Country Statistics
Chile is a long and narrow country on the southwestern coast of South America, extending from latitude 18 ° South down to Cape Horn. If superimposed on North America it would go from slightly south of Mexico City up to Alaska. It also claims a wedge of Antarctica including the Antarctic Peninsula, from 53° to 90° west of Greenwich, and its Pacific Ocean possessions include Easter Island.
The terrain is a desert plateau from the northern boundary with Peru down to latitude 26° S. From there to latitude 42° S the land divides into low coastal mountains, a green fertile central valley, and the rugged and snow-capped Andes mountains in the east. From 42° S to Cape Horn it encompasses western Patagonia and innumerable islands and fjords.
The climate is varied. Dry in the northern desert, with warm days and cool nights; temperate, mediterranean type in the central valleys; maritime on the coast, cool and damp in the south.
The country is divided into 13 administrative chapters.The capital city is Santiago and its main seaports are Valparaiso and San Antonio. Other large cities are Concepcion, La Serena - Coquimbo, Antofagasta and Temuco.
The population is slightly over 15 million. About one third live in the Metropolitan Chapter, in or near Santiago. The ethnic composition is 95% white or white-amerindian, with 3% pure amerindian and 2% other racial mixtures. The largest immigration has come from Spain, but with substantial contributions from Italy, Germany, Great Britain, France, Croatia, and lately from the Middle East and Korea.
The language is Spanish. About 75% of the population is Roman Catholic, 12% Protestant, 5% Jewish. Church and state are separate since 1925.
For further information, please visit www.sernatur.cl
Health Statistics
Fertility rate: 2.17 children born/woman
Birth rate: 17.53 births/1,000 population
Infant mortality rate 13.2 deaths/1,000 live births
General death rate: 5.68 deaths/1,000 population
Life expectancy at birth: males 71.5 years, females 77.95 years
Age structure of the population: 0-14 years 29%, 15-59 years 61%, 60+ years 10%.
Main causes of death: Cardiovascular diseases, cancer, pneumonia.
Number of physicians in the country: 110/100,000 inhabitants (source: United Nations Program for Development)
For more health statistics: see www.paho.org
Medical Education
There are 62 Universities in Chile, with 12 of them having medical schools. The most prestigious Schools of Medicine are those of the University of Chile (established in 1833), the Catholic University of Chile (established in 1930) and the University of Concepción (established in the 1920's ). Since 1980 several new medical schools have been created.
The seven medical schools with the longest tradition and largest experience are grouped in an association called ASOFAMECH (Association of Faculties of Medicine of Chile), where their Deans discuss topics related with medical education and address government officials with agreed upon stances.
Many practicing physicians regard the growing number of medical schools with concern because they think that quality standards may dwindle because of the limited supply of teachers, laboratories, and infrastructure. Others view it as an opportunity for professional improvement. Government officials think that the number of physicians in the country is still low and welcome the creation of new schools of Medicine.
About 800 new physicians graduate every year from all medical schools, but this number is expected to increase steeply in the coming years. The estimated total number of practicing physicians is currently about 18,000 (1 physician for every 830 inhabitants).
Chilean Universities with a Medical School:
Pontificia Universidad Católica de Chile
Universidad Andrés Bello
Universidad Austral de Chile
Universidad de Chile
Universidad de la Frontera
Universidad de Los Andes
Universidad de Santiago
Universidad de Valparaíso
Universidad del Desarrollo
Universidad Mayor
Universidad San Sebastián
Foreign Medical Graduates
Since 1980, the number of foreign medical graduates has shown a sharp rise. At present they add up to a 6% of all practicing physicians in Chile. The largest numbers come from Ecuador and Cuba. Most of them work as primary care physicians in inner city clinics and take jobs most national graduates would not be interested in. However, a few of them have had specialty or subspecialty training and are very successful in their practices.
The practice of Medicine is regulated by law. A valid title of "Médico-Cirujano" (Physician-Surgeon, the equivalent of the US.'s MD) issued by one of the Universities accredited by the Ministry of Education is the only requisite for practice. Foreign medical graduates must pass an examination at the University of Chile before being granted permission to practice. Graduates from Ecuador and Uruguay are exempted from this requisite by dint of a Treaty signed in 1904.
The Practice of Medicine
Upon graduation, a physician can apply for a job in general medicine with the Public Health System, apply for a residency in order to become a specialist, or go into private practice, either on a solo basis or as part of a larger group of physicians that may or may not be affiliated with institutions such as HMO's, Armed Forces, or Managed Care Organizations.
Posts with the Public Health System are assigned after an open call where merit is evaluated by a score given by medical school grades obtained, research done, presentations, extracurricular activities, etc. Thus most hospitals in remote areas of Chile get their doctors, who spend there a minimum of three years and can then apply for specialization within the Public Health System under an agreement with some of the major universities . About half of each year's graduates follow this pathway.
Specialization and Employment
The most sought-after pathway is direct specialization via a Residency. The University of Chile and the Catholic University run the largest and most prestigious programs. ASOFAMECH has an evaluation system for residency programs. However, some newly created universities are running their own programs without external evaluation, even before having a pregraduate medical school in operation. About 25 to 30% of each year's graduates enter this pathway. Upon successful completion of a university program of specialization, the universities grant the title of specialist.
There is no legal recognition or regulation of medical specialties. Many physicians are opposed to government regulation of specialties, which are considered a rapidly changing and dynamic area, unsuitable for bureaucratic rigidity. However, in view of the growing number of physicians who claimed to be specialists, in 1984 a private organism for accreditation of specialists was created by ASOFAMECH (the mainstream university medical schools), the main Medical Societies (professional organizations), the Academy of Medicine (the senior and most highly reputed professors), and the Medical College (the doctors' union), with the Ministry of Health participating only as an observer. This new organism called CONACEM (acronym for Autonomous National Corporation for the Certification of Medical Specialties) has defined what medical specialties need to be certified and has certified between one third and one half of all practicing physicians in Chile. Application for certification is voluntary, and certification is obtained by having either an ASOFAMECH-sponsored specialist title, a specialist title given by a foreign university after determining that the requisites for its obtainment are at least equivalent to those in force in Chile, or after an examination for those who can give proof of at least five years of practice in an adequate environment.
A list of credentialed specialists may be found at www.conacem.cl
Medical organizations think that there is no shortage of specialists in the country, except for some minor areas. About 60% of all specialists live in Santiago or the following largest cities in the country, a fact that mimics the population distribution. Therefore, there is a lack of qualified specialists in smaller cities and towns, as well as in scarcely populated areas. Also, many specialists have migrated from the Public Health System to private practice, in search of higher income and better working conditions.
Almost all practicing physicians work for a salary and also have a private practice. The largest single employer of physicians continues to be the Ministry of Health. Universities, Armed Forces and HMO's account for the remaining salary payers. Most physicians work for one or more of these institutions in the morning and then go to their private practices in the afternoon, where they remain until 8 or 9 PM. The average monthly salary for government-employed physicians is about US$ 1,000 for an eight-hour day. The average fee for a general internal medicine consult is about US $20.
Medical Professional Societies
Physicians began to get organized in the 1860's. In 1869 they founded the Santiago Medical Society that grouped doctors from all specialties. Eventually the surgeons, gynecologists and pediatricians migrated to form their own societies in the first quarter of the twentieth century. Therefore, the Santiago Medical Society became a society of internists devoted mainly to scientific endeavors. Since the mid-twentieth century, with the return of scores of internists who had subspecialized abroad, subspecialty societies began to emerge, under the aegis of the Santiago Medical Society. Today about twenty subspecialty societies are affiliated with the Santiago Medical Society. This Society publishes the Revista Médica de Chile since 1872.
To learn more about the Santiago Medical Society, please visit www.smschile.cl
In 1948 doctors from all specialties formed a union to defend the profession's prerogatives and to represent the profession before the government and international organizations. This union is the Colegio Médico de Chile. Affiliation was compulsory by law until 1981and all ethical as well as malpractice claims from patients and general public were resolved by it. Now about one third of Chilean physicians is not registered at the Colegio Médico and claims have to be filed in court. The Colegio's resolves bind only those who are affiliated with it.
To learn more about the Colegio Médico de Chile, visit www.colegiomedico.cl
Page updated: 06-17-05
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Contact Information
Maria Pinto, MD, FACP
Governor, Chile Chapter
Joan Murdoch
Chapter Coordinator
Sociedad Medica de Santiago
Bernarda Morin 488
Providencia
Santiago, Chile
Phone: 56-2-753-5501
Fax: 562-341-3068