RESUMO Em contexto nacional e internacional, discute-se a formação médica devido às mudanças na sociedade contemporânea e suas demandas de saúde. No Brasil, preconiza-se a inserção do aluno na Atenção Primária à Saúde (APS) durante todo o curso médico. Tal inserção é dificultada pelos cenários práticos inadequados

Objectives. To investigate associations between COVID-19-related factors and depressive symptoms among primary care workers (PCWs) in São Paulo, Brazil, and to compare the prevalence of probable depression among PCWs before and during the pandemic. Methods. In a random sample of primary care clinics, we examined 6 pandemic-related factors among 828 PCWs. We used multivariate Poisson regression with robust variance to estimate prevalence ratios for probable depression. We assessed the prevalence of probable depression in PCWs before and during the pandemic in 2 comparable studies. Results. Adjusted prevalence ratios were substantial for insufficient personal protective equipment; experiences of discrimination, violence, or harassment; and lack of family support. Comparisons between PCWs before and during the pandemic showed that the prevalence of probable depression among physicians, nurses, and nursing assistants was higher during the pandemic and that the prevalence among community health workers was higher before the pandemic. Conclusions. Our findings indicate domains that may be crucial to mitigating depression among PCWs but that, with the exception of personal protective equipment, have not previously been examined in this population. It is crucial that governments and communities address discriminatory behaviors against PCWs, promote their well-being at work, and foster family support. (Am J Public Health. 2022;112(5):786–794. https://doi.org/10.2105/AJPH.2022.306723 )

Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a “place of conversation”, but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors’ attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents’ financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.

Medical training is current topic of discussion both on the national and international stage due to changes in contemporary society and the consequent health demands. In Brazil, insertion into the workplace of the Primary Health Care (PHC) student is recommended throughout the medical course. However, such insertion is hampered by inadequate practical scenarios, the lack of preceptors, insufficient training of general practitioners to receive students, teachers without adequate training in teaching in the area and resistance by teachers of traditional disciplines. This article describes and analyzes a model for insertion into PHC and Family and Community Medicine (FCM) of students from a medical course in São Paulo, the challenges of teaching-management integration and the actions that help to address these issues. The proposal is based on educational objectives aimed at developing competences (knowledge, skills and attitudes) so that the student can offer comprehensive care, understanding the individual in the context of family, social and environmental life. The program contents were developed to provide learning in an increasing degree of complexity, connecting previous knowledge to new knowledge. From this starting point, the development of the educational project has as innovative brand involving a combination of planning and educational management that adopts the following measures to improve the quality of the teaching-learning process: (1) insertion of students into Basic Health Units (BHU) from the first year to internship; (2) hiring family doctors as faculty staff; (3) integration of the contents of the Family Medicine and PHC modules with the contents of other disciplines, such as Epidemiology, Health Policies and Evidence-Based Medicine; (4) critically questioning teaching methodologies regarding their suitability for the topic addressed and the student and teacher profiles; (5) formative assessments; (6) pedagogical improvement for teachers and preceptors for the exercise of teaching in health; (7) practices that encourage students to work in interprofessional teams; (8) encouragement of national and international exchange programs for undergraduate and residency students in FCM; (9) promotion of the publication of books, articles and research in PHC. Among the facilitating factors for the good progress of this teaching proposal, it is highlighted that FCM and PHC are the axial foundations of the political-pedagogical project of the medical course and are developed in an institution that has a long history of assistance and teaching in the health area, contributing significantly to service-school integration. Dialogue is required for the execution of didactic activities in the practical settings, due to the proximity between local management, preceptors and teacher-managers. Another factor which strengthens the proposal is the investment in the preceptor team through training, participation in the construction and integration of content proposed in the FCM modules and a human resources policy that values them. Thus, it is considered that the presentation of this initiative could contribute to the debate on educational models for curricular insertion into FCM and PHC, and the related challenges and possibilities in contemporary medical education.

Introduction: Throughout the SARS-COV-2 pandemic, schools had to adopt social distancing and remote learning, which, according to recent studies suggest an increase in depression, anxiety and behavioral disorders among university students. Medical training, which has a heavy load of psychological issues had to face this aggravating factor, reinforcing the need for support actions for students, such as mentoring programs. Mentoring programs offer empathetic and developmental support that encourages self-care, well-being and resilience. Experience report: A group of teacher-mentors from a medical school adapted the mentoring activities to a remote model, offering them to upper-level students who had already participated in mentoring, and, separately, to students who were newly enrolled in the medical course. In the remote format, the mentoring proposal was maintained as a “place of conversation”, but on a digital platform. The technical follow-up was carried out by remote meetings of the group of teacher-mentors, and consultation with students through a self-administered online questionnaire. The data obtained were submitted to content analysis. Discussion: From March to December, 109 virtual mentoring meetings were held. The students considered the meetings satisfactory in terms of the quality of discussions, the mentors’ attitudes and the emotional environment. The interactive development varied among groups, but it was observed to be easier in the groups of upper-level students. Among the newly-enrolled students, the recurring topic was the fear of poor performance in the tests, losing the semester, or not learning. Upper-level students highlighted the difficulties of adapting to remote learning and organizing their activities, and the decrease in practical activities. All groups reported fear of the pandemic, of death, of the worsening of parents’ financial situation, and sadness about the loss of relatives to COVID-19. It drew the attention of the mentors the fact that the students, even in a welcoming space, kept the cameras turned off. Conclusion: For mentors and students, virtual mentoring worked as an important student support system. Upper-level students and first-year ones reported feeling cared for, supported and grateful, suggesting that the meetings allowed a good interaction and produced beneficial effects. A limitation of this study was the duration of the experiment. Therefore, it is recommended that the research be maintained.