This review article aims to present the problems of Peruvian legislation, and a general view of the health sciences internship, thereby considering the importance of formulating a law or issuing guidelines that correctly define the rights and obligations, guaranteeing a protection for inmates. Furthermore, this problem represents the deficiencies and lack of decent conditions in the area of health and education. Under this perspective, thousands of Peruvian students raised their voices in various marches and protests demanding that the Ministry of Health (MINSA) guarantee the minimum safety conditions for a boarding school without precariousness with quality benefits, decent treatment considering life insurance and health, fair schedules with 6-hour days or 150 hours per month, personal protective equipment (PPE), food on duty, adequate academic training, a monthly stipend equivalent to a minimum vital remuneration, also putting a stop to to mistreatment and abuse. In addition, the validation of pre-professional practices as work experience. The pandemic caused by COVID-19 showed us the need to rely on interns to close the human resources gap. For this purpose, the legislative decrees, regulations, laws and educational models were reviewed. The method used was the analysis and synthesis of information from different academic sources and/or scientific articles, such as the systematic review of different national and international bibliographic sources. The reviewed scientific articles are indexed in reliable databases, such as Web of Science. (ESCI), Scielo Latindex and Scopus. Therefore, it is concluded that Health sciences inmates need the issuance of a law that protects them from many injustices and inequalities, recognizing their importance and need in the context of the Pandemic.

WHO: World Health Organization

 MINSA: Ministry of Health

PPE: personal protective equipment

D.L: Legislative Decree

 D.S: Supreme Decree

 D.U: Emergency Decrees

At the end of 2019, in Wuhan, Hubei province (China), cases of viral pneumonia of unknown origin emerged.(1)World Health Organization (2) became aware for the first time on December 31, 2019 about a disease associated with the coronavirus. The International Committee on Taxonomy of Viruses (ICTV) named the virus as SARS-CoV-2 and the disease as COVID-19.(3)

The Director General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus(4) declared COVID-19 as a pandemic on March 11, 2020 after having spread to more than one hundred countries in the world at an accelerated rate. Since its emergence, the pandemic has had a great impact on the social, economic, educational and health system.(5)

In Peru on March 6, 2020, The national report No. 030-2020(6) informs us that the President of the Republic Martin Vizcarra confirms the first case of coronavirus in Peruvian territory, in a 25-year-old young man from Europe: who was in Spain, France and the Czech Republic (7). Meanwhile, on March 15, 2020, the Peruvian Government took measures and declared the country in a state of emergency, issuing Supreme Decree No. 044-2020-PCM that established mandatory social isolation measures in force from 00:00 on March 16 and the suspension of all face-to-face academic activities(8)(9). Due to the serious circumstances as a result of the COVID-19 outbreak.

However, this is where virtuality begins to take center stage, facing this new insertion coupled with the concern of teachers as well as students to join this new change in an accelerated manner(10). Educational institutions and universities had to assimilate to this digital world by implementing strategies so that students continue receiving classes(11).Such is the case of the University of Huánuco, which incorporated the use of Google Meet to provide classes remotely with the facility similar to a video call and Google Classroom to share educational materials, tasks and maintain teacher-student communication.

García (12), states that since the beginning of the pandemic, teachers were not trained for virtualization, yet they took on the challenge of learning in a short time the use of ICT tools to develop educational strategies, as well as having the possibility of recording and performing their live classes from their homes, The process of transforming face-to-face classes to virtual classes and the innovation that this entails, had a direct effect on the increase in teachers' working hours, not only in the preparation of educational material, but also in the time spent attending to students during each class. The use of ICT tools such as (Zoom, Microsoft Team, among others) serve as great support so that the teacher can implement new ideas and strategies.

According to the UNESCO report (13), The pandemic significantly impacted the education sector, which has affected 68% of the total student population worldwide, according to data acquired during the first week of June 2020. The COVID-19 outbreak has affected approximately 1,200 millions of students and young people around the world, since almost all educational institutions at all educational levels canceled their in-person activities by implementing their temporary closure.

The destructive impact was not only in the educational aspect. On the other hand, health professionals were also affected during the COVID-19 pandemic.(14) This is due to the restriction measures taken by the Government to prevent the spread of the coronavirus, which generated work suspensions, layoffs, and labor instability. (15) (16) Added to this, the fear of becoming infected during work hours, bringing the virus home and infecting their families, and even being admitted to intensive care units and dying (17)(18).

Because this occupational group is in constant contact with COVID-19 positive patients in moderate or severe conditions, the possibility that this represents a great risk of suffering from this disease is high, for example, to date in Peru. The death of more than half a thousand doctors and another hundred nurses, psychologists and health personnel has been reported.(19)

In the context of the pandemic, the most affected were the health sciences students, who were beginning the final stage of their professional career to complete their studies. As is known, the internship is a stage of training for the future professional, which seeks to strengthen their abilities by putting into practice their skills and abilities acquired throughout their academic training. During this period the intern accepts tasks and responsibilities within the various hospital services, with the supervision of a health professional coordinator who conducts the entire process during the stay. Furthermore, both the externship and the externship correspond to the curricular framework of the University to which the intern belongs. Which are necessary to graduate as Health professionals (20).

Unfortunately, the lack of a law or regulation for internships in health sciences, the delay in issuing guidelines from the MINSA (Ministry of Health) leads to unrest for thousands of inmates(21) since, if they attended Hospitals or Health Centers at that time they would find a collapsed health system, with insufficient protective equipment, with a higher mortality rate due to COVID-19(22) and even worse without a law to protect them

On August 3, 2020, after several months of waiting, the Peruvian government issued Emergency Decree No. 090-2020, which establishes exceptional and temporary measures that contribute to closing gaps in human resources in health to face the COVID-19 pandemic, where it mentions in article two, the resumption of activities of health sciences interns , in the public establishments of the MINSA, its public organizations, the regional governments, the health services of the National Police of Peru and the armed forces. All of this as of August 15, 2020. For this purpose, the entities would provide personal protective equipment (PPE), the right to a monthly stipend equivalent to a minimum vital remuneration; as well as having Es Salud insurance and life insurance. However, this decree does not specify whether the rights granted will continue after the state of emergency (23). In addition, there is a shortage of protective equipment and non-compliance with payments and bonuses; Likewise, they do not consider the health situation of the inmates, nor do they consider whether they present risk factors or comorbidities, which has led the student unions to speak out (24).

On June 17, 2021, they issued Emergency Decree No. 053-2021, in article four it provides for the continuity of activities of health sciences interns, in the careers authorized by the Ministry of Health, through the Ministerial Resolution, begin the internship in person in 2021, in the institutions of the MINSA, its public organizations and regional governments, and even receive a monthly stipend equivalent to S/ 770.00 (SEVEN HUNDRED AND SEVENTY 00/100 SOLES) ; granting SIS (comprehensive health insurance), and protective equipment (25). It was not what was expected, but it represented an improvement compared to the Supreme Decree of 2002 where the stipend was S/ 400.00 (FOUR HUNDRED AND 00/100 SOLES), only for human medicine and dentistry degrees.

In this sense, thousands of inmates from various health science careers such as Human Medicine, Nursing and Obstetrics, in their marches and sit-ins, requested the Ministers of Economy and Health to approve a budget for the guidelines required by inmates, as well Something similar occurred in the regions of Arequipa, Lambayeque, Huánuco, Cusco, Junín and Puno, where human medicine and nursing students from different universities requested to start internships in the Regional Hospitals (26). Unfortunately, the marches were not enough, in June 2022, a new group of students will begin boarding school, two months later than imagined, because the MINSA delayed the time.

However, on April 29, 2022, the General Directorate of Personnel of the Ministry of Health issued a circular letter No. 072-2022-DG-DEGEP/MINSA (27), where they specify a stipend of s/. 400 soles to human medicine and dentistry interns. leaving more than 70% of the inmates homeless. As of May 1, 2022, Supreme Decree No. 020-2002-EF will come into force again in short, we have not improved, on the contrary, we have gone backwards. We deserve no less since the minimum wage has increased and the economic crisis afflicts us more and more. Currently, it being 2023, we are still waiting for a law that protects inmates from many injustices and inequalities].

Based on what is stated in this article, we can conclude with the following:

Within the state of emergency caused by the COVID-19 pandemic; Without a doubt, the health sector was the most affected, health sciences students worldwide have suffered changes in their learning methods; but the most affected were the interns from various health sciences careers(28) since this stage is purely clinical, and due to the pandemic they had to leave it waiting, since the health system was collapsed, with many shortcomings and poor safety conditions (29). Despite this, interns in medicine and other professional careers who were negatively affected, not only nationally but also internationally, postponed external rotations, national exams, elective courses, and that was not all, The majority of inmates as a result of this problem ended up with health problems such as anxiety and depression (29)(30). It is worth mentioning and emphasizing that inmates form a key part of the health system's workforce].

  Table 1: Chronology of Peruvian Legislation

It is necessary to encourage more research on our problems to obtain first-source information and make more appropriate decisions. Likewise, we emphasize that it seems necessary to investigate this situation in more detail in order to be able to assert these statements with greater evidence, from a reflective perspective and based on what has been stated.

Conflict of Interest

There is no conflict of interest.