Vivência integrada na comunidade: inserção longitudinal no Sistema de Saúde como estratégia de formação médica

Abstract

Innovative teaching-learning process proposals for medical courses have been developed for generalist, humanistic, critical professional education. Beginning with approval of the More Doctors Program, new schools were created, adopting active teaching methodologies and promoting further community-service-teaching integration. This paper is an experience report on the development of the Integrated Experience in the Community module in the medical course at the Medical Sciences Multi-campuses College of Rio Grande do Norte, which provides students with longitudinal insertion opportunities in the healthcare system of the hinterland towns of the Northeast region. This proposed module has been promoting further integration between the university managers, and healthcare workers. The goal of this module is to contribute to securing physicians for in the region and strengthening the healthcare system in the Brazilian hinterland. IntroductionIn accordance with the Federal Constitution of 1988 1 , and the creation of the Brazilian National Health System (SUS) in 1990, Brazil has been undergoing a series of changes in an attempt to rearrange health professional education. Since then, the Brazilian government has facing ongoing challenges in trying to redraft the health care model based on the principles of primary health care (PHC) and the implementation of generalist-oriented educational programs, using PHC as the structuring axis for professional practice 2 . This paper presents the longitudinal insertion experience of medical students in the SUS in the interior of Rio Grande do Norte (RN), which has been added to the set of medical education measures currently underway in the country. The objective was to report the experience with pedagogical planning; agreement with the healthcare network of the cities involved; and the ramifications of the Integrated Experience in the Community (VIC) module, offered from the 2 nd to 8 th semesters of the medical course at the Medical Sciences Multi-campuses College at Federal University of Rio Grande do Norte (EMCM/RN).Although PHC has guided the formulation of health policies in Brazil since the 1990s, only in 2006 did it became a State policy with the publication of the National Primary Health Care Policy (PNAB), which was redrafted in 2011 3 . Among the challenges to the consolidation of PHC in the country, shortages of physicians to work effectively and efficiently at that care level was underscored, especially in the North and Northeast regions. According to Schefferet et al. 4 , despite the significant rise in the number of physicians that has occurred from the 1970s up to the present, unequal distribution remains the same, particularly when related to capital-hinterland differences and the size of Brazilian cities. It can be said that the existence of areas of hyperconcentration and, at the same time, other areas with shortages of physicians, ultimately prevent the establishment of the principles and doctrines that guide the SUS, notably when the aim is universalization, in...

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