The More Doctors Program and the changing role of the State in the regulation and organization of medical education

Pinto, Hêider Aurélio; Chioro, Arthur; Ribeiro, Renato Janine; Loula, Maria Rosa

doi:10.1590/interface.170960

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…The National Registration of Specialists was expected to provide easy access to an authoritative list of physicians in any medical specialty but, unfortunately, it has not been maintained as prescribed by the More Doctors Law. 48 Consequently, the number of family and community physicians is surely overestimated, even if we expect this overestimation to be minor because family and community medicine is a fairly young specialty in Brazil. 44 In 2018, Augusto et al 23 (using the same methods as us) estimated there would be 5,438 family and community physicians in Brazil, 276 (5%) more than the 5,162 found by Scheffer et al , 44 who had access to CFM data.…”

Section: Discussionmentioning

confidence: 98%

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

Fontenelle¹,

Rossi

Oliveira

et al. 2020

Fam Med Com Health

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ObjectiveOur objective was to describe the postgraduate education trajectories of family and community physicians in Brazil, where neither primary healthcare nor family and community medicine is recognised as a knowledge area for the purpose of research and postgraduate education (master’s and PhD degrees).DesignAn observational, exploratory study, using administrative data. A nationwide list of family and community physicians as of late November 2018 was compiled from multiple sources. Data on the mode of specialisation was obtained from the same sources and were correlated with data on master’s and PhD degrees, obtained from the curricula vitae on the Lattes Platform.SettingThis study was set in Brazil.Participants6238 family and community physicians (58.3% female), of whom 2795 had earned a specialist certificate (identified from the list of physicians certified by Sociedade Brasileira de Medicina de Família e Comunidade) and 3957 had completed medical residency (identified from SisCNRM, the national information system for medical residency).ResultsA master’s degree was held by 747 (12.0%) family and community physicians, and a PhD by 170 (2.7%); most degrees were in collective health (47.0% and 42%, respectively). Men were more likely than women to hold a master’s degree (adjusted odds ratio (aOR) 1.24, 95% uncertainty interval (UI) 1.07–1.45) and even more likely to a hold PhD (aOR 1.86, 95% UI 1.35–2.59). Family and community physicians were also less likely to hold a PhD degree if their master’s degree was professional (oriented towards jobs outside academia) instead of academic (aOR 0.15, 95% UI 0.05–0.39) or in some area other than collective health or medicine (aOR 0.41, 95% UI 0.21–0.78, compared with a master’s degree in collective health). The postgraduate degree was more likely to precede specialisation for family and community physicians specialising through certification (master’s degree 39.9%, PhD 33%) than through medical residency (master’s degree 9.1%, PhD 6%).ConclusionFamily and community physicians in Brazil increasingly earn academic and professional master’s and PhD degrees, with an emphasis on collective health, even though women seemingly face barriers to advance their education. The consequences of different postgraduate trajectories should be critically examined.

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Section: Discussionmentioning

confidence: 98%

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

Fontenelle¹,

Rossi

Oliveira

et al. 2020

Fam Med Com Health

View full text Add to dashboard Cite

show abstract

“…The National Registration of Specialists was expected to provide easy access to an authoritative list of physicians in any medical specialty, but unfortunately it has not been maintained as prescribed by the More Doctors Law. 48 Consequently, the number of family and community physicians is surely overestimated, even if we expect this overestimation to be minor, because family and community medicine is a fairly young specialty in Brazil. 44 In 2018, Augusto et al .…”

Section: Discussionmentioning

confidence: 97%

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

Fontenelle

Rossi

Oliveira

et al. 2019

Preprint

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Neither primary health care or family and community medicine are recognized as knowledge areas in Brazil, for the purpose of postgraduate education (master's, Ph.D.) or research. Our objective was to describe the postgraduate education trajectories of family and community physicians in Brazil. In this observational, exploratory study, we used data from SBMFC and SisCNRM to compile the list of physicians and community physicians, and then downloaded their curricula vitae from the Lattes Platform, verifying all data for consistency. A master's degree was held by one in eight, and a Ph.D., by one in forty; most degrees were in collective health. Women (versus men) were less likely to hold master's degrees, and even less likely to hold Ph.D. degrees. Professional (versus academic) master's degrees and those in other areas (versus in medicine or collective health) were also associated with lower probability of obtaining a Ph.D. degree. Certified specialists (versus those with a medical residency) with a postgraduate degree were more likely to have earned it before becoming family and community physicians. We suggest that researchers in public health critically examine the relative benefits of different postgraduate trajectories for the professional performance of family and community physicians.

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“…O estudo mostrou também que o gestor municipal, quando é médico e ligado ao HE, ao operar no âmbito da micropolítica, não fica imune ao jogo interno da organização hospitalar. Mesmo após as reformulações das diretrizes curriculares empreendidas pela Lei Federal que criou o Programa Mais Médicos e determinou que 30% do internato fosse cumprido com ênfase na AB, o HE continua como o centro formativo, mantendo em seu bojo diferentes ações de atenção primária 11 .…”

Section: Atenção à Saúdeunclassified

A política de contratualização dos hospitais de ensino: o que mudou na prática?

Chioro

Furtado

Araújo

et al. 2021

Ciênc. saúde coletiva

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Resumo O Programa de Reestruturação dos Hospitais de Ensino (HE) foi implantado como uma das estratégias para enfrentar a crise do setor. Pretendia introduzir novos modos de financiamento, de gestão e articulação destes hospitais com a rede de saúde. O artigo apresenta resultados de estudo qualitativo, de caso múltiplo, envolvendo quatro HE contratualizados em 2004. Foram entrevistados, em 2010, 32 dirigentes hospitalares, gestores do Sistema Único de Saúde (SUS) e dos ministérios envolvidos. Utilizando como referencial teórico elementos da micropolítica das organizações de saúde, revisitou-se o banco de dados como objetivo analisar as mudanças decorrentes dessa política governamental no cotidiano dos HE, procurando caracterizar o posicionamento e protagonismo dos diferentes atores institucionais e as dificuldades na sua implementação. A despeito da melhoria das condições financeiras, as mudanças observadas nos HE foram restritas. Analisar a política de contratualização permite compreender como um projeto consistente e idealizado pode reproduzir o comportamento conservador que caracteriza a gestão pública.

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The More Doctors Program and the changing role of the State in the regulation and organization of medical education

Cited by 4 publications

References 13 publications

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project

A política de contratualização dos hospitais de ensino: o que mudou na prática?

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