Foreign-trained physicians without a revalidation exam still account for nearly 40 percent of the more than 8,000 professionals working in the program; ministerial studies offering postgraduate courses to attract new participants
OR Ministry of Health will expand the program More doctors favoring graduates on the national territory, but maintaining professionals trained abroad without a revalidated diploma, who today correspond to more than 3,000 doctors, almost 40% of the total. At the moment, a new cooperation agreement with the government of Cuba to involve Cuban professionals, the main controversy of the original version of the program, is excluded.
The new federal administration is also considering offering postgraduate and graduate courses to participants as a way to attract more Brazilians based on upcoming public announcements of the program.
Plans to retake and reinforce Mais Médicos were detailed when Stadium For Philip Proenço, deputy secretary for primary care of the ministry. Family and community doctor and public health doctor, Proenço coordinated the Mais Médicos program between 2013 and 2016, while managing Dilma Rousseff (PT).
He states that, with the increase in vacancies in medical schools in recent years (the number has doubled in 12 years), the new federal management hopes to attract more Brazilians, but explains that the same Mais Médicos law, approved in 2013, provides for the possibility of calling doctors trained abroad without a revalidated diploma (exchange students) when all the vacancies are not employed by doctors registered in Brazil. The exceptional permit has come under criticism from medical organizations since its inception.
“We rely heavily on doctors trained in Brazil, including the fact that the number of vacancies has increased (of Medicine) and, therefore, outputs. But, during all these years, exchange students remained in the program, with professional practice through the registration of the Ministry of Health, following the prerogatives (by right) of Mais Médicos”, says Proenço, who defends the combination of formats to attract more professionals.
“It is evident that we need to deal with diversified strategies for the supply of doctors and, in this sense, we can count, in some situations, on doctors who have recognized their professional practice in other countries and who undergo a reception form here and evaluation This is a multi-country strategy to guarantee supply in the most difficult areas to integrate”, said the secretary.
Mais Médicos was born with the aim of bringing emergency doctors to places that are difficult to find, such as cities far from the big centres, indigenous neighborhoods and the suburbs of the capitals.
It had 18,200 professionals, including 11,000 Cubans brought in through a cooperation agreement between the Brazilian government and Cuba brokered by Pan American Health Organization (PAHO). Most Cubans left Brazil at the end of 2018, shortly after the election of Jair Bolsonaro (PL), opposed to the agreement and critical of the government of the Caribbean country.
Despite the criticism of Mais Médicos and the promise to create a program to replace it – which earned Bolsonaro the support of a significant part of the medical profession – the former president ended up maintaining the main features of the program created by the PT and was unable to get it removed Doctors in Brazilborn to replace the PT management project.
The initiative was announced in 2019, but its first public notice was only released in 2021. Today, the two programs coexist, but Mais Médicos has more professionals than Médicos pelo Brasil.
According to Proenço, there are 8,321 professionals working for Mais Médicos and 5,515 for Médicos pelo Brasil, which only accepts those who have a professional registration in the country. Of the total number of doctors currently working at Mais Médicos, 39% (or more than 3,200) are trained abroad without a revalidated diploma, the so-called exchange students.
Proenço said the new administration “does not see” the need for a new cooperation agreement like the one signed with Cuba. “We have several other steps forward: we offer the vacancy to doctors registered in Brazil, then to Brazilians trained abroad, then to foreigners, and collaboration would be only a fourth step. We rely on Brazilian professionals trained in these most recent courses,” he says.
Two surveys released this week by the Federal Council of Medicine (CFM) and the Brazilian Medical Association (AMB) show that the number of newly trained doctors in the country has doubled in 12 years and broken a record. The increase in vacancies in medicine has been stimulated by the Mais Médicos program whereby, over the years, exchange students have gradually been replaced by professionals graduated from Brazil.
Despite this, professionals remain concentrated in the wealthier regions and cities and the program still depends on exchange students, who remain in the program because, not having their diploma revalidated, they can only practice medicine on the national territory in this way.
Asked why the increase in vacancies has not yet translated into a better distribution of doctors, Proenço said Mais Médicos rules promoting medical training “were poorly characterized” in the governments of Michel Temer and Bolsonaro.
“For example, Mais Médicos has envisaged a training course proposal through residency, the training of family and community doctors. This has established these professional figures in these areas. Those who graduate and reside in the same location have a very high chance of staying in that position.”
Ministry studios offering postgraduate courses to attract more Brazilians
Proenço says the ministry is studying ways to offer medical training to participants as a way to keep them in the program. “Our guideline is to work with the perspective that as the physician enters the program, they may gain training as a specialist, may have access to postgraduate modalities because one of the reasons we see for dropping out of the program is Brazilian doctors look for other formats of medical education. What we are studying is exactly what is the feasibility of having this offered by the program itself,” he says.
According to Proenço, the average length of stay of doctors trained in Brazil is one year and eight months, while that of exchange students reaches three years.
The secretary said that, ahead of the opening of new public tenders for Mais Médicos, the government is resuming two public tenders launched last year, also under the Bolsonaro administration, and which were paralyzed by budget restrictions. Overall, the two tenders offered 1,174 vacancies, of which 152 aimed at indigenous districts.
“There was the assignment of professionals, the publication of the Municipalities in which they would operate, but there was no resource to proceed with these public notices. We have resumed these public notices and in March the doctors who confirm their participation begin”, he has declared .
The assistant secretary said the ministry was still evaluating the number of new vacancies offered in upcoming public tenders from Mais Médicos. In a meeting with representatives of the National Council of Municipal Health Secretaries (Conasems) last month, the titular secretary of primary care, Nesio Fernandes, indicated that this number could reach 5,000.
Source: Terra
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