Medical schools in Brasil: population, economic and historical analysis

SUMMARY BACKGROUND To describe the current distribution and historical evolution of undergraduate courses in medicine in Brasil. METHODS Analytical cross-sectional study of secondary data. Through the Ministry of Education, the data of the medical courses were obtained, and through the Brazilian Institute of Geography and Statistics, the population and economic data of the Brazilian states were obtained. RESULTS In Brasil, there were 298 medical courses (1,42 courses / million inhabitants) in January 2018, totaling 31,126 vacancies per year, with 9,217 gratuitous vacancies (29.6%) and 17,963 vacancies in the hinterland (57, 7%). In Brazilian states, there are positive and statistically significant (p <0.001) correlations of the variables: "vacancies" and "population" (R 0.92); "vacancies" and "gross domestic product" ("GDP") (R 0.83); "percentage of vacancies in the hinterland" and "population in the hinterland" (R 0.71) and "percentage of vacancies in the hinterland" and "GDP" (R 0.64). There was a negative and statistically significant correlation between "gratuitous vacancy percentage" and "GDP" (R -0.54, p = 0.003). More paid courses than gratuitous courses and more courses in the hinterland than in the capitals have been created since 1964, in proportions that have remained similar since then, but in higher numbers since 2002. CONCLUSIONS The distribution of medical courses in Brasil correlates with the population and economical production of each state. The expansion of Brazilian medical education, which has been accelerated since 2002, is based mainly on paid courses in the hinterland, in the same pattern since 1964.

RESUMO OBJETIVO Descrever a distribuição e evolução histórica das vagas em cursos de graduação em medicina no Brasil. MÉTODOS Estudo transversal analítico de dados secundários. No Ministério da Educação obtiveram-se dados dos cursos de medicina e no Instituto Brasileiro de Geografia e Estatística foram obtidos dados populacionais e econômicos dos estados. RESULTADOS Havia no Brasil, até janeiro de 2018, 298 cursos de medicina (1,42 curso/milhão de habitantes), totalizando 31.126 vagas anuais, com 9.217 vagas gratuitas (29,6%) e 17.963 vagas no interior do País (57,7%). Nos estados há correlações positivas e significativas (p<0,001) das variáveis: "vagas em medicina" e "população" (R 0,92); "vagas em medicina" e "produto interno bruto" ("PIB") (R 0,83); "percentual de vagas em medicina no interior" e "população no interior" (R 0,71) e "percentual de vagas em medicina no interior" e "PIB" (R 0,64). Há correlação negativa e significativa entre "percentual de vagas gratuitas" e "PIB" (R -0,54, p=0,003). Passaram a ser criados mais cursos pagos do que gratuitos e mais cursos no interior do que nas capitais a partir de 1964 (p <0,001), e a relação curso/milhão de habitantes aumentou a partir de 2002 (p<0,001). CONCLUSÕES A distribuição de vagas em cursos de medicina no Brasil correlaciona-se à população e à produção econômica de cada estado. A expansão do ensino médico brasileiro, acelerada além do crescimento populacional a partir de 2002, é baseada principalmente em cursos pagos no interior dos estados brasileiros, característica inalterada desde 1964.

Ciências humanas e medicina: as contribuições da história para a formação e a prática do médico / Human science and medicine: the contribution of history to medical education and practice

Este artigo trata das possíveis contribuições da História para os profissionais e estudantes da Medicina.Incluindo-se no interior do atual debate acerca da importância do ensino das Humanidades para a formação do futuromédico, identificam-se as particulares contribuições dessa disciplina científica para aprofundar o conhecimento daMedicina como prática ao mesmo tempo técnico-científica e social. Examinando-se em especial a perspectiva do cuidadocomo produto da prática do médico, no exercício de sua profissão, define-se esta noção de cuidado e justificasea tomada dos estudos sobre as práticas de saúde para considerar as contribuições da História. Nesse sentido, mostra-se metodologicamente de que modo a História das Práticas de Saúde diferencia-se dos estudos acercada História das Ciências e também dos estudos de corte memorialista, ainda que guarde relações com ambos. Sãoexaminadas três categorias da análise histórica, a saber, as permanências, as rupturas e a circularidade, mostrando-se como se expressam relativamente à abordagem do adoecimento como experiência do paciente em interação com a construção da doença com base na nosografia médica, como experiência do médico. Tal construção interativa,facultada pelos aportes da História, permitem a configuração do encontro clínico e da relação médico-pacientenecessários à produção do cuidado...

This article deals with the contributionsof History as a scientific discipline for professionals and students of medicine. It is included inside of the currentdebate about the importance of teaching the Humanities for future doctor, inside which were identified the particular contributions of History to the knowledge of Medicine as ascientific, a technical and a social practice at the same time. By examining in particular the health care as an outcome of the medical practice in the exercise of this profession, the notion of care is defined, and based on it the approach of studies on health practices is justified for the exam the contributions of History. In this sense, it is pointed out how methodologically the history of health and medical practices differs from the history of science and also of the studies on memory, although having relations with both. Three categories of historical analysis were examined: the historicalstays, the historical breaks and the circularity, showing how to express themselves with regard to approach the illness as patient experience in interaction with the construction ofthe disease based on medical experience. Such interaction provided by the historical contributions allows creating the specific setting of the clinical encounter, and of the doctorpatient relationship, necessary to reach a good care...

Quarenta anos de desprestígio do ensino médico profissional no Brasil

A transformação de algumas escolas de medicina em institutos de investigação está causando um declínio do médico hipocrático, isto é, daquele que cuida do doente. Se o atual estudante deseja ser um verdadeiro médico, deveria primeiro estudar enfermagem e depois medicina.Em suma, não se pode trocar o hospital pelo biotério e o doente pelo ratinho!

Duzentos anos de ensino médico no Brasil / Two hundred years of medical education in Brazil

INTRODUÇÃO: Foco do trabalho é os nos 200 anos de existência do ensino médico no Brasil. OBJETIVO: Esta tese analisa o ensino médico brasileiro identificando os marcos e o contexto político, econômico, social e mundial. MATERIAL E MÉTODO: A metodologia escolhida foi a grounded teory (teoria fundamentada). A análise dos dados foi feita sob a luz do referencial teórico. Do levantamento quantitativo e qualitativo das escolas médicas brasileiras destacam-se distintos momentos de expansão das escolas médicas no Brasil. RESULTADOS: Foi detalhada a distribuição atual das 167 escolas médicas, que ofertaram 16.228 vagas no processo vestibular de 2007. CONCLUSÃO: Registram-se, também, a evolução da criação das escolas médicas, a distribuição regional e os processos de avaliação governamental (Provão/SINAES) e da sociedade (CINAEM). Discute o papel indutor dos mecanismos de incentivos conduzidos pelo Estado, na interface da saúde e da educação.

INTRODUCTION: Focus of the work is those in the 200 years of existence of medical education in Brazil. OBJECTIVE: This work analyzes the Brazilian medical education, identifying the landmarks and economical-political environment, internally and internationally. MATERIAL AND METHODS: The methodology chosen was the grounded theory. The data analysis was made under the theoretical reference. Observing the quantitative and qualitative data of the Brazilian medical schools, distinct moments of expansion are noticed. RESULTADOS: It was specified the actual distribution of the 167 medical schools, that offered 16,228 openings in the 2007 recruiting process. In Brazil, there were several different expansion processes of Medical Schools with diverse characteristics. CONCLUSÃO: It is also noticed the evolution of the creation of those schools, along with their regional distribution and the governmental and nongovernmental assessment tools (Provão/SINAES and CINAEM). It discusses the inductive role of incentive mechanisms used by federal government in the health and education interface.

75 años de la Facultad de Medicina de la Pontificia Universidad Católica de Chile / Seventy five years of the Medical School of the Pontifical Catholic University of Chile

Aiming to join academic excellence and an ethical and Christian approach to medical profession, the Medical School of the Pontifical Catholic University of Chile initiated its activities in 1930. Since then, the associated Health Care Network has incorporated all the technological breakthroughs in medicine and developed all the specialties. Undergraduate teaching is oriented to promote creativity and innovation. There is also a special concern about humanity of Medicine, throught the Program of Humanistic Medical Studies and the Bioethics Center. Post graduate education is also an important activity of the School, through specialty training, Master and Doctorate programs. Researchers have also obtained important grants and generated a great number of publications in high impact journals. Our University is defined as «complex¼, meaning that we must take important challenges, be creative and lead knowledge generation. We must also improve ourselves to serve in the best possible way our students and the Country. Paraphrasing the words of our founder, Monsignor Carlos Casanueva, we must train physicians that will serve our community not only with science but also with humanity.

Evolución de las universidades chilenas 1981-2004 / The evolution of Chilean universities from 1981 to 2004

In 1981, a supreme decree allowed the creation of private universities in Chile. As a consequence, 50 new universities were created in one decade, under the surveillance of the Council for Superior Education. This paper analyzes the evolution of this expansion process, that resulted in an admission of 370,000 students to 60 universities along the country, during 2004. At the moment, 42% of the universities, designed as traditional, receive state financing and 58% are private. Twenty six percent are owned by the state, 52% are secular and 22% are confessional. The 25 traditional universities are complex organizations of a high academic level. New private universities are only devoted to teaching and some have obtained their autonomy. Some have improved the quality of their academic staff, perform research and impart doctorate degrees. However, most are small and with a limited academic staff. Traditional universities are stratified in a superior level. Eight private universities and some regional institutions, that are becoming complex and performing research activities, are stratified in a middle level. Two thirds of the private universities are in the lower level. The expansion of superior education is a sign of the social and cultural progress that Chile has experienced.

Desarrollo histórico de la enseñanza médica superior en Cuba desde sus orígenes hasta nuestros días / Historical development of the higher medical education in Cuban from its origin to our time

Se hace un breve recuento sobre el surgimiento de las universidades y las facultades de Medicina en el mundo. Se describe y analiza el inicio de la enseñanza de la medicina en Cuba y su desarrollo en los períodos colonial, republicano burgués y revolucionario socialista de nuestra historia

A brief account is made on the emergence of medical universities and schools in the world. The beginning of medical education in Cuba and its development through the colonial, republican-bourgeois and revolutionary-socialist periods of our history are described and analyzed.