Medical entities criticize the return of Mais Médicos – 03/21/2023 – Health

Entities representing the medical profession criticized the federal government’s announcement of the return of the Mais Médicos program. According to these institutions, it is essential that doctors trained outside Brazil have their skills revalidated in the country – at Mais Médicos, this is not a requirement.

The subject returned to the discussion this Monday (20th), when the Lula government announced the opening of 15,000 vacancies through the program. In total, in 2023 alone, R$ 712 million will be invested.

The program was created in 2013, during the first term of Dilma Rousseff (PT), but was abandoned during the government of Jair Bolsonaro (PL) due to budget deficiencies. At the moment, there are about 13 thousand doctors who work in the program. With the new hires expected, the total should jump to 28 thousand.

With the resumption, according to the Ministry of Health, 96 million Brazilians will be guaranteed medical care in primary care, the gateway to the SUS. The return of the program has some changes to increase the permanence of doctors in the locations where they are allocated.

The initiative, however, is criticized by medical organizations. For the president of AMB (Brazilian Medical Association), César Eduardo Fernandes, Mais Médicos has problems in its formulation. He says that in some locations it is difficult to provide for medical needs. However, hiring professionals without Brazilian registrations would not be the right solution.

“We understand that any solution for the provision of physicians […] it must be done with physicians who are registered with their respective state medical councils”, says Fernandes. In the case of Mais Médicos, it is not necessary to revalidate a medical diploma issued by an international institution in Brazil.

“We want to contribute, we just can’t give shelter to the solution of bringing doctors without the necessary proof of their skills”, he continues.

The president of the AMB also says that there are other alternatives to overcome the problem of fixing doctors in remote locations without adopting professionals who do not have proof of their skills in Brazil.

One case would be to design medical residency programs that place residents, along with their advisors, in locations that face a greater lack of health services. By doing this, continues Fernandes, it would be possible to provide quality medical services to these regions while collaborating with the training of doctors in Brazil.

The CFM (Conselho Federal de Medicina) was another body that criticized the program, especially with regard to the lack of requirements for revalidation of the diploma. “Professional allocation programs in difficult-to-hire areas must observe this legal requirement to reduce the risks of exposure of the population to people with inconsistent training,” he said in a note.

The entity assumes that there are impasses to allocate doctors in certain locations, but that the improvement in the distribution of professionals “depends on offering adequate remuneration, continuing education programs and infrastructure for care […] and the possibility of functional progression”.

Health Minister Nísia Trindade said she was already aware of the criticism. “We have had an intense dialogue with the entities that represent doctors, such as the AMB and, in fact, the big point is doctors without registration in Brazil.”

For Ricardo Dantas, a researcher at Fiocruz’s Institute of Communication and Health Information (Icict), Mais Médicos had a positive impact on public health in remote locations in Brazil. Dantas says this based on his participation in a survey on the effects of the program between 2013 and 2017.

The conclusion of the study was that the initiative led to the improvement of different health indicators, such as a reduction in mortality and improvement in prenatal care. “For many places in Brazil outside, especially small and remote municipalities, it was the first time they had access to care, with a doctor present and available”, he says.

Dantas also states that the program provided the improvement of other health fronts, such as the provision of nurses and equipment. “I understand the program as successful in providing access to physicians and other professionals”, he concludes.