Brazil reached the end of 2023 with 564,363 qualified doctors, representing 2.7 professionals per thousand inhabitants. This year, it should reach the mark of almost 600 thousand in a population of 205 million people. Professor Mário Scheffer, from the Faculty of Medicine (FM) of the University of São Paulo, comments on the subject.
“Next year, the country will reach this mark of three doctors per inhabitant, surpassing countries such as the United States, Japan and China”, says the professor. Despite the positive mark, he raises reservations: “This could be an opportunity for the health system, but it also raises some warning signs, mainly in relation to the lack of planning”.
Estimates for 2035 are that there will be more than 1 million doctors in Brazil, almost five doctors per thousand inhabitants. With such a large and accelerated expansion, according to the expert, “Brazil needs to get busy discussing these doctors in the health system”. For him, the growth of the medical field needs to be considered so that benefits are optimized and problems minimized.
One of the issues raised, for example, is the distribution of professionals in public and private systems. “The increase in the number of doctors has led to a greater concentration of these professionals in private health services, which do not serve patients in the Unified Health System (SUS)”, points out Scheffer.
This issue also implies avoiding the excessive concentration of doctors in large urban centers, which is what tends to happen. “Policies need to think twice about how to better distribute professionals and promote greater participation of doctors in municipalities that are currently devoid of these professionals”, he adds.
Suitable qualification
A second issue addressed by the professor is ensuring that trained doctors are good and meet the needs of the population. “The mark is 400 medical courses. This means that around 45 thousand doctors will graduate every year in Brazil and we only have around 20 thousand residency vacancies today”, comments Scheffer. Residency is required for medical specialization.
To exemplify the problem, the professor comments: “There is a shortage of anesthesiologists in several services, mainly public services. Mental health care, which is today a major public health problem, and there is also a lack of psychiatrists in many networks”.
With the expansion of medical courses (almost 400 existing), the government authorized the opening of 95 more. For Scheffer, this increase must be regulated and subject to quality criteria: “In courses over the last ten years, more than 80% of these vacancies are in private institutions that need to be monitored regarding the adequate existence of fields of practice for qualified teaching staff. And the way this will be evaluated needs to be discussed.”
He states that, for example, the creation of a regulatory agency for medical education is being evaluated. Proposals such as a terminal assessment at the end of the six-year course or a college accreditation system are under debate.