Study Warns That Expansion of Distance Medical Courses Could Undermine Specialist Training in Brazil
The Faculty of Medicine (FM) of the University of São Paulo, in conjunction with the Brazilian Medical Association, recently released the preliminary results of the study Medical Demography in Brazil , which provides unprecedented surveys on the supply of medical specialization courses in Brazil. According to the results, approximately 41.2% of these courses are offered in the distance learning format, while 11.1% operate in a blended format, which raised an alert about the consequences of these formats on the training of specialist doctors.
The survey analyzed 2,148 specialization courses in medicine, offered by 373 institutions in Brazil, revealing a significant growth in the supply of this type of education. According to Mário Scheffer, professor of the Department of Preventive Medicine at FMUSP and coordinator of the study, these are lato sensu postgraduate courses , a type of education aimed at professional development and improvement, but with little regulation, since there is no authorization for recognition by the MEC or any other government agency.
“In medicine, according to our legislation, there are only two ways to obtain a medical specialty title: completing a medical residency program, the most appropriate way to become a medical specialist, or obtaining a title from a medical specialty society affiliated with the Brazilian Medical Association. What we are studying are specialization courses that do not give the doctor the right to present themselves as a specialist,” he adds.
Distance medical education
Scheffer emphasizes that the phenomenon of growth in the supply of these courses is directly linked to the growth of the private medical education sector. While Brazil graduates around 46 thousand new doctors annually, there is a significant gap in the number of medical residency vacancies, with only 15 thousand to 16 thousand vacancies available for the first year of residency, considered the most appropriate method for training specialists.
For him, there is an inability to expand medical residency at the same speed and proportion as the opening of new courses. “As a result, this market is growing. Today, more than 200,000 doctors in Brazil do not have a specialist degree, so they become a potential target audience for this type of lato sensu postgraduate course ,” he explains.
One of the most worrying points, however, is the high proportion of courses offered online. Scheffer emphasizes that, for many medical specialties, this modality is not suitable, since face-to-face practice is essential for the development of technical skills. “It would require face-to-face training, with practical fieldwork, with practical content, so this is a problem that we have identified,” said the professor.
Other points
The lack of adequate regulation is another point highlighted in the study. Scheffer warns that, while some renowned institutions, such as USP itself, offer excellent courses, other institutions lack infrastructure and qualified faculty. Thus, many of these courses are offered by institutions without experience or proven capacity to train specialists, generating a heterogeneous and, in many cases, low-quality offering.
Another problem identified by the study is the disconnect between the 390 medical courses in Brazil and the real demands of the Unified Health System (SUS). The professor points out that many of the courses offered are aimed at the private market, while public medical care faces huge queues for consultations, exams and specialized surgeries.
Changes for the future
Given this scenario, Scheffer advocates a review of the regulations for lato sensu medical specialization courses , suggesting that civil society entities and experts, such as the Brazilian Medical Association, be involved in a more comprehensive evaluation process for these courses. “They need to have minimum quality standards, with a well-trained faculty, infrastructure and a pedagogical project,” he highlights.
On this subject, he concludes: “Brazil needs specialist doctors, and will need them even more in the future, due to the aging population and to try to solve, for example, the waiting lists and medical specialties. There will be a need to certify these lato sensu postgraduate courses , which requires reviewing the responsibilities that are currently the responsibility of the MEC and, on the part of the University, continuing with research. We need to produce more and more knowledge, not only by recommending regulations, but also by evaluating the quality of the supply. The ultimate goal of a public university is to bring scientific knowledge, in this case, closer to the best medical training, the priorities of the SUS and the health needs of the population.”