Policies for expanding access to higher education and changing the profile of medical graduates in Brazil: a cross-sectional study

Figueiredo, Alexandre Medeiros de; Lima, Kênio Costa de; Massuda, Adriano; Azevedo, George Dantas de

doi:10.1590/1413-81232022279.07092022en

Cited by 1 publication

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References 31 publications

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“…The expansion of residency places in family medicine is no longer mandated and the number of medicine residency enrolments has been decreasing 47 . In 2018, there were 25 173 undergraduate medical places in private for‐profit schools (74.4%), 6663 (26.5%) in federal schools, 2362 in state public schools (9.4%) and 1557 in municipal private, not‐for‐profit schools 24 . Despite these initiatives, there are still medically underserved areas and imbalances in access to medical education, which demand improvement in public policies.…”

Section: Discussionmentioning

confidence: 99%

“…24 Between 2004 and 2018, there was an important change in the profile of medical school graduates. 24 The percentage of medical graduates who studied in public high schools increased from 9.0% to 24.9% and the percentage of non-White students increased from 20.6% to 28.8%. 24 While these findings show positive results, it is important to evaluate the impact of affirmative policies on physicians' career choices.…”

Section: Introductionmentioning

confidence: 99%

“…In 2012, a federal law ( Lei de Quotas ) defined that 50% of undergraduate vacancies in federal universities would be reserved for students from public high schools, prioritising low‐income students, Blacks, indigenous people and people with disabilities 23 . These policies changed the profile of medical graduates in Brazil, providing evidence of reduced inequities in access to medical education 24 . Between 2004 and 2018, there was an important change in the profile of medical school graduates 24 .…”

Section: Introductionmentioning

confidence: 99%

“…These policies changed the profile of medical graduates in Brazil, providing evidence of reduced inequities in access to medical education 24 . Between 2004 and 2018, there was an important change in the profile of medical school graduates 24 . The percentage of medical graduates who studied in public high schools increased from 9.0% to 24.9% and the percentage of non‐White students increased from 20.6% to 28.8% 24 …”

Section: Introductionmentioning

confidence: 99%

“…Between 2004 and 2018, there was an important change in the profile of medical school graduates 24 . The percentage of medical graduates who studied in public high schools increased from 9.0% to 24.9% and the percentage of non‐White students increased from 20.6% to 28.8% 24 …”

Section: Introductionmentioning

confidence: 99%

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Impact of educational policies on access to health care in Brazil: A cross‐sectional study

et al. 2023

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Introduction Various initiatives to improve access to health care have been implemented internationally. In Brazil, this has included policies intended to expand access to higher education for underrepresented socio‐economic groups. These measures have reduced inequalities in access to medical education, but it is not known whether they influence career choices. We examine the effect of these educational policies on physician practice patterns in primary care and/or in medically underserved areas. Methods This is a cross‐sectional study that analysed the association between affirmative educational policies and the career choices of physicians who graduated between 2010 and 2015. Multivariate binary regression analysis was used to evaluate the impact of affirmative educational policies on physician career choices, including primary care practice, practice in cities with ≤20 000 inhabitants, and practice in less developed municipalities 4 years after graduation. Results We identified the practice patterns of 65 304 (82.8%) physicians 4 years after their graduation. Most physicians included in our analysis were female (54.5%), aged ≤27 years (72.4%), born in developed cities and studied in private medical schools. Physicians admitted to medical school based on racial or social access policies were more likely to practice in municipalities with fewer than 20 000 inhabitants (odds ratio [OR]: 1.64; 1.36–1.98) and in primary care (OR: 1.55; 1.35–1.53). Physicians who benefited from scholarships for under‐represented socio‐economic groups were more likely to practice in small cities (OR: 1.24; 1.07–1.43) and primary care (OR: 1.23; 1.11–1.37). The provision of financial aid also improved the likelihood of practice in primary care and underserved areas. Graduation from medical schools located in smaller cities was associated with practice in municipalities ≤20 000 inhabitants and primary care. Conclusions Our results demonstrated that educational policies implemented in the Brazilian context are effective in reducing inequities in physician distribution and led to an increase in the number of physicians practicing in primary care.

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Section: Discussionmentioning

confidence: 99%