Poor distribution of doctors is one of the biggest public health challenges – Portal Política Distrital

Poor distribution of doctors is one of the biggest public health challenges – Portal Política Distrital

By Ricardo Melo

Despite the high number of doctors, Brazil still struggles to ensure care for the entire population. studying Medical demographics of Brazil, from the Federal Council of Medicine (CFM) and the University of São Paulo (USP), indicates that the country has 500 thousand physicians, with a ratio of 2.4 per group of thousand inhabitants. In numbers, we have relatively more physicians than Japan and are close to developed countries such as the United States (2.6), the United Kingdom (2.8), and Canada (2.7). Despite this, it is common for municipal councils in remote areas to offer high salaries and still fail to attract these professionals.

Abramito President, Eduardo Costa Teixeira - Image: Disclosure
President of Abramito, Eduardo Costa Teixeira – Photo:

Most of them work in the southeast. The region, which is home to 41% of Brazil’s population, has 57.3% of physicians. The population of the South is 14% of the population, and the population of the South is 16%. The situation is dramatic in the Northeast, which has 15.7% of the country’s doctors, serving 27% of the Brazilian population. The North, where 8.7% of Brazilians live, has only 3.7%. The population pays, often with their own lives, for the consequences of this inequality. The democratization of the Brazilian population’s access to physicians is one of the greatest public health challenges,” comments Eduardo Costa Teixeira, President of the Brazilian Association of Postgraduate Physicians with Postgraduate Experience (APRAMIPO).


The Doctors for Brazil program, formerly known as More Doctors, may have been the driver of this democratization, but Abramebo warns that an illegal requirement is preventing 70% of the country’s doctors, some 350,000 professionals, from applying for this. job opportunities.

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Some notices include as a prerequisite RQE (Registration of Specialist Qualifications), which can only be obtained by professionals who are in medical residency or who have a specialist title issued by the Brazilian Medical Association (AMB) and are registered, with the exception of postgraduate programmes. Registered with the Ministry of Education (MEC).

There are not enough medical residency vacancies to serve all of the graduating physicians. About 70% of students are excluded and choose to specialize in other postgraduate courses also recognized by the MEC. By law, a trained doctor can work with patients, but this decision prevents the possibility of filling gaps in new vacancies accumulated over decades, ”explains the head of the entity.

In Teixeira’s assessment, given the scarcity of vacancies in medical residency programmes, it is up to the MEC, as the body responsible for vocational training, to organize postgraduate programmes, with different minimum workloads and other requirements. “The RQE requirement is illegal because it is against constitutional principles and the judiciary is already making decisions in this regard. But more is needed. If there are not enough vacancies in medical residency, it is necessary to organize postgraduate courses in the medical field so that they are Solving another chronic public health problem: the demand for specialists,” Teixeira notes.

development islands

Using an exclusive criterion to solve the problem of poor distribution of doctors in Brazil is, according to Abramibo, a contradiction. “You have physicians chasing an opportunity, and when you impose this standard that excludes 70% of segregation, you undermine the effectiveness of the program,” adds the entity’s president.

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To balance the distribution of doctors in remote areas of Brazil and increase the number of specialized professionals able to work in all regions, Abramibo advocates not only the modification of the Doctors for Brazil program, but also the regulation of the MEC. “As the highest entity that supports undergraduate and postgraduate courses, the MEC has the power to regulate postgraduate courses. After all, what many people don’t know is that a medical residency is exactly that: a postgraduate course with specific standards and rules. Today we have excellent postgraduate programs at universities very respectable, which cannot be used by doctors who want to take the test for RQE, since they are not related to AMB. While this does not change, it will be difficult for us to democratize access to doctors and good public health “, Teixeira sums up .

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