either to the FMT-HVD or was temporary staff from UEA. Today the permanent staff is composed of 10 research professors from FMT-HVD, 9 faculty members from UEA and 4 researchers from other institutions. Recently, the FMT-HVD held a public selection process for 6 researchers, with the possibility of admission in 2018.

General objectives of the program

The field of study of the PPGMT contemplates the tropical and infectious diseases of greater occurrence and impact in the Amazon Region in its diverse biological, immunological, epidemiological, entomological, pathogenetic and therapeutic aspects. UEA’s partnership with a research institution (FMT-HVD) which is also part of the Unified Health System (SUS) allows for continuous feedback on research lines and priorities, based on disease burden. That is, the applied research that is developed in the PPGMT is a response to the main public health problems related to infectious diseases in the State of Amazonas, collaborating very directly to their control or solution.

Curricular structure

In 2018, a reformulation of the stricto sensu regulations was approved at UEA, which we considered to be beneficial for the approval of a new curriculum structure in PPGMT. This is now more flexible and allows for greater interaction between the existing courses in the university itself and with courses from other institutions. The curriculum of the courses in the program is composed of a set of classes taught in the form of theoretical classes, seminars, practical work or other didactic activities. Supervised Teaching Practice, which was not an independent class before, has become an obligatory activity for scholarship students and optional for the others, providing greater interaction with undergraduate students. In the new regulations of the course, the student who is the author or co-author of a work published in the journal Qualis B2 or higher (in the area of Medicine II), and has a permanent professor as co-author during the course, will be entitled to 2 (two) credits per article, via formal request to the program coordinators. All the elective credits obtained in other UEA programs, which will be computed by the PPGMT in specific curricular units, may be accepted. Likewise, all credits obtained from other Tropical Medicine / Tropical Diseases programs of other institutions in Brazil, which will be computed by the PPGMT in specific curricular units, may be accepted. This last change was an achievement obtained after the creation of the National Network of Postgraduate Programs in Tropical Diseases / Tropical Medicine, currently composed of 9 programs, at the initiative of the PPGMT coordination.

Currently, the curriculum structure of the PPGMT is summarized as follows:

Compulsory Credits: 6;
Optional Credits: 24;
Total Credits: 30. Workload in Research - Project Dissertation: 10.

DOCTORATE DEGREE:

Compulsory Credits, including Evaluation Seminars and / or publication of scientific articles: 10;
Optional Credits: 30;
Total Credits: 40. Workload in Research - Thesis Project: 20.

Innovative training experiences

The PPGMT has had excellent participation of the Doctoral students in the Coordination of projects in two categories:

1) Project coordination approved in a development agency - In the State of Amazonas, the Foundation for Research Support of the State of Amazonas allows Masters to compete in the bidding for research funding. Thus, upon completing the Master´s degree, the professional is able to gain the financial resources for his Doctoral project. Thus, in the PPGMT, both graduates and Masters graduated in other programs do not rely on the supervisor's finances to be inserted in a project and thus do the Doctorate course. Around 20% of Doctoral students have obtained financial resources to carry out their thesis projects.

2) Coordination and orientation of Scientific Initiation projects - PhD students are encouraged to submit subprojects linked to the objectives of their thesis proposals to the FMT-HVD and UEA Scientific Initiation Support Program. Thus, they are trained in the orientation of SI students, thus contributing to the training of undergraduates.

3) In 2018, a reformulation was approved in the PPGMT regulations, a student who has been regularly enrolled in the Master´s course for at least 12 months, may, at the time of the qualification examination, apply for migration to a doctoral degree if he or she has the advisor´s consent.

The FMT-HVD begins the training of graduate students through scientific initiation by offering opportunity admission to the Master´s and / or Doctorate courses. It also offers specialization for medical professionals in Infectology, Dermatology, Hepatology, Pediatrics and Tropical Medicine and multi-professional residency (Pharmacy, Physiotherapy, Psychology and Nursing). Upon completion of the Doctorate, those who have shown good scientific production and who already have funded projects can apply to become part of the program´s teaching staff. In addition, the institution has multiple partnerships with national and international institutions, which facilitates internships. It is possible, therefore, to train the scientist from his or her undergraduate basis up to his or her maximum qualification.

National and International Exchanges

NATIONAL NETWORK OF POSTGRADUATE PROGRAMS IN TROPICAL DISEASES / TROPICAL MEDICINE – Currently, we have 9 programs through the initiative of the PPGMT coordination. The implementation of the following activities will be stimulated within the network:

i) To facilitate the exchange of teaching staff and visitors between the programs, contributing to important actions for the development of the programs, with productive, good quality exchanges that respect that the sustainability of each program, however, they must always be based on all of the permanent faculty;

ii) To Promote / organize national and international scientific events, involving the faculty and students of the programs;

iii) To promote inter-institutional agreements in the area of education, with the mobilization of the student body of the programs, by the creation of disciplines shared between the programs, especially taught in English language. In the PPGMT, all the credits obtained from other Tropical Medicine / Tropical Diseases programs of other institutions in Brazil, which will be computed by the PPGMT in specific curricular units, may already be accepted. This last change was an achievement obtained after the creation of the National Network of Postgraduate Programs in Tropical Diseases / Tropical Medicine.

iv) To promote inter-institutional agreements in the area of research, with the mobilization of the student body of the programs, especially of doctoral students, by stimulating internships in institutions with partner courses;

v) To stimulate the launching of calls that guarantee the promotion of projects within the network;

vi) To promote the exchange of postdoctoral researchers between the courses of the network, especially with the support of development agencies;

vii) To encourage collaboration among network teachers through a policy of multi-center projects and joint scientific publications;

viii) To promote activities such as participation of the teaching staff of the network courses in lectures, examining rooms, courses and other didactic activities, with extension for the whole network;

ix) To encourage the joint raising of financial resources from national and international funding agencies;

x) Creation of space for annual evaluation of the activities of the network in the congresses of the Brazilian Society of Tropical Medicine.

JOINT AND SYSTEMATIC ACTIVITIES WITH OTHER PROGRAMS - Since its creation, the PPGMT has been strengthened by the partnership between UEA and FMT-HVD. Over the 15 years of partnership and activities carried out, the trend has been towards greater formal and informal interaction with other HEIs and Research Institutes in Amazonas and other Brazilian states.

In addition to the physical infrastructure, personnel and access to the research subjects of both institutions, the program partners and develops projects in collaboration with important local institutions, such as the Institute of Amazonian Research (INPA), Instituto Leônidas and Maria Deane (FIOCRUZ ) Hematology and Hemotherapy Foundation of Amazonas State (HEMOAM), Alfredo da Matta Foundation (FUAM), Health Surveillance Foundation (FVS), Nilton Lins University (UNL) and the Federal University of Amazonas (UFAM), where many counselors also work in the research area.

Outside of the Amazon region, the main partnerships are with the Federal University of Espírito Santo (UFES), René Rachou Research Center (FIOCRUZ-Minas Gerais), Oswaldo Cruz Institute (IOC-FIOCRUZ), Federal University of Minas Gerais (UFMG), University of Brasília (UNB), Federal University of Rio de Janeiro (UFRJ), Evandro Chagas National Institute of Infectology (INI-FIOCRUZ), São José do Rio Preto Medical School (FAMERP), University of Campinas (UNICAMP) Butantan Institute (IB), Federal University of São João del Rei (UFSJ) and Federal University of Goiás (UFG).

An important achievement in the area of National Exchanges was the approval of the project "Strengthening Postgraduate Programs in the Amazon and Extra-Amazon, with emphasis on ophidian poisoning: a strategy of personnel training and interdisciplinarity", in the CAPES PROCAD CALL No. 071/2013. In this proposal, the Postgraduate Programs in Tropical Medicine (PPGMT), Toxinology of the Butantan Institute (PPGTox) and Environmental Sciences of the Federal University of Tocantins (UFT) (PPGCiamb) will seek the joint and multidisciplinary training of Master´s and Doctorate students that act on the problems related to snake poisoning under the clinical, toxinological and environmental prisms, advancing in the knowledge of the problem of the Amazon, and with extensible responses to the other areas where the ophidism stands out as a health problem. In this area, the PPGTox (IBU) has extensive experience in studies of the composition and mechanism of action of poisons and anti-venoms and the development of important laboratory tests for the diagnosis and monitoring of ophidian accidents. In addition, Instituto Butantan is an international reference center for the production of anti-ophidian serums used in the treatment of these incidents. The PPGMT (FMT-HVD) recently implemented the line of research on incidents involving venomous animals. The FMT-HVD is the reference in the state of Amazonas for this type of health problem and, since 2013, with the construction of the PESCLIN III Unit, intends to increase its work in clinical trials projects, either by the greater contribution of resources, by the vocation of the endemic area of Manaus or the insertion of the FMT-HVD into the National Network of Clinical Research of the Ministry of Health, which constitutes a strength of the program. The PPGCiamb (UFT) presents a vocation for studies on biodiversity and is beginning its work in the field of Toxinology. Considering the complementary nature of the expertise of each team, it is expected that these interactions will bring important results in the post-graduate programs involved through inter-institutional cooperation that will allow a multidisciplinary training of students, with internships and courses in other programs. In addition to relevant and high-impact publications, we also expect results of interest to society, such as the design of new immunogens, production of new anti-venoms, immune-diagnostic tests for ophidism, and establishment of clinical parameters and protocols that will substantiate multi-center clinical studies for the treatment of ophidian accidents, improving the clinical capacity established to deal with the condition in the northern region, aiming at reducing clinical complications and deaths, with more favorable prognoses.

The exchange is intense and many students of these institutions develop their dissertations and theses in partnership with our professors in Manaus and vice versa. This ensures visibility of the program and its institutions, as well as allowing our students to work together with students from other graduate programs.

Within the goals of the PPGMT for the next four years, is the training of human resources beyond the scope of the capital of Amazonas. This possibility has been discussed between the collegiate and the possibility of realizing the selection of the candidates interested in the municipality where UEA has higher education centers is being discussed. Of the five existing centers, three (3) are professionals in the areas of health and biological sciences (Parintins, Tefé and Tabatinga). At the moment, we do not yet have a cadre of teachers who can move to carry out the activities in the interior and so it will be necessary for the selected graduates to gain their credits in Manaus. We are discussing the possibility of carrying out the projects in the municipality of origin, especially with the collaboration of permanent faculty from the UEA. In this sense, it is intended to train human resources with the collaboration of professors from the UEA itself, as well as to train professionals who do not yet have Master´s or Doctoral degrees to work within the State.

In the context of institutions in other countries, PPGMT has collaborated with Instituto de Salud Global (ISGlobal-Spain), CRESIB (Spain), Institute of Hygiene and Tropical Medicine (IHMT-Portugal), Walter & Eliza Hall Institute Medical College (India), Manhiça Foundation (Mozambique), Instituto de Inmunología del Valle (Colombia), Peruana Cayetano Heredia University (Peru), John Hopkins School of Medicine and Emory University (USA).

National and international professors and researchers are often invited to give lectures at the Scientific Sessions (held every Wednesday from 11 to 12 noon at FMT-HVD's Dr. Luiz Montenegro Auditorium) or at sporadic events held by UEA or FMT-HVD. There are also frequent invitations to participate in trial workshops for dissertations and theses of the program.

The search for professionals from other Latin American, African (São Tomé and Príncipe) or even European (Spain) countries for inclusion in the PPGMT, has added an important experience of internationalization in the relation between faculty and students, expanding even the horizons of the main lines of the program. An advance in this regard was the agreement signed by the UEA with the Program for Alliances for Education (PAEC), offering Master´s and Doctoral scholarships for selected students from the OAS member states (Organization of American States). Today, PPGMT has 3 Doctoral students and 5 Master´s students from this program.

The posters for dissemination of the selective processes today are sent on physical media to various HEIs and Research Institutes from around the world, as well as calls on websites of companies and scientific journals of high visibility. In 2014, the joint administration agreement was signed with the University of Barcelona (Spain), with which UEA already maintains close technical-scientific collaboration.

Research lines

Within the scope of internal academic activities, there was a change in the lines of research, with the inclusion of 2 new lines, which will allow a better distribution of research projects and academic production of the teaching staff:

1) Research Lines:

a) Unusual Diseases and Emerging and Re-emerging Infectious Diseases

Description: Outbreak and epidemic investigation of new cases of communicable and non-communicable diseases that pose threats to the health of people, establishing causal agents, risk factors and prevention and control measures.

b) Sexually Transmitted Diseases and Viral Hepatitis

Description: Develop studies on aspects related to the transmission of STDs and viral hepatitis, considering local specificities, epidemiology, clinical picture, immune-pathogenics and therapeutic sensitivity. Phenotypes, opportunistic and concomitant infections in HIV / AIDS patients.