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Disponível em: https://www.glasbergen.com/. Acesso em: 4 mar. 2024
Making family medicine a more attractive specialty: strategies to address the shortage of primary care specialists in Brazil
Primary Health Care (PHC) is often the first level of the health system and is responsible for the coordination of medical and interdisciplinary care. As the preferred entry point to the Brazilian Unified Health System (SUS), PHC is of fundamental importance and is present in all regions of the country. It aims to enable access to health care and ensures the coordination and completeness of care. This structure can treat approximately 80% of the overall need related to diseases presented in the Basic Health Units.
Despite its importance, the valorization of PHC and Family Medicine (FM) as a discipline and a public policy has not been prioritized in most Brazilian educational institutions. According to the study on medical demography carried out by the Regional Medical Council of São Paulo (CREMESP), Brazil had 500,000 physicians in 2020, but with unequal distribution among the nation’s five regions, and a concentration of professionals in the capital cities compared to the countryside.
This issue is faced by many countries. In the United States (US) of 8,116 primary care postgraduate training positions (which includes pediatrics, internal medicine, and family doctors), 42 percent were filled by graduates of U.S. medical schools and the American Association of Medical Colleges (AAMC) projects a shortage of 21,100 to 55,200 primary care physicians (PCP) by 2034. In Europe, where PCP was traditionally respected and recognized, the lack of General Practitioners (GP) is also increasing and is a matter of concern. Workload and a lack of perceived prestige associated with the PCP track can make primary care less attractive. These sorts of misconceptions, along with lower salaries, burnout, and difficult career advancement makes primary care a difficult specialty to attract and retain doctors.
For Feuerwerker, vacancies in Brazilian institutions are the result of several elements: the encouragement of distinctive specialties and institutions, the historical misunderstanding and importance of the practice, and the increased incentive of specialization in medical education. The lack of investments in supplies and infrastructure in primary care, career development concerns, and low salaries, and the valorization of the formation of FM doctors in the work of the EFS also contribute to difficulty in retaining these positions in Brazil.
With the aim to reduce the vacancy rate in the medical residency programs for FM, some Brazilian health departments introduced reforms and additional financing for FM training. In 2020, the region of Campinas, where we work, introduced a program called “More Doctors for the City of Campinas” (PMMC), which established a partnership between public and private higher education institutions, hospitals, and Urgency/Emergency Units with a novel post-graduation proposal for FM. It created a program to support the training of specialists in family medicine, stimulate research, and expand care in Basic Health Units, and has since resulted in a 50% decrease in vacancies.
One of the successful elements of the Campinas program, together with quality of medical training, is that it helps bring medical classroom training closer to the community and everyday social reality. PMMC-trained physicians are aware of how their work impacts the local community and its particular health needs. The program has resulted in care that is more responsive to community needs, especially from the perspective of adopting a care model that prioritizes health promotion, disease prevention, diagnosis, and treatment in an integrated manner. However, for the EFS to continue to innovate and improve its response capacity to contemporary health problems, it must invest heavily in professional training, the rational incorporation of information and communication technologies, and the creation of appropriate working conditions for multidisciplinary teams.
Disponível em: https://speakingofmedicine.plos.org/2023/01/13/. Acesso em: 4 mar. 2024. [Adaptado].
A problem mentioned in the text is:Making family medicine a more attractive specialty: strategies to address the shortage of primary care specialists in Brazil
Primary Health Care (PHC) is often the first level of the health system and is responsible for the coordination of medical and interdisciplinary care. As the preferred entry point to the Brazilian Unified Health System (SUS), PHC is of fundamental importance and is present in all regions of the country. It aims to enable access to health care and ensures the coordination and completeness of care. This structure can treat approximately 80% of the overall need related to diseases presented in the Basic Health Units.
Despite its importance, the valorization of PHC and Family Medicine (FM) as a discipline and a public policy has not been prioritized in most Brazilian educational institutions. According to the study on medical demography carried out by the Regional Medical Council of São Paulo (CREMESP), Brazil had 500,000 physicians in 2020, but with unequal distribution among the nation’s five regions, and a concentration of professionals in the capital cities compared to the countryside.
This issue is faced by many countries. In the United States (US) of 8,116 primary care postgraduate training positions (which includes pediatrics, internal medicine, and family doctors), 42 percent were filled by graduates of U.S. medical schools and the American Association of Medical Colleges (AAMC) projects a shortage of 21,100 to 55,200 primary care physicians (PCP) by 2034. In Europe, where PCP was traditionally respected and recognized, the lack of General Practitioners (GP) is also increasing and is a matter of concern. Workload and a lack of perceived prestige associated with the PCP track can make primary care less attractive. These sorts of misconceptions, along with lower salaries, burnout, and difficult career advancement makes primary care a difficult specialty to attract and retain doctors.
For Feuerwerker, vacancies in Brazilian institutions are the result of several elements: the encouragement of distinctive specialties and institutions, the historical misunderstanding and importance of the practice, and the increased incentive of specialization in medical education. The lack of investments in supplies and infrastructure in primary care, career development concerns, and low salaries, and the valorization of the formation of FM doctors in the work of the EFS also contribute to difficulty in retaining these positions in Brazil.
With the aim to reduce the vacancy rate in the medical residency programs for FM, some Brazilian health departments introduced reforms and additional financing for FM training. In 2020, the region of Campinas, where we work, introduced a program called “More Doctors for the City of Campinas” (PMMC), which established a partnership between public and private higher education institutions, hospitals, and Urgency/Emergency Units with a novel post-graduation proposal for FM. It created a program to support the training of specialists in family medicine, stimulate research, and expand care in Basic Health Units, and has since resulted in a 50% decrease in vacancies.
One of the successful elements of the Campinas program, together with quality of medical training, is that it helps bring medical classroom training closer to the community and everyday social reality. PMMC-trained physicians are aware of how their work impacts the local community and its particular health needs. The program has resulted in care that is more responsive to community needs, especially from the perspective of adopting a care model that prioritizes health promotion, disease prevention, diagnosis, and treatment in an integrated manner. However, for the EFS to continue to innovate and improve its response capacity to contemporary health problems, it must invest heavily in professional training, the rational incorporation of information and communication technologies, and the creation of appropriate working conditions for multidisciplinary teams.
Disponível em: https://speakingofmedicine.plos.org/2023/01/13/. Acesso em: 4 mar. 2024. [Adaptado].
According to the text, Primary Health Care (PHC)
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AMARAL, Tarsila do. Os operários, 1931. Disponível em: <http://www.arteeartistas.com.br/operarios-tarsila-do-amaral/>. Acesso em: 01 out. 2018.
Mulher proletária – única fábrica que o operário tem, (fabrica filhos)
tu
na tua superprodução de máquina humana
forneces anjos para o Senhor Jesus,
forneces braços para o senhor burguês.
Mulher proletária,
o operário, teu proprietário
há de ver, há de ver:
a tua produção ao contrário das máquinas burguesas
salvar o teu proprietário.
LIMA, Jorge de. Mulher proletária. In: Antologia poética. São Paulo: José Olympio, 1978, p. 21.
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AMARAL, Tarsila do. Os operários, 1931. Disponível em: <http://www.arteeartistas.com.br/operarios-tarsila-do-amaral/>. Acesso em: 01 out. 2018.
Mulher proletária – única fábrica que o operário tem, (fabrica filhos)
tu
na tua superprodução de máquina humana
forneces anjos para o Senhor Jesus,
forneces braços para o senhor burguês.
Mulher proletária,
o operário, teu proprietário
há de ver, há de ver:
a tua produção ao contrário das máquinas burguesas
salvar o teu proprietário.
LIMA, Jorge de. Mulher proletária. In: Antologia poética. São Paulo: José Olympio, 1978, p. 21.
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CHAUÍ, Marilena. Convite à Filosofia. 13. ed. 2003. São Paulo: Ática. p. 90.
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Predictions for the future of 'smart' education
Posted by Charley Rogers - January 22, 2018
A wave of new technology has been introduced into schools up and down the country changing the way
teachers deliver lessons and how students learn.
A research by Randstad Education found schools and colleges have adopted the latest tech to improve teaching and make lessons more interactive and engaging. Some of the innovations already in use include ‘gamifying’ lessons by incorporating game-like rules and tasks to increase motivation. For example, Shireland Academy in the West Midlands included Minecraft on its curriculum.
Education, the research found, will become more project-based and include more interactive content to keep up with students’ changing attitudes towards traditional media. Classrooms, it is predicted, will join the Internet of Things – a network of devices like smartwatches that connect and share data with other items and systems – and create ‘smart schools’ where the teachers, students and devices become more connected.
Pressure on teachers – 75% find their workload unmanageable – as well as rising student numbers means technology will play a larger role performing tasks to save time. Teachers are also reaping the rewards as lessons and assessments move out of the classroom and onto platforms that make it easier for them to chart progress and achieve a better work-life balance. Education experts have highlighted the importance of new techniques that help teachers do their jobs.
However, while tech will become more commonplace in the classroom, it is expected to compliment teachers and not replace them. It´s important to understand that teaching tools have come a long way since the days when teachers used to write on chalkboards and present using an overhead projector.
The research says that students today benefit from some of the most exciting technology available to schools, but it’s not just the pupils who benefit from these innovations through invigorating lessons and virtual learning. Teachers are also reaping the rewards as lessons and assessments move out of the classroom and onto platforms that make it easier for them to chart progress and achieve a better work-life balance.
Technology has arrived and the teachers and classrooms of tomorrow are here today.
Disponível em: <https://edtechnology.co.uk/Article/predictions-for-the-future-of-education>. Acesso em: 19 set. 2018. (Adaptado).
