Residência médica em cirurgia geral no Brasil - muito distante da realidade profissional

Santos, Elizabeth Gomes dos

doi:10.1590/s0100-69912009000300017

Cited by 12 publications

(8 citation statements)

References 6 publications

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“…Nevertheless, dissatisfaction with surgical care in Brazil remains high. 9 Our analysis points to large geographic disparities which raise concerns of equity. Policies should focus on stimulating appropriate geographic allocation of the surgical workforce, addressing the deficits of certain specialists, and better distributing surgical volume.…”

Section: Discussionmentioning

confidence: 88%

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Assessing the Brazilian surgical system with six surgical indicators: a descriptive and modelling study

et al. 2017

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BackgroundBrazil boasts a health scheme that aspires to provide universal coverage, but its surgical system has rarely been analysed. In an effort to strengthen surgical systems worldwide, the Lancet Commission on Global Surgery proposed a collection of 6 standardised indicators: 2-hour access to surgery, surgical workforce density, surgical volume, perioperative mortality rate (POMR) and protection against impoverishing and catastrophic expenditure. This study aims to characterise the Brazilian surgical health system with these newly devised indicators while gaining understanding on the complexity of the indicators themselves.MethodsUsing Brazil's national healthcare database, commonly reported healthcare variables were used to calculate or simulate the 6 surgical indicators. Access to surgery was calculated using hospital locations, surgical workforce density was calculated using locations of surgeons, anaesthesiologists and obstetricians (SAO), and surgical volume and POMR were identified with surgical procedure codes. The rates of protection against impoverishing and catastrophic expenditure were modelled using cost of surgical inpatient hospitalisations and a γ distribution of incomes based on Gini and gross domestic product/capita.FindingsIn 2014, SAO density was 34.7/100 000 population, surgical volume was 4433 procedures/100 000 people and POMR was 1.71%. 79.4% of surgical patients were protected against impoverishing expenditure and 84.6% were protected against catastrophic expenditure due to surgery each year. 2-hour access to surgery was not able to be calculated from national health data, but a proxy measure suggested that 97.2% of the population has 2-hour access to a hospital that may be able to provide surgery. Geographic disparities were seen in all indicators.InterpretationBrazil's public surgical system meets several key benchmarks. Geographic disparities, however, are substantial and raise concerns of equity. Policies should focus on stimulating appropriate geographic allocation of the surgical workforce and better distribution of surgical volume. In some cases, where benchmarks for each indicator are met, supplemental analysis can further inform our understanding of health systems. This measured and systematic evaluation should be encouraged for all nations seeking to better understand their surgical systems.

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Section: Discussionmentioning

confidence: 88%

“…Surgical residency began in Southeastern cities in 1948, and even in 2008, 73% of general surgery training positions remained in the South and Southeast. 9 While disparity in availability and quality of surgical care is widely acknowledged, 8-10 it has not yet been systematically studied.…”

Section: Recommendations For Policymentioning

confidence: 99%

Assessing the Brazilian surgical system with six surgical indicators: a descriptive and modelling study

et al. 2017

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“…A equipe de professores tem a responsabilidade de selecionar, no conteúdo da disciplina, temas adequados à realização desta estratégia; conhecer e dominar os temas; orientar a questão da busca, atualidade, confiabilidade e acessibilidade das fontes de informação; esclarecer as dúvidas; mediar o debate e controlar o tempo de realização da atividade, reservando espaço para as conclusões e sínteses 1,5,8,15 .…”

Section: Painel De Artigos Cirúrgicos Painel De Artigos Cirúrgicos Paunclassified

Uso de painel de artigos cientificos no ensino da cirurgia ambulatorial

Skinovsky

Fernandes

2013

Rev. Col. Bras. Cir.

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“…In 1889, surgeon William Stewart Halsted had the idea of implementing the first professional training program in hospital service, at Johns Hopkins Hospital, where he became the Head of the Service in the following year 1 . He realized that teaching surgery at the time, carried out through direct exposure to medical practice (classic practice: traineemaster) was flawed and inefficient.…”

Section: Introductionmentioning

confidence: 99%

O Reflexo do Aumento de Vagas da Residência de Cirurgia Geral no Brasil

Tonatto-Filho

Gallotti

Treiguer

et al. 2020

Rev. bras. educ. med.

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Introduction: In recent years, there has been an increase in the number of medical residency programs in all regions of Brazil, only in the last 4 years, from 2014 to 2018, there was an increase from 18,953 general spots offered for the first year of medical residency to 26,094, 37% more, this was also observed in General Surgery Residencies around Brazil. As a result, the number of general surgeons has increased substantially, from 12,430 in 2008 to 34,065 in 2018, an absolute percentage increase of 174%. These new surgeons are bringing with them their theoretical and practical knowledge already updated, regarding new techniques and surgical modalities. In this context, in the last 2 decades, video-assisted surgery has become the choice for numerous procedures in Brazil and in the World, considering its benefits for patients, such as less postoperative hospital stay and less metabolic response to surgical trauma, for example. The current study correlates the data between the increase in the number of spots in medical residency programs, related to the graduation of new surgeons in Brazil, to the increase of videolaparoscopic surgeries in the public health system. Methodology: Review and online analysis of the national electronic public health registry database - DATASUS. The most performed Surgeries in Brazil were chosen for our data analysis. Results: The results were divided into five geographically distributed areas in Brazil. At the end of the current study, the number of video-assisted surgeries increased by 233%, accompanied by a 63% increase in the number of medical residency openings and a 174% absolute increase in the number of new surgeons in Brazil at the same period. Conclusion: The current study showed that the increase in the number of video-assisted surgeries in the country is related to the exponential increase in the number of medical residency spots and, consequently, to the number of new graduated general surgeons. This increase occurs more and more in a context of videolaparoscopic techniques, revealing multiple benefits already recognized for patients. We could conclude, therefore, that the increase in the number of medical residencies in general surgery - which are increasingly teaching videolaparoscopic techniques - has contributed as a complementary factor to the increase in the number of video-assisted surgeries observed in all regions of Brazil.

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Residência médica em cirurgia geral no Brasil - muito distante da realidade profissional

Cited by 12 publications

References 6 publications

Assessing the Brazilian surgical system with six surgical indicators: a descriptive and modelling study

Assessing the Brazilian surgical system with six surgical indicators: a descriptive and modelling study

Uso de painel de artigos cientificos no ensino da cirurgia ambulatorial

O Reflexo do Aumento de Vagas da Residência de Cirurgia Geral no Brasil

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