Project More Doctors for Brazil in remote areas of the state of Roraima: relationship between doctors and the Special Supervision Group

Abstract

This article aims at discussing aspects of the Project More Doctors for Brazil’s Special Supervision Group in areas of difficult access in the Brazilian state of Roraima. It is focused on the relationships between supervisors and doctors, identifying potentialities and difficulties, and highlighting strategies to overcome them. This is an experience report from a thematic content analysis of documents produced by supervisors in 2015 and 2016. Three key categories emerged: potentialities, challenges of the process and constructions based on supervision. Based on the analysis, this is an innovative relationship in healthcare, where academia and services hardly ever come together. It is a complex relationship with structural, cultural and educational limitations. It requires creativity and planning to play all different roles under construction.

Percepções acerca do Programa Mais Médicos e do Processo de Supervisão Acadêmica

“…A positive perception of academic supervision was observed, as a formative process that uses the dialogical approach to carry out the synthesis between theory and practice, allowing a reflective praxis, which makes it possible to improve the performance in PHC. The power of supervision lies in stimulating the search for new knowledge 31,32 through problematizations, based on the concrete reality 16,17 , which presents increasing complexity in PHC due to the deterioration of the population' s quality of life in recent years as a result of the economic recession 33 .…”

“…The supervision has been used as a support strategy in several countries with remote areas, aiming to assist doctors in making the most timely and correct decisions [15][16][17] . However, its introduction in PHC practices requires a change in professional culture, with greater appreciation of this type of support since the academic training of doctors 14 .…”

“…Supervision has been adopted for different purposes and strategies by other countries as support for doctors working in remote and vulnerable areas, achieving satisfactory results in the technical improvement of care, in reducing the professionals' feeling of isolation, and certainly in strengthening permanent education 13,14 . And in Brazil, within the scope of the PMM, it was implemented as support for the doctors, aiming at improving the Primary Health Care (PHC) work and management process [15][16][17] .…”

Programa Médicos pelo Brasil: inovação ou continuidade?

“…Além disso, um outro elemento destacado na literatura como indutor de fixação de médicos é o suporte educacional e contato com centros formadores ao diminuir a sensação de isolamento. 35,36,[40][41][42][43] No PMM este elemento aparecia através da supervisão e dos encontros locorregionais e, mesmo que acontecesse apenas 1 vez ao mês, o seu caráter longitudinal se mostrou associado à intenção de permanência na APS quando havia um bom supervisor. 31 No novo programa este suporte educacional perdura apenas nos 2 primeiros anos de bolsa formação, podendo após este período levar à sensação de isolamento nos locais mais distantes e, com isso, levar ao abandono do programa.…”