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Original research
Postgraduate education among family and community physicians in Brazil: the Trajetórias MFC project
  1. Leonardo Ferreira Fontenelle1,
  2. Stephani Vogt Rossi1,
  3. Miguel Henrique Moraes de Oliveira1,
  4. Diego José Brandão2 and
  5. Thiago Dias Sarti3
  1. 1Medical School, Universidade Vila Velha, Vila Velha, Brazil
  2. 2Commission of Medical Residency, Universidade Vila Velha, Vila Velha, Brazil
  3. 3Department of Social Medicine, Universidade Federal do Espirito Santo, Vitoria, Brazil
  1. Correspondence to Professor Leonardo Ferreira Fontenelle; leonardof{at}leonardof.med.br

Abstract

Objective Our objective was to describe the postgraduate education trajectories of family and community physicians in Brazil, where neither primary healthcare nor family and community medicine is recognised as a knowledge area for the purpose of research and postgraduate education (master’s and PhD degrees).

Design An observational, exploratory study, using administrative data. A nationwide list of family and community physicians as of late November 2018 was compiled from multiple sources. Data on the mode of specialisation was obtained from the same sources and were correlated with data on master’s and PhD degrees, obtained from the curricula vitae on the Lattes Platform.

Setting This study was set in Brazil.

Participants 6238 family and community physicians (58.3% female), of whom 2795 had earned a specialist certificate (identified from the list of physicians certified by Sociedade Brasileira de Medicina de Família e Comunidade) and 3957 had completed medical residency (identified from SisCNRM, the national information system for medical residency).

Results A master’s degree was held by 747 (12.0%) family and community physicians, and a PhD by 170 (2.7%); most degrees were in collective health (47.0% and 42%, respectively). Men were more likely than women to hold a master’s degree (adjusted odds ratio (aOR) 1.24, 95% uncertainty interval (UI) 1.07–1.45) and even more likely to a hold PhD (aOR 1.86, 95% UI 1.35–2.59). Family and community physicians were also less likely to hold a PhD degree if their master’s degree was professional (oriented towards jobs outside academia) instead of academic (aOR 0.15, 95% UI 0.05–0.39) or in some area other than collective health or medicine (aOR 0.41, 95% UI 0.21–0.78, compared with a master’s degree in collective health). The postgraduate degree was more likely to precede specialisation for family and community physicians specialising through certification (master’s degree 39.9%, PhD 33%) than through medical residency (master’s degree 9.1%, PhD 6%).

Conclusion Family and community physicians in Brazil increasingly earn academic and professional master’s and PhD degrees, with an emphasis on collective health, even though women seemingly face barriers to advance their education. The consequences of different postgraduate trajectories should be critically examined.

  • primary health care
  • physicians, family
  • community medicine
  • education
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/fmch-2020-000321

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    Footnotes

    • Twitter @doutorleonardo, @dias_sarti

    • Contributors LFF, DJB and TDS helped in study conceptualisation. LFF, SVR and MHMdO performed data curation. Formal analysis was done by LFF. Investigation was done by LFF, SVR and MHMdO. LFF, DJB and TDS discussed the methodology. LFF helped in project administration, software management and visualisation. LFF and SVR helped in writing the original draft. Writing (review and editing) was done by SVR, MHMdO, DJB and TDS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests LFF and DJB are board members of Associação Capixaba de Medicina de Família e Comunidade (ACMFC), an organisation affiliated to Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC).

    • Patient consent for publication Not required.

    • Ethics approval Research Ethics Committee of Universidade Vila Velha, report n° 3033911, certificate [CAAE] 02957118.2.0000.5064.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Because our data are personally identifiable, it will be available to other researchers presenting an ethically approved research project with an analysis plan. https://doi.org/10.5281/zenodo.3376310.