The process of change that has taken more than 10 years in our university has given birth to the first cohort of doctors graduating from the New Training Plan, Malla Innovada 2015, in the year 2023. The curricular innovation was developed in the Faculty of Medical Sciences (FCM) of the National University of Asuncion (UNA) having as a circumstantial substrate: a) the recommendations of the ANEAES emanating from the Accreditation of the Medicine Career (year 2010); b) the mandate of the faculty to review the curriculum and introduce the Rotary Internship to the undergraduate pre-professional practice (October 2011) and; c) the renovating movement gestated in the first cohort of teachers graduated from the Master's Degree in Higher Medical Teaching that conceived the transformation of medical training adapting it to the minimum global standards and requirements ⁸.

The Curricular Innovation of the FCM Medical Career was framed in the global scenario of Higher Education ⁷ marked by the tendency to move towards dynamic, flexible curriculum, linked to the environment ¹, with a vision of continuum in professional training articulated with postgraduate studies, whose common language was and seems to continue to be the Competency Model ^3,5,6. In this model, the focus is on student learning, a graduate profile is established based on the health needs and demands of the context ⁴ and the competencies for excellent professional performance are defined ², emphasizing the values of the profession, ethics, humanism, patient safety, mental health and social commitment at the same level of importance as scientific and technical competencies ⁵.

Today, 6 years after the beginning of the implementation (2017), we can say with satisfaction that in the FCM of the UNA we have managed to implement competency-oriented curricular innovation from curricular integration, overcoming several obstacles from the beginning. At the beginning, the implementation took place in a turbulent post-crisis scenario of ¨UNA no te calles¨, in which students took center stage demanding transparency and quality in higher education. In addition, the abrupt change of authorities and the consequent budget cut by the state, and later the COVID 19 pandemic, were unavoidable elements of the context that conditioned and even hindered, to a certain extent, its development.

The innovation process had three major strengths that sustained its progress: a) in the political dimension: the support received from the authorities, even with the successive changes of directors, who have been able to maintain the political support that allowed overcoming the demands coming from two overlapping curricula, in addition to the difficulties arising from the budgetary restrictions to which the faculty has been subjected; b) in the teaching dimension: the leading team, formed by highly motivated professors, teaching assistants and students, evidenced in an intense and sustained commitment. The Curricular Commission, which has participated with constant interest, contributing and making its knowledge and experience available to others, as well as getting actively involved in the work requested. The formation of subject management teaching teams and Integration Modules ⁹, which have been adhering to an integrative vision, moving from the individuality that characterized the work of teachers in the institution, towards a culture that emphasizes multi- and interdisciplinary work and c) in the student dimension: the students were and are a strength that resisted stressful situations during the development of the implementation, especially in their resilience, their adherence and alignment to the innovation, actively participating in their training process, in the Curricular Commission, and in the construction of their personal, citizen and professional projects.

This is a moment of utmost importance, in which it is necessary to reflect on the achievements reached, the obstacles encountered, the weaknesses and mistakes detected in the implementation of the innovated 2015 curriculum and, above all, the assessment of the impact of such a joint effort. Openness to unlearn and relearn, reflection on praxis, humility, objectivity, clarity and understanding of the context in which this transformation took place would be, among others, fundamental ingredients to critically assess what has been achieved so far.

In this sense, today we ask ourselves: are we satisfied with the impact of the curricular change implemented in our house of studies? To what extent have we responded, in our daily teaching practice, to what was designed and planned in the new model? What did we miss? What should we discard and what aspects have not been covered with this innovation? What learning have we built throughout the process? Have we responded to the health needs of the population, the needs of the students and the expectations of the medical teachers of the FCM?

We are at a stage of accounting to the academic community and society about the innovative process of training physicians at FCM and to observe to what level the competency profile declared in the Academic Project has been internalized and how it has been understood by the key actors of the academic community. That is why the Permanent Curricular Commission, together with the Coordination of the career, the Academic Direction and the Direction of Quality Assurance are devoted to the evaluation of what has been implemented so far. For this purpose, an evaluation process is proposed that includes quantitative data and qualitative information, focusing on a comprehensive analysis that is valid to make the pertinent adjustments to the curriculum.

The evaluation will be multidimensional, including products, internal efficiency indexes, as well as the satisfaction from the perception of the Chair chiefs, subject managers, teachers and students about the aptitudes, satisfaction about the changes made, values built and future expectations.

The participation of the teaching teams in this evaluation will be of utmost importance and is recognized as fundamental to generate reliable information on the strengths, weaknesses and opportunities detected in the different areas, as well as the proposals for improvement emanating from the key actors of the teaching-learning process.

We are certain that no system or model is perfect, but rather perfectible, and above all, that no system is more important than its professors and even less important than its students, understanding that we are all focused on the maintenance and recovery of the health of the patient and their environment, institutionally we are at a key moment, and it is our responsibility to promote and establish a culture of evaluation that reflects continuously in order to have clear and valid evidence to propose the corresponding adjustments and continue the path towards excellence in the training of more humane, ethical and socially responsible physicians for Paraguay and the world.