Educação médica brasileira em evidência: uma análise dos avanços e insuficiências a partir das Diretrizes Curriculares Nacionais.

Abstract

Discussions on how medical training is thought and organized, combined with profound changes in the world of health work, broadened the past three decades, marked by the establishment of the Unified Health System (SUS), the National Curriculum Guidelines (DCN) in 2001 and recent changes in education and health policies, through the More Doctors law. It is noted in this regard that it is essential to evaluate the course of the Brazilian medical education. This research has the general objective to investigate what progress and shortcomings in the process of curriculum reform, are found in Brazilian medical schools, during the last fifteen years, after the DCN 2001 and the specific objectives of investigating the impact of curriculum reform on the teaching-service-community integration and teacher development. A literature review of the integrative type was performed. It was adopted as a research source, the database found in the Virtual Health Library (BVS): LILACS (Latin American and Caribbean Health Sciences). The selection of the researches took place through the readings of the titles, abstracts and full texts, and 15 papers were selected at the end. After the DCN, medical schools have introduced changes in their political-pedagogical projects to train professionals focused on the needs of the population and the SUS. In this sense, studies show it is essential to encourage the teaching-service-community integration, especially with the longitudinal integration of students in diverse scenarios, with emphasis on Primary Health Care and teacher involvement. The inducing policies created during the 2000s produced changes in the list of courses with the health system and the community, but they represent limited experience in relation to its scope in all the schools and the power of influence on the graduate's profile. On teaching, studies indicate the important role of teachers in implementing the curriculum changes. The studies highlight the failure on the pedagogical training and managerial training process as barriers, considering the importance of these skills to print changes in vocational training. Therefore, it is evident that the DCN have caused changes, but a real transformation is still far. Thus, it is necessary to reframe the education and to promote their integration with the health system, for only then, medical training will fulfill their social role.