The persistence of bio-medically oriented practices and the mismatch between training and work are identified as the challenges for the rolling out of Primary Health Care (PHC) in Brazil.This paper analyzes work changes in PHC after following specialization level training courses on community and family health, from the point of view of the trained professionals. It is a qualitative study carried on from 2011 to 2013 in the Federal District (DF) involving doctors, nurses and dentists. Data was collected with the use of digital questionnaires, semistructured interviews and focal groups. From the thematic content analysis, two categories emerged: "a universe of knowledge has opened up" and a "new way of doing things in an adverse working environment". The context of the PHC in DF is a constraint but the training had the potential to generate professional competences. Teamwork has been neglected in professional training [12][13][14] in spite of the ample consensus of its fundamental role in implementing comprehensive actions.
COMUNICAÇÃO SAÚDE EDUCAÇÃO 2016; 20(58):691-702The contradictions between professional practices and training call for revisiting the educational strategies 15 to incorporate the dialectic relations between labor and education. Complexity of health issues and of the actions that such issues demand, show the urgent need to develop pedagogic processes encompassing political, organizational and operational competences at all levels of the health system, thus breaking apart with the point of view that looks down on PHC while overrating technologically dense techniques developed in the secondary and tertiary levels of health care.It is therefore a main task to put together teams able to act in synergy with different social policies and existing resources, taking into account the multiple factors that affect the quality of life of populations, and at the same time the imperatives of universal and democratic access to health, the interactions with other levels of care, the working conditions and the diversity of stakeholders that are needed to make SUS a reality. To effectively implant a model that goes beyond the biomedical approach, there is a need to make changes in the day-by-day context of work and in the professionals' mindset about the mode of production in health.In this context, an array of graduate courses have being supported through grants of the Ministries of Health and Education since the 90's as a strategy to train professionals able to perform competently in HFS, following the NPPHC.Working in PHC, using knowledge and practices to face problems that are frequently rooted outside the health area, demands specific competence. This competence may be characterized as a dialectic combination of different ingredients that integrate how to act, i.e. "the mastery of the precedent norms" 16 , to be willing to act, " to be motivated to adhere to a collective project" and to be able to act, " to be capable of facing the environment's restrictions" 17.Taking into account the fact that there is no...