Dear Editor:

We have read with interest the article entitled "Theory classes: a thing of the past in the teaching of basic sciences in Medical Schools?" ¹ by Enrique Ruiz-Mori, published in the last volume of your journal. The article emphasizes the importance of keeping a balance between three axes for undergraduate teaching of Human Medicine: theory, practice and seminar. On this matter, from our undergraduate experience, we support such approach; however, we would like to highlight the significance of clinical simulation centers as a support to the practice axis in medical education. We would also like to highlight the little importance given to the study of the pathophysiology specific to the elderly in some undergraduate educational programs.

Currently, some medical schools in Peru have implemented environments called "clinical simulation centers" as a teaching tool for the practice axis of clinical courses. In these simulation centers, typical clinical cases pertinent to the course are presented. Given the demographic increase in the elderly population according to the Instituto Nacional de Estadística e Informática del Perú (INEI - National Institute of Statistics and Informatics of Peru) ², it is not surprising that the elderly make up an increasing percentage of clinic patients ³. For this reason, Universidad Científica del Sur has deemed it necessary to implement the Geriatrics course as part of its undergraduate curriculum. Within the context of teaching, simulation practices focused on patients in this age group are conducted. For example, delirium, which has a rising incidence ⁴, requires a timely diagnosis to avoid poor prognosis. Therefore, proper teaching, based on the aforementioned three axes, would help prevent the underdiagnosis of such pathology ⁵. Clinical simulation centers, included in the practice axis, enable students to develop skills and abilities that will help them make appropriate, timely and safe clinical decisions in real situations.

In order to determine the percentage of Peruvian universities that include Geriatrics in their Human Medicine undergraduate curricula, a cross-sectional, observational and descriptive study was carried out. All accredited universities or those undergoing the accreditation process for Medicine undergraduate programs by the Superintendencia Nacional de Educación Superior Universitaria (SUNEDU - National Superintendency of University Education) were included. One of the researchers of this article reviewed each university’s official website in search of the most updated Human Medicine curricula. These curricula were then categorized based on the inclusion of the Geriatrics course. Such table of results was validated by the other researcher to ensure accuracy. Subsequently, the data were tabulated (Table 1) and analyzed by absolute frequencies and percentages.

Out of the 47 Peruvian universities offering Human Medicine, only 38 % (n = 18) include Geriatrics. This percentage is slightly lower in the capital, Lima, where out of the 19 universities offering this program, only 31 % (n = 6) include such course (Table 1).

In conclusion, 62 % (n = 29) of the universities do not offer the Geriatrics course. Graduates from these universities may lack adequate training in managing elderly pathologies, increasing the risk of not providing comprehensive care to patients in this age group. The implementation of this course in the curriculum should include the three axes, considering in the practice axis the activities conducted in the "clinical simulation center."