> Dr. Gary Conboy wrote:
> I have talked to several physicians (trained in North America)concerning the amount of time devoted to the discipline of parasitology
> Dr J-F Magnaval replied:
> In France, teaching time for Parasitology is about 24 h of theoretical
> courses, together with 16h of practical works, during the 3d year of
> medical studies.
> Dr. Gary Conboy replied:
>Thank you for the information. Do you think this amount of training is
>adequate for the practice of medicine in France?
Dear Dr Conboy,
In France, parasitological problems encountered by
non-specialized physicians practically belong to 2 types:
- tropical parasitic diseases occurring in European travelers or existing
in immigrants, mostly from Africa;
- autochthonous parasitic diseases among which the most important
is certainly toxoplasmosis, due to the risk of congenital infection;
others problems which often arise are allergic signs due to
helminthiases, e.g., toxocariasis, tape-worm or pin-worm disease and GI
disturbances (same etiologies).
Opportunistic infections in immunocompromized patients are mostly
seen in specialized units.
Given these facts, students' training as described above appears
to be rather conveneint. In our Faculty, parasitology
courses are oriented towards clinic, diagnosis and treatment.
Fundamemntal points, e.g., life-cycles, are given undetailed for a b
etter comprehension of disease's epidemiology and physiopathology.
Post-university teaching is also dispatched, during which main points
concerning parasitic diseases are recalled. IMHO they are:
- correct set-up of malaria prophylaxis for travelers;
- always think of malaria when dealing with a patient showing persistent
- be aware of giardiasis, strongyloidiasis, and tape-worm disease when GI
(pain, bloating, chronic diarrhea) are encountered;
- always investigate any hypereosinophilia (an algorithm is then given);
- always rule out strongyloidiasis prior to give a patient
- rule out helminthiases when a patient (even with a known atopic status)
complains of persistent allergy signs;
- this last point is a legal obligation in France: correct serological
followup of toxoplasmosis status in non immunized pregnant women.
Jean-Francois Magnaval, MD, DrSc
31059 - Toulouse, France
Phone (33) 05 61 77 20 12
Fax (33) 05 61 77 23 78