Abstract
Training for specialist physicians in Brazil can take place in different ways. Closer liaison between institutions providing this training and assessment and health care services may improve qualifications. This article analyzes the impact of closer links and joint work by teams from the National Medical Residency Committee (Comissão Nacional de Residência Médica, CNRM) and the Brazilian Society of Neurosurgery (Sociedade Brasileira de Neurocirurgia, SBN) towards evaluating these programs. Retrospective and prospective study, conducted in a public university on a pilot project developed between CNRM and SBN for joint assessment of training programs across Brazil. The literature in the most relevant databases was reviewed. Documents and legislation produced by official government bodies were evaluated. Training locations were visited. Reports produced about residency programs were analyzed. Only 26% of the programs were immediately approved. The joint assessments found problems relating to teaching and to functioning of clinical service in 35% of the programs. The distribution of programs in this country has a strong relationship with the Human Development Index (HDI) of the regions and is very similar to the distribution of specialists. Closer collaboration between the SBN and CNRM had a positive impact on assessment of neurosurgery medical residency across the country. The low rates of direct approval have produced modifications and improvements to the quality of teaching and care (services). Closer links between the CNRM and other medical specialties have the capability to positively change the structure and function of specialty training in Brazil.
Highlights
The world is currently facing a lack and poor distribution of healthcare professionals.[1]
Focusing on the quality of neurosurgical residency, a single assessment instrument was developed by the Comissão Nacional de Residência Médica (CNRM) and Sociedade Brasileira de Neurocirurgia (SBN) in relation to the supervised in-service educational process, which aimed to investigate the following factors: infrastructure and characteristics of the institution; educational program; care profile; staff qualifications; whether the staff worked exclusively for the institution in question; clinical demands; and development of medical residents
We evaluated all the assessments that were made and all the opinions issued by the CNRM technical council, and attempted to check their impact on the recent history of each program and the consequences for the healthcare provided at the institution and for medical education decisions
Summary
The world is currently facing a lack and poor distribution of healthcare professionals.[1] Many institutions and official bodies around the world have been studying and planning workforce supply and strategies, such as the European Union’s Joint Action on Health Workforce Planning and Forecasting,[2] Australian Medical Advisory Committee,[3] Netherlands Advisory Committee on Medical Manpower Planning, Belgian Health Workforce Planning Unit, International Medical Workforce Collaborative and others. The task of determining the distribution, specialist types, quantity and quality of healthcare professionals has been started around the world, in order to plan the future healthcare workforce.[4,5,6]. The time span from the beginning of medical school until entering the labor market may be more than 12 years.[7] Understanding the specialization processes and distribution of medical specialists seems to be essential for good workforce planning
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