Surgical Education in Brazil

Abstract

The surgical residency was implemented in Brazil in 1944. Gradually, several programs were created under the auspices of the National Committee of Medical Residency (Comissão Nacional de Residência). A candidate for a residency program is submitted to a selection process in various institutions. One of the greatest obstacles to medical education in Brazil is that the number of graduate students is much larger than the number of available vacancies. As a consequence, they end up looking for other alternatives to their professional training, and these cannot offer the same results as a formal residency. Regarding the current residency program in surgery, Brazil has roughly 200 general surgery programs, which offer 1,040 vacancies yearly. The surgical residency program lasts 2 years with rotation in various surgical specialties, which is a requirement for the following years in specific specialties. The 1,040 who are enrolled in the first 2 years of a residency in surgery take a new examination to continue their training. Here, there are only 573 vacancies; therefore, 45% of the newly trained surgeons start a practice or become apprentices. The 573 residents who move on to further education then pass 2 years in basic general surgery at an institution and continue in the same or are transferred to another department. The next training period should be 2 or 3 years, depending on the specialty. The General Surgery program lasts 4 years: two initial basic years and two more years of training in elective, emergency, and trauma surgery and intensive care. The objective is to become competent in the diagnosis and treatment of the most common diseases that affect the community. Medical entities in specialties have their own selection process to grant the title of specialist. The Brazilian College of Surgeons (Colégio Brasileiro de Cirurgiões) is responsible for granting the title "general surgeon," following the model of the American Board of Surgery.