Reference : Practice report of a family doctor in vocational training in a Brazilian Alagoas semi...
Scientific congresses and symposiums : Poster
Human health sciences : Public health, health care sciences & services
Human health sciences : General & internal medicine
Practice report of a family doctor in vocational training in a Brazilian Alagoas semi-arid area.
Herminia, Elza [Universidad Franz Tamayo, Cochabamba, Bolivia, > Faculdad de medicina > > >]
Horita, Julia [Universidade do Estado do Rio de Janeiro, Brazil > > > >]
Jamoulle, Marc [Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques >]
du 7 au 11 novembre 2019
[en] family medicine ; general practice ; vocational training ; epidemiology of primary care
[en] Title : Practice report of a family doctor in vocational training in a Brazilian Alagoas semi-arid area.
Authors : Elza Herminia1, Julia Horita2, Marc Jamoulle3
1MD. GP in vocational training, Unidade Básica De Saúde 18, Alagoas, Brazil, 2 MD, GP, Universidade do Estado do Rio de Janeiro, Brazil 3 MD, PhD, GP, Département de médecine générale, University of Liège, Belgium
Descriptors :
• MeSH ; Health Services; Health Services Research; Inservice Training ; Physicians, Primary Care; Health Education
• Q-Codes : family doctor; vocational training; primary care setting; accessibility; patient knowledge; epidemiology of primary care; ICPC-2; Q-Codes
Introduction: In 1994 the Family Health Strategy was implanted by the Brazilian Unified Health System (SUS) as the basis of its Primary Care public service. The lack of interest of the medical professionals in working in remote areas practically drove the program to bankruptcy. Shortage of manpower led to the launch of the Mais Médicos (More Doctors Program) in 2013 based on three strategic fronts: i) new Medical Courses ii) investments in the structure of Primary Healthcare Units; iii) allocation of Brazilian and foreign doctors [1]. The first author, trained in Universidad Franz Tamayo, Cochabamba, Bolivia, after working for several years as a dentist in Brazil, is in first year vocational training in rural medicine in Teotônio Vilela, a municipality of the state of Alagoas, in northeast Brazil, in a zone of extreme poverty (level 7, WHO). Her team is formed by a nurse, two nursing assistants, three community health agents and one administrative assistant in the Primary Care Unit n°8, which covers 10 small villages. Geographical accessibility is complicated: the journey to the villages are 25 to 30 km long, which takes hours especially in the rainy season, allowing to meet 10 patients a day (20 in periods of drought). Working conditions are aggravated by the lack of basic material such as pediatric scale and basic drugs, lack of infrastructure (making it difficult to ensure confidentiality), illiteracy and poverty of the population. The team organizes sessions of health education following Paulo Freire principles [2].
Aim: To describe the vocational training activities in the Mais Médicos (More Doctors) Program
Methods: Factual observation of the contacts with the population using CIAP-2 [3] to describe the clinical activities and Q-Codes [4], a new tool to describe the non-clinical situations at stake during the patient doctor encounters and activities
Results: Data is currently being collected and it is intended to show the daily activities during two months focusing on the problems of accessibility (geographical, temporal, cultural, economic), on the variety of the problems addressed and the decisions to take.
Discussion: It will be addressed in the poster after analysis of data. The present study is also an example of international collaboration, enabling a field actor to analyze her activity [5] and feel in step with the international community of primary care researchers
1. Santos, L. M. et al. (2015) Cien Saude Colet, 20(11) .
2. Chiarella, al (2015). Rev Br Educ Méd
3. Landsberg et al. (2012) Cien Saude Colet, 17(11), 3025-3036.
4. Jamoulle, M et al.(2018). Eur J Gen Pract, 24(1), 68-73.
5. Johnston, J., et al. (2014) Rural Remote Health, 14(3), 2870.

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