Fight for medical course has 1 decision per day – 08/16/2023 – Education

The MEC (Ministry of Education) had to comply, between March and early August, with one court decision per day amid the rush of private teaching companies for injunctions seeking to open medical courses.

The folder registers 335 requests in progress due to injunctions obtained by companies. These processes represent a demand for 57,743 new vacancies. If implemented, the number would more than double the size of the private education network in the area.

Private higher education companies have a strong interest in opening these courses. These 335 ongoing processes represent an estimated market of R$ 67 billion, according to reports collected from consultants in the sector.

A medical course with 100 places is worth around R$ 200 million, taking into account recent negotiations. High monthly fees (the average in the country is R$9,000) and excellent student retention rates leverage market values.

The Lula government (PT) informed the total of these processes to the Sheet after a week of refusal. MEC’s ​​Seres (Secretary for Regulation and Supervision of Higher Education) is responsible for this work.

The folder commanded by Camilo Santana did not inform, on the other hand, how many of these processes are in the initial document analysis phase. Proceedings at this stage must be interrupted, according to a recent decision by Minister Gilmar Mendes, of the STF (Federal Supreme Court).

There is still no clarity on the part of the government about how to interpret the decision and, therefore, how many of these processes should be interrupted to follow the Supreme Court’s determination.

The position of the STF minister comes amid a flood of court decisions to guarantee companies that proposals for new medical courses move forward in the MEC. Until March, there were 223 processes. That number rose to 335 by August 7, the date of the STF decision. Which means almost one order per day in the period.

The private sector currently has 223 medical courses. There are 41,723 vacancies, according to data from 2021 (the most recent).

MEC also received injunctions to expand vacancies in existing graduations. In March, there were 22 court cases requesting the expansion of 2,406 vacancies. This framework reached, in August, 34 requests from 2,584 vacancies.

Gilmar determined that new requests for courses must follow the rules of Mais Médicos, 2013, in the model of public calls. Even lawsuits that have already gone through the initial analysis will only continue if they meet the program’s rules, such as the social need for the course for the city.

The Lula government published an ordinance in April, resuming the calling model. However, it has not yet released the edicts. This should happen by September.

Public calls define, for example, criteria such as infrastructure and locations to, in theory, meet the lack of doctors in certain situations. This system was interrupted in 2018, the last year of the Michel Temer (MDB) government, when there was a five-year interruption for the opening of new courses.

During this period of delay, the explosion of judicial decisions began, which forced the MEC to continue with the course opening procedures. Law firms began to specialize in getting these injunctions.

The preliminary injunctions do not guarantee the automatic opening of the course, but rather that the MEC will carry out the process – like the rules that apply to any degree. In addition to the ongoing processes, the folder has already authorized, until March, 11 courses whose processing began after a court order.

The government says it will comply with the court ruling, but is unsure of the correct interpretation. “The MEC awaits to be notified of the decision and the AGU’s opinion of enforceable force [Advocacia-Geral da União]with due interpretation as to the best form of compliance”, says a note.

Questioned, the AGU did not respond to the report.

The dispute taken to the STF deals with the maintenance of the Mais Médicos calling model, arguing for its constitutionality — which was accepted by Gilmar. The fight in court put entities representing private institutions of higher education on opposite sides.

Anup (National Association of Private Universities) defends the continuation of the appeals in court. As for the Crub (Council of Rectors of Brazilian Universities), that the opening is not restricted to calls and that there is also the possibility through the traditional protocol of the MEC.

There is a debate about the size of the need to have more doctors in Brazil, which also involves discussions about the quality of courses, efforts for a better distribution of professionals in the country and the freedom of companies to expand the offer. This involves government, medical entities, specialists, businessmen and politicians.

In January 2023, Brazil had 562,229 physicians, which corresponds to the national rate of 2.6 physicians per 1,000 inhabitants. The data are from the study Medical Demography in Brazil, coordinated by USP (University of São Paulo).

This index equates the country to developed nations. But such a rate camouflages regional inequalities: in Pará, for example, the ratio is 1.18 physicians per 1,000 inhabitants.

According to Professor Mario Scheffer, from the USP Faculty of Medicine and responsible for Medical Demography in Brazil, it is now important to assess the quality of graduations and analyze the real need for new physicians.

Scheffer says he agrees with the public call model. He points out, however, that there is still a lack of analysis of the policy’s potential to ensure better distribution of trained physicians.

“Today there is pressure coming from the strength of the private sector, with large companies that see in medical courses the goose that lays the golden eggs, and also from parliamentarians and mayors. Our expectation is that the government stipulates more rigorous criteria”, he says, which emphasizes the need for a connection with the offer of specialties, such as residency.