Dear Editor,

We consider Clara Nogueira's Editorial very timely and correct, when she states that the Portuguese Society of Angiology and Vascular Surgery (SPACV), among other priorities, will maintain the focus of attention on continuing education as a fundamental pillar, and the need to accept new challenges, get out of the comfort zone, explore new ways to stay alive and intellectually active.¹

Criteria that we share, from the presidency of the Provincial Chapter of Ciego de Ávila, of the Cuban Society of Angiology and Vascular Surgery (SCACV), when considering professional improvement as synonymous with continuing education, which purpose is to guarantee the updating of knowledge, and the development of skills in novel techniques, in particular, for the treatment of chronic arterial insufficiency, as it is one of the most prevalent peripheral vascular conditions in our hospital institution.

In this sense, progress has been made since 1972, when the Society of Angiology was created in Cuba, with the fundamental mission of updating specialists in this medical field. From that moment, the academic-investigative and attentional aspects are integrated in the professional improvement of the angiologist; using methods and forms of improvement according to international standards, but with self-identification according to the context of medical action.

Our reflections arise from the changes produced in Cuba with the training of residents in the specialty in 1963 and the creation of the SCACV, defining three stages, which, in the opinion of the authors, have gone through the process of professional improvement of Angiology specialists and Vascular Surgery in Cuba.

Stage 1 - (1963-1973). Emergence of the training of residents and creation of the SCACV as a scenario for updating specialists in Angiology and Vascular Surgery: In this stage, improvement was linked to the scientific activities developed by the Society of Angiology, which scheduled different meetings that made possible the exchange of experiences between specialists. The use of the investigative method for participation in these conferences is evident. It also stands out as a way of overcoming the delivery of specialty consultations together with other specialists, interns and residents in polyclinics from different health areas, particularly in primary health care.

Stage 2 - (1974-1999). Systematization of the SCACV as a scenario for updating specialists in Angiology and Vascular Surgery and the emergence of periodic publications to support this work: At this stage, the emergence of the scientific journal of the specialty "Topics of Angiology and Vascular Surgery", where specialists could publish, but also get feedback on the knowledge that was shared here. The "Cuban Forum of Angiology and Vascular Surgery" also constituted an excellent space for the exchange of experiences.

Stage 3 - (2000-2022). Development of professional improvement activities for national and international specialists: At this stage, special attention is paid to professional improvement activities (courses, training, diploma courses, for Cuban and international specialists). Although it is necessary to perfect the methods and forms used from the academic-investigative-attentional relationship, as well as the investigative methods as the basis of training. A new format emerges for the Cuban Journal of Angiology and Vascular Surgery, official and scientific organ of the National Institute of Angiology and Vascular Surgery and the SCACV, with national and international reach, and open access.

The analysis of these stages reveals that the process of professional improvement of Angiology and Vascular Surgery specialists has gone from the scientific exchange that occurs in different scientific conferences, as a fundamental form of improvement and the systematization of publications that also make it possible to update specialists, to the organization of the process of professional improvement in courses, training, diplomas, for specialists in the country and internationally.

That is why we work to develop professional improvement, continuing education, or continuing professional development, as it is often called in the United States, as a strategy to ensure that health professionals participate in lifelong learning and maintain competence in clinical practice and thus ensure that high-quality care is provided to patients.²

While it is argued that in some countries continuing professional development is a neglected part of the health education continuum,² to achieve this, we are working on a model of the dynamics of the professional improvement process of the specialist in angiology and vascular surgery for the treatment of chronic arterial insufficiency, focused on this specialist as a student of professional improvement.

Keywords: Continuing Medical Education, Continuing Medical Education/trends, Continuing Medical Education/history