A escolha pela medicina de família entre estudantes de escolas médicas numa região neotropical no Brasil central

• Autor(a) principal: Issa, Afonso Henrique Teixeira Magalhães
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/10170
• topic: Medicina de família e comunidade; Atenção primária à saúde; Sistema único de saúde; Educação médica; Estudantes de medicina; Escolha de especialidade; Primary health care; Career choice; Medical student; Family medicine; CIENCIAS DA SAUDE::MEDICINA

Introduction: Family Medicine (FM) is an essential specialty for the strengthening of Primary Health Care (PHC) in the world. Several researches point out that the shortage of FM experts threatens the goal of universal and sustainable coverage of health systems. Brazil, a reference in PHC in low- and middle-income countries, has only 1% of its FM specialists. In addition, 70% of FM residency vacancies are vacant. Objective: To analyze the perceptions of Brazilian students in four medical schools, from two different states, on the factors influencing student choice or rejection by career in MFC. Methodology: Literature Review was conducted in tropical regions papers in the last 10 years that investigated factors influencing the choice for FM among medical students. The International Protocol with Preference Items for Systematic Literature Review Reports (PRISMA) was followed. Two field surveys were carried out. The first qualitative research, conducted in 2013, in a medical school in state of Goiás, used Laurence Bardin's Content Analysis methodology. The other study, in 2015, involved four schools, three from Goiás and one from the Federal District, observational and transversal, quantitative, applying a questionnaire based on the theoretical reference of influencers of professional choices of Bland-Meurer. Participants: 186 senior medical students from 2 public institutions and 2 private schools. Results: Ten (10) articles were found that revealed a much lower prestige of FM than in temperate regions, low insertion of FM in medical curricula in tropical regions. No student in 2013 and less than 10% in 2015 chose FM. The social relevance of the profession, the comprehensiveness of several problems in clinical practice, the continuous relationship with patients, a greater exposure to this specialty, and especially the presence of GPs in the undergraduate program would be positive influences on FM students' choice. The lack of prestige in the university, identified in the discourse of preceptors and teachers, the lack of model teachers, in addition to the low recognition of the society and the remuneration were the main de-motivating factors in the choice of the area. FM is a specialty not required and students do not choose this specialty in the students' own perception due to the absence of a career path for this specialty, as well as a discouraging medical school experience. Socio-demographic factors did not show a correlation with the outcome studied. Conclusion: Medical curricula should be modified to include FM as a medical specialty, and public policies need to value the role of this professional in the health systems of these countries. The research agenda that seeks to understand the factors influencing FM choice among medical students should be expanded, especially in tropical countries.