A prática da Medicina de Família e Comunidade no Brasil: contexto e perspectivas

Abstract

This article aims to demonstrate the development of Family and Community Medicine (MFC) which in Brazil began in a pioneering way in the 1970s (pre-SUS), with residency programs in MFC in Rio Grande do Sul, Rio de Janeiro and Pernambuco. During that period, managers and even the academic world had little support for these initiatives, which later made it difficult to implement, from 1994 onwards, the Family Health Program (PSF) in a robust manner, due to the lack of professionals with this training. In recent decades, we have lived with low harmony between training institutions and the SUS, regarding the need and supply of professionals for PHC. Thus, the operationalization of the Health Reform, especially PHC, lasted longer than in countries with health systems oriented towards this (Canada, Cuba, Spain, Portugal). In these countries, in the 1980s and 1990s, specialized medical training for PHC was regulated (medical residency defined as the gold standard of training), minimum percentages were established for MFC and residency was mandatory for incorporation into the health system. . In Brazil, one of the obstacles to this international movement came from the medical schools themselves which, until recently, insisted on an alleged terminality in graduation.