Program History & Objectives

The Strictu Sensu Graduate Program in Cardiology at the Faculty of Medicine of the University of São Paulo consists of a set of advanced, individualized, and structured activities, supervised by an advisor. These activities focus on teaching and research, always aiming for the integration of knowledge. The program should be understood as both a system of intellectual development and a means of generating knowledge in each area of expertise. It is based at the Heart Institute (InCor) of the Clinical Hospital of FMUSP.

To achieve these objectives, the Cardiology program accepts students who are licensed physicians, as well as individuals from other professional backgrounds, affiliated with or sent by university and non-university institutions connected to the Health System or to research and teaching centers with an interest in Cardiology. The inclusion of multidisciplinary professionals greatly benefits the development of basic research within the program’s research projects.

Candidates must be presented for the selection exam by a faculty member accredited as an advisor of the program.

Upon completion of the course—after passing the required subjects, the general qualifying exam, and the thesis defense—the student will be awarded the title of Doctor of Science by the Cardiology Program at FMUSP.

Within the program, the role of the advisor is of utmost importance and includes responsibilities such as:

  • Recommending the student for admission;
  • Designing the thesis project;
  • Continuously monitoring the development of the thesis project;
  • Preparing the student for the general qualifying exam;
  • Assisting with the final preparation of the doctoral thesis; and
  • Overseeing the publication of the thesis in the form of an article.

History

The Graduate Program in Cardiology at the University of São Paulo (USP) dates back to 1973 and was one of the first programs in the state of São Paulo to be recognized by the Ministry of Education. The history of the USP Graduate Program in Cardiology is closely tied to the pioneering efforts of Brazilian cardiology, which, during the 1970s, gained prominence at the Clinical Hospital of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), in parallel with advances in cardiovascular surgery and specialized care for cardiac patients. At that time, international collaborations began to emerge between HC and major global centers. Basic and clinical research in cardiology was taking root, and in this context, the Heart Institute (InCor) was established in 1977. Today, InCor is one of the eight institutes of HC-FMUSP and is among the largest cardiology centers in the world in terms of patient volume, infrastructure for care, education, and research. Its mission is to train physicians and researchers in cardiology to work throughout Brazil and beyond its borders.

Over the course of its existence, the USP Graduate Program in Cardiology has had the involvement of more than 153 advisors, graduated 15 Master’s students, and over 792 PhDs. Until 2013, the program focused specifically on meeting the national demand for cardiology training, adopting a broad strategy for PhD education. This produced graduates who went on to hold leadership positions in cardiology education across the country and significantly contributed to strengthening the specialty nationwide. During this period, the program considerably increased the number of advisors and students, aiming to expand its reach throughout Brazil, achieving up to 100 defended theses in a single year.

In 2013, recognizing that it had already fulfilled an important role in the broad training of PhDs and the dissemination of knowledge at the national level, the institution conducted a critical analysis of graduate education in cardiology in Brazil. As a result, it was decided to reform certain aspects of the program in order to incorporate the concept of translational cardiology in the training of PhDs. The new focus emphasizes critical thinking, high-level scientific output, and the generation of knowledge applicable to society, all centered on the principles of internationalization.

Cardiology has advanced immensely over the past fifteen years. This progress is largely due to the intersection of major fields of knowledge—such as biochemistry, molecular biology, bioinformatics, and prevention—alongside the undeniable growth of clinical research, particularly the generation of practical knowledge through large-scale, multicenter randomized trials that have had a significant impact on society. In response, the Coordinating Committee of the Cardiology Program (CCP) at USP, in 2013, following discussions with faculty and students within the General Graduate Committee of the Faculty of Medicine at USP, revised its regulations and implemented structural changes, applying new concepts to meet the current demands of an internationally recognized program of excellence.

Between 2011 and 2015, the Program served as the lead institution for the DINTER InCor Cardiology–Ceará initiative, which successfully trained 13 PhD graduates across a wide range of knowledge areas.

To achieve these goals, it was decided to maintain the Program’s infrastructure based on the Department of Cardiopneumology at FMUSP, as well as the program’s core structure and strong capacity for resource acquisition—key strengths highlighted in evaluations. At the same time, the number of faculty members was significantly reduced following a review and modernization of the internal regulations, in alignment with new CAPES guidelines. This included the restructuring of research lines and academic disciplines.

The Program subsequently established new objectives focused on the following areas: student research output, development of critical thinking among researchers, the advisor-advisee partnership, internationalization aimed at the generation and dissemination of high-quality knowledge to society, interdisciplinarity, and the pursuit of research with high citation potential. A strategic plan was implemented to align the program’s structure with the institution’s broader goals. Additionally, areas of concentration and research lines were redefined according to the program’s mission and academic model. We also revised the program’s processes and evaluation methods, maintaining a continuous focus on student development and intellectual training.

New rules were introduced into the program’s regulations, and the faculty began to undergo regular reclassification based on updated criteria regarding their qualifications, commitment, and dedication to the Program’s quality and to student training, as well as a thorough analysis of their intellectual output. At the same time, quality control measures were implemented to evaluate student research projects prior to enrollment. These included statistical review, assessment of scientific merit and the projected impact of the proposed knowledge, along with support structures for article review (derived from thesis work) to enhance the likelihood of publication in high–impact factor journals.

The internationalization of the Graduate Program in Cardiology was expanded and actively encouraged in all aspects, aligning with the broader strategy of the University of São Paulo, which in recent years has intensified efforts to promote internationalization at both undergraduate and graduate levels.

We therefore aimed to foster the production of high-quality dissertations, implemented measures to monitor the career paths and professional performance of alumni, and encouraged greater student engagement in order to promote more comprehensive research training.

The strengthening of the Program—with a highly qualified faculty focused on student development and knowledge production—led to a significant increase in student enrollment, the number of defended theses, and a marked rise in scientific output involving students. This included publications in high–impact factor indexed journals and a greater number of citations. As a result, the Program began to advance toward innovation, driven by the intellectual capacity of its members, ultimately generating significant social and cultural impact.

In the 2013–2016 CAPES four-year evaluation, the Program received the highest possible rating—score 7—recognizing it as a graduate program of international excellence.

The 2013–2016 CAPES four-year evaluation brought significant responsibility and commitment to our institution to maintain the Program’s level of excellence, focusing on the development of highly qualified human resources through the production of high-quality science for the benefit of society. Internationalization has become a central tool in the ongoing pursuit of academic excellence. Thus, in the new quadrennium that began in 2017, the Program maintained its main objectives, grounded in the formation of students with a high standard of scientific, technical, and professional competence, critical thinking skills, and active societal engagement—all within a program structured around internationalization and housed in a reference institution with strong institutional ties and a commitment to the training of high-level professionals.

To support this vision, the Program has increasingly promoted policies and actions aimed at internationalization, including the establishment of partnerships with foreign researchers and institutions, expansion of student and faculty mobility, the creation of infrastructure to support English language proficiency (including courses and various academic activities conducted in English), and the implementation of international collaborations to increase the number of dual-degree opportunities and foster high-quality science published in high-impact journals with direct societal benefits.

At its core, the Program consistently seeks opportunities for social engagement and aims to secure diverse and adequate funding sources to enable ongoing research. In 2019, an important collaboration was established with InCor’s Scientific Committee, which led to faster regulatory processes, improved success rates in acquiring graduate research funding, and an increasing number of shared, multi-user academic activities.

Also in 2019, the FMUSP Cardiology Program initiated a new DINTER (Interinstitutional Doctorate) partnership with the Federal University of Paraíba, funded by CAPES. A total of 16 students were enrolled, under the supervision of 11 advisors from our program, and their dissertations are currently in progress.

During this quadrennium, the majority of the Program’s courses began to be offered in English. The Program maintained and expanded its number of international partnerships and agreements, established new collaborations, emphasized interdisciplinarity, encouraged strong advisor-advisee collaboration for the production of high-quality research, and reinforced its focus on student development.

The Program recorded the following student enrollment and graduation flow:

  • In 2017, there were 126 students enrolled, 38 new students admitted, and 26 students graduated.
  • In 2018, there were 137 students enrolled, 29 new admissions, and 34 students graduated.
  • In 2019, there were 140 students enrolled, 49 new admissions—16 of whom were part of the Interinstitutional Doctorate Program (DINTER) between the Cardiology Program and the Federal University of Paraíba—and 37 students graduated.
  • In 2020, there were 157 students enrolled, 17 new admissions, and 17 students graduated.
  • In 2021, there were 140 students enrolled, 35 new admissions, and 25 students graduated.
  • In 2022, there were 150 students enrolled, 25 new admissions, and 29 students graduated.
  • In 2023, there were 146 students enrolled, 22 new admissions, and 34 students graduated.
  • In 2024, there were 133 students enrolled, 35 new admissions, and 38 students graduated.

An important point to highlight is the significant impact that the COVID-19 pandemic had on education, healthcare, and research in Brazil. Our program made several adaptations to help maintain both student and faculty productivity. Among these measures were:

  • Courses began to be offered fully online;
  • The program encouraged and supported applications for research funding focused on combating COVID-19;
  • Thesis defenses and qualification exams were conducted entirely online;
  • The program’s administrative office significantly increased its communication and interaction with students and faculty via the internet and social media;
  • The official website was expanded, with increased visibility for scientific programming and research output;
  • Student monitoring and research productivity tracking were adapted;
  • Following guidelines from the General Graduate Committee, some students were granted thesis extensions, provided that they were justified and closely monitored.

As a result, the Program successfully maintained its academic productivity and thesis defenses without setbacks, while also playing a leading role in the fight against COVID-19.

Professor Ludhmila Hajjar was one of the recipients of the USP Women in Science Award—2020 edition, recognized for her outstanding publications on COVID-19.

The faculty was also highly active in combating the pandemic, offering guidance to the public, participating in webinars and seminars, supporting underserved regions, and providing scientific information to the general population. Furthermore, the Program stood out for its scientific output specifically related to COVID-19 research.

1. General Objective:

The Graduate Program (PhD) in Cardiology at the University of São Paulo School of Medicine aims to foster the generation of knowledge in cardiology and is designed to provide the appropriate training of professors and researchers with a critical, scientific, and interdisciplinary approach to research, in order to meet the needs of development across all sectors.

2. Specific Objectives and Strategies:

Specific objectives of the Program include:
a) To train professionals qualified for teaching in cardiology, with up-to-date pedagogical and academic skills;
b) To produce innovative, high-impact scientific research, addressing basic, clinical, epidemiological, and technological aspects;
c) To develop advanced technologies for diagnosis and treatment in cardiology;
d) To strengthen international partnerships, promoting academic and scientific exchange;
e) To conduct applied research with direct impact on clinical practice and public policies in cardiovascular health;
f) To prepare clinical and research leaders for outstanding performance in academic and healthcare institutions.

In this context, the Graduate Program in Cardiology at USP provides opportunities for generating knowledge in the field, based on internationalization, translational approaches, and interdisciplinarity. The Program’s specific objectives are outlined below:

2.1 Specific Actions in Innovation and Technology:

  • Development of Innovative Medical Devices:
    Validation of diagnostic and therapeutic technologies in collaboration with biomedical engineering centers and companies. Clinical studies involving next-generation stents, ventricular assist devices, and advanced cardiac imaging technologies.
  • Artificial Intelligence and Big Data:
    Use of machine learning algorithms for cardiovascular risk prediction, image analysis, and remote patient monitoring. Application of Big Data to identify epidemiological patterns and predictive factors for cardiovascular outcomes.
  • Precision Medicine and Genomics:
    Identification of genetic variants associated with cardiovascular diseases, prognosis, and therapeutic response. Genetic sequencing to personalize treatment strategies.
  • Telemedicine and Remote Monitoring:
    Development of digital platforms for continuous monitoring of patients with heart failure, hypertension, and arrhythmias. Studies on the feasibility and impact of telemonitoring in high-risk populations.
  • Virtual and Augmented Reality:
    Immersive simulations for training and skill development, especially in complex interventional procedures. Evaluation of applicability in medical education and hospital practice.
  • Digital Platforms for Knowledge Management:
    Creation of interactive databases and collaborative platforms for optimized integration and exchange of clinical and scientific information among researchers and clinicians.
  • Partnerships with Industry and Technology Centers:
    Collaboration with companies and startups for innovative solutions with robust clinical validation. Promotion of academic entrepreneurship to translate scientific discoveries into practical products and services.

2.2 Training of Faculty and Researchers with Critical Scientific and Ethical Vision
The core training of the researcher is a central goal of the Program. Activities range from involvement in undergraduate education and mentoring of scientific initiation students to hypothesis generation, research development, data presentation and discussion, as well as the exchange of information and its application in society. It is essential to the Program that researchers acquire a critical view of knowledge and develop scientific reasoning within the ethical principles that govern research.

The Program employs modern pedagogical strategies, integrating theory and practice through active methodologies, interactive seminars, and practical activities in laboratories and clinical settings. Faculty members receive continuous training in new educational technologies, including digital platforms and simulations. Technological resources such as virtual environments, simulators, augmented reality, and data analysis software enrich the learning process. Assessment is continuous and formative, involving projects, presentations, clinical case discussions, and scientific articles, with constant feedback. Interdisciplinary integration and clinical practice enhance understanding and application of knowledge. Periodic evaluations ensure ongoing improvement and alignment with contemporary demands, training professionals for innovation and excellence in cardiovascular medicine.

2.3 Faculty Renewal
Strategy: The Program’s regulations require ongoing evaluation of faculty based on regular student supervision, high-quality scientific production, joint student-faculty-alumni publications, generation of applicable knowledge, acquisition of research funding, and internationalization efforts. If these criteria are not met, the faculty member’s accreditation is not renewed. At the same time, young researchers—mostly program alumni—are encouraged to begin their activities as faculty, maintaining a balanced and dynamic faculty body.

2.4 Program Internationalization
Strategy: Actions taken by the University of São Paulo and by the Program itself continuously promote the internationalization of education and research. Numerous exchange programs and agreements have been established between the Cardiology Program and leading universities in Europe, the United States, South America, Asia, and Africa. Ongoing information exchange between Program researchers and international counterparts, increased numbers of students participating in sandwich PhD programs, involvement of foreign researchers in collaborative studies and publications, faculty and student mobility actions, adoption of English in several courses, and the growing number of publications in high-impact international journals are all examples of the Program’s internationalization efforts.

2.5 Promotion of Innovation and Technology
Strategy: Provision of infrastructure and qualified human resources to support the development of innovation and technology in research. The increase in patent registrations, along with greater interaction between the Program’s research lines and fields such as bioinformatics, engineering, molecular biology, and computer science, reflect the Program’s ongoing commitment to innovation.

2.6 Creation of an Academic Environment
The Program encourages the maintenance of a high-quality academic environment within the Heart Institute (InCor), aligned with the Program’s research lines. Graduate students are expected to engage deeply with their chosen research themes throughout their academic training, actively participating in educational activities, critical analysis and presentation of results, and mentorship of scientific initiation students and laboratory interns, as well as in interdisciplinary and shared research activities.

2.7 Promotion of Quality in the Teaching-Learning Process of Program Courses
Strategy: The courses were reformulated to cover all of the Program’s research lines, along with encouragement for offering classes in English. In addition, in-person workload for students was reduced, while distance learning activities, discussions, and critical analysis components were expanded. Some courses are already being offered with the participation of foreign professors via videoconference. Several of our Program’s students are also engaged in USP’s Telemedicine Course, which includes various online activities and uses the Moodle distance learning platform. InCor has long maintained a dedicated Telemedicine department, providing extension courses via teleconference and integrating with the RUTE (Brazilian University Telemedicine Network) Cardiology Network. Telemedicine promotes national and international academic exchanges within our Program.

The Program has encouraged modernization of audiovisual teaching resources and was included in a major renovation at InCor, covering classrooms, the library, and auditorium. This included the installation of cutting-edge technology, such as an interactive internet-connected screen for live presentations and interinstitutional information exchange. At the end of each course, students complete an evaluation form assessing course structure, workload, syllabus content, and quality of instruction. The Graduate Program Committee (CCP) meets with the instructor to analyze the evaluations and implement corrective actions for improvement.

2.8 Publication of Scientific Output in High-Impact Journals
Strategy: From the initial project review—conducted before student enrollment—the Program applies several measures to ensure the publication potential of the research and its dissemination in the scientific community. Before submitting a project to the Research Ethics Committee (CEP), it is first sent to a professional statistician who reviews feasibility and methods, offering corrections and improvements. The project is then revised by the student and advisor, reviewed again by the statistician and the CCP, and finally evaluated by a CCP or ad hoc reviewer who, upon approval, authorizes submission to the CEP.

During the first year after enrollment, students present their projects in both semesters in the English-language courses Scientific Seminars I and Scientific Seminars II, which include regular review of the project and its status with a focus on publication. After the qualification exam, students begin writing their scientific manuscripts, and are encouraged to submit to A1-ranked journals. The Program provides ongoing support from the statistician and CCP for manuscript review. In addition, students receive financial support to submit their manuscripts for international editing services, such as the American Journal of Experts. These initiatives have led to a significant increase in the Program’s scientific output, including more publications in high-impact journals and increased citation rates.

2.9 Interaction with Other Universities to Encourage Faculty Development for Other Institutions
Strategy: InCor is recognized as one of the world’s largest cardiology centers, and in recent years, it has expanded its core role as a knowledge hub, training thousands of medical and non-medical professionals to serve society. Since its inception, the USP Postgraduate Program in Cardiology has stood out for producing faculty and researchers who now work across Brazil. Many alumni have gone on to establish graduate programs in other institutions. National collaborations are maintained through active alumni involvement in joint activities between programs.

An Interinstitutional Doctorate Program (DINTER) was conducted from 2011 to 2015 with the following institutions: Ceará State University, Federal University of Ceará, and the Dr. Carlos Alberto Studart Gomes Hospital of Messejana, resulting in the training of 13 PhDs.

In 2017, a new DINTER proposal was submitted in partnership with the Federal University of Paraíba (UFPB). After receiving all necessary approvals within USP in 2018, the program officially began on November 4, 2019. The Cardiovascular DINTER between USP and UFPB includes fifteen faculty members from Paraíba—three of whom are alumni of our Program. The initial plan was to enroll 15 students, but due to the high quality of applicants, 16 were accepted. The UFPB leader, Dr. Marcelo Dantas Tavares de Melo, is an alumnus who defended his thesis in 2018 and published in the European Heart Journal – Cardiovascular Imaging with the paper titled: Decreased glycolytic metabolism in non-compaction cardiomyopathy by 18F-fluoro-2-deoxyglucose positron emission tomography: new insights into pathophysiological mechanisms and clinical implications. The Program secured R$ 785,000 from UFPB and R$ 299,847 from CAPES (DINTER Program 1212/2019, Process 23038.007068/2019-14), valid from 12/20/2019 to 12/31/2023, to support a program focused on internationalization and faculty/student mobility with modern educational tools.

2.10 Introducing the Graduate Studies Concept to Undergraduate Students and Residents
Strategy: To sustain a successful graduate program, it is essential to maintain a steady influx of students, with new enrollments and graduations keeping pace with alumni output. In recent years, possibly due to the national economic crisis, there has been a decline in interest among physicians in pursuing graduate studies. Thus, graduate programs must collaborate—through their academic committees and with support from the University’s Graduate Dean’s Office—to develop initiatives that attract physicians.

The USP Cardiology Program began a cycle of discussions with the Medical Residency Committee, supported by the Graduate Dean’s Office, to integrate residents into graduate studies. This includes setting aside dedicated time within the residency for research-related activities. FMUSP undergraduate students are also encouraged to participate in scientific initiation projects and earn academic credit for doing so. These students are welcomed by the Program and directly involved in research projects under joint supervision by faculty and graduate students. This experience serves as an introduction to graduate-level research and encourages students to pursue a thesis in the future.

The Program offers MD-PhD tracks for undergraduate students and Resident-PhD options for physicians wishing to combine clinical practice with advanced scientific research. The MD-PhD path identifies talented individuals early in their medical education, allowing them to engage in research alongside their studies. The Resident-PhD path is designed for residents aiming to conduct impactful scientific research during their medical training. Both tracks emphasize academic leadership, critical thinking, evidence-based medicine, technological innovation, and excellence in translational and clinical research. This approach prepares physician-scientists to occupy strategic roles and lead relevant research, strengthening cardiovascular science nationally and internationally.

2.11 Training Researchers with Broad Knowledge and Expertise
Strategy: Students must be involved in every stage of their research project: literature review, project development, statistical design, funding acquisition, scheduling, and project execution. During the doctoral period, students are encouraged to participate in a variety of scientific activities, such as presenting at national and international conferences, mentoring undergraduate students in scientific initiation, improving English proficiency, and publishing not only from their original project but also from other research conducted during the program. They are also expected to teach and present seminars. The Program’s regulations promote these activities by awarding credits for specific tasks, as previously defined.

The qualification exam is conducted once the student has completed half of the required credits. It aims to evaluate both the student and the project, focusing particularly on research methods, the execution timeline, and guidance toward publication. The Program, followed by the FMUSP Graduate Committee, has made it mandatory for students to submit a manuscript to an internationally circulated high-impact journal prior to defending their thesis. Upon completion of the PhD, the student should be fully prepared to take on a faculty and/or research position in an academic or research institution and be capable of independently developing scientific research projects.

2.12 Increasing Program Interaction with Society
Strategy: Graduate studies should be seen as an active agent of social change, stimulating both thought and action, and fostering solidarity among faculty and students—which ultimately contributes to societal improvement. The USP Cardiology Graduate Program promotes active engagement between faculty, students, the university, and society, through knowledge exchange, faculty mobility, and direct involvement with real-world problems faced by the population, in a joint search for viable solutions.

2.13 Modifications in the Qualification Exam Process
Following guidance from the FMUSP Graduate Committee, students must present their project’s objective in a clear and concise manner. The methods section must be developed with as much detail as possible. Information regarding the research site and approval by the Ethics Committee (if applicable) must be included. For studies involving human subjects, the sample size criteria, inclusion and exclusion criteria must be clearly stated. A precise and thorough description of the methods—including materials and equipment used—is essential. Statistical procedures should be cited and referenced when relevant.

Preliminary results may be presented to support the explanation of the project. However, discussing those results is not mandatory; instead, students are encouraged to reflect on the progress of their research. Comments on the research subject and encountered challenges may be shared. A fundamental part of the qualification process is the student’s ability to adequately respond to questions posed by the examination committee.