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It has been a challenge to identify optimal strategies to integrate EBM in the formal medical curriculum in Brazil. The theoretical and practice background in critical appraisal and evidence interpretation can be time consuming and may impose barriers to this integration.
There is a concern about the appropriate time to introduce EBM concepts among medical students. It might be early for this to happen from the beginning of the medical course. In Brazil, where the medical course lasts 6 years and adopts a traditional learning approach, during the first years, students are mainly exposed to basic sciences. There is too little contact to patients or clinical practice, and therefore teaching EBM outside this scenario, without a realistic basis for developing a scientific clinical rationale, may seem disconnected.
By contrast, to offer EBM only when students are already in clinical rounds may be too late. By that time, students are overloaded with information and have a short time to devote themselves to theoretical concepts, including study designs, risk of bias and statistics. In fact, most of them are entirely focused on assimilating content that will ensure a position as a medical resident, which usually has a fierce competition here.
In the early 2000s, the undergraduate medical course from Universidade Federal de São Paulo incorporated an EBM discipline into its regular curriculum. After adjustments throughout last years, in 2012 the discipline assumed its current format. From then, we realised that both interests existed: (1) students would like to have had earlier contact with EBM throughout the medical course and (2) after completing the course, egresses would like to continue deepening on new themes in EBM. So, in 2013 the first EBM academic league in Brazil was created as an alternative to provide a continuum education and at an earlier stage (table 1).
Over 7 years, teaching, research and extension activities have been developed by members and tutors of the league (table 2).
We recognise that it would be ideal to have an educational process that regularly integrates EBM content and critical thinking alongside clinical disciplines, but until this is achieved, EBM academic leagues may accomplish important gaps.
By sharing our experience, we hope to demonstrate that it is possible to disseminate EBM in medical schools, even outside the formal curriculum. We hope to encourage the creation of other academic leagues like this one so that, in the near future, we can promote activities integrating all of us.
Patient consent for publication
Contributors Conception and design: GFAR, COCL, RLP and RR. Data collection: GFAR and RLP. Manuscript draft: GFAR, COCL, RLP. Content revisor: RR. Final approval: all authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests All authors are current members of the EBM Academic League, Unifesp.
Provenance and peer review Not commissioned; internally peer reviewed.