Abstract
Abstract: Introduction: The number of medical schools in Brazil, as well as the number of vacancies offered at these schools, has grown considerably in the last few years. Since 2013, this increasehas aimedat reaching especially the rural and underserved areas of the country. Objective: Considering that there are many different interests concerning this debate and that this reality directly influences the education and health policies of the country, the aim of this study was to evaluate the number and the distribution of the medical courses,as well as vacancies in these schools in 2020, presenting an updated overview of the Brazilian medical schools. Methods: This was a cross-sectional study, based on data gathered from the Brazilian Ministry ofEducation and Institute of Geography and Statistics (IBGE) website. The utilized variables were the number of courses, number of vacancies offered in each course, characteristics of the cities where the medical schools are located, such as population size, Human Development Index (HDI) and distance to the capital city of each state. Results: Among the institutions that have already initiated their activities, there are 328 active courses, offering 35.480 vacancies for Medical School applicants. There is a difference when analyzing public or private institutions and paid or tuition-free institutions. There is a greater offer of paid courses (74,1%) and of courses located in the countryside (69,8%). Among the courses in the countryside, 27,8% of the vacancies are offered within 100 km of the capital city. Only 7,9% of the annual vacancies are offered in cities with a medium HDI, and the remainder are offered in cities with high or very high HDI. The increase in HDI is related to the higher proportion of private courses offering medical vacancies. It was observed that there is no correspondence between the absolute number of vacancies and the population of the North region, differentfrom what occurs in the other regions of the country. Conclusions: Medical training is under many influences, such as economic and political trends. This discussion needs to consider the regionalization and democratization of access. It was observed that public institutions tend to be located in municipalities that are farther away from the capitals. Even though there is now greater homogeneity between the regions, the Southeast still concentrates almost half of the vacancies in medical courses. Also, the increase in the number of vacancies in private courses brings up the reflection about the socioeconomic profile of medical students who have the opportunity to gain access to this level of education.
Highlights
The number of medical schools in Brazil, as well as the number of vacancies offered at these schools, has grown considerably in the last few years
The increase in the number of vacancies in private courses brings up the reflection about the socioeconomic profile of medical students who have the opportunity to gain access to this level of education
A 2015 study that evaluates the implementation of the PMM, one of the main factors that influenced the most recent changes in the number of medical courses and vacancies, pointed out that the process of shifting the location of medical schools towards the countryside had enough power to invert the absolute number of vacancies in the capitals and in the countryside[4]
Summary
The number of medical schools in Brazil, as well as the number of vacancies offered at these schools, has grown considerably in the last few years. The current distribution of medical schools in Brazil reflects the relatively recent public policies aimed at improving national health indicators[1]. The 1960s were characterized by the creation of 35 medical schools This increase progressed to the point that 113 schools were created at the end of the last century[4]. This expansion was more intense in the first decades of the new century, since, in the last 20 years, the number of schools almost tripled[5]. At the end of 2010, there were 179 medical courses[5], reaching a total of 351 medical courses and 37,221 authorized vacancies in 2020
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