PHYSICIANS ON PRIMARY HEATH CARE IN BRAZIL A STUDY OF RELATIONS BETWEEN MEDICAL TRAINING AND THE PRACTICE OF CARE

This paper discuss how Primary Health Care (PHC) pratices links to training of physicians in Rio de Janeiro, Brazil. Medical education has direct implications for patient care and it points to needs for medical training. In process to organization of this health system based on PHC, Brazil, has faced numerous challenges. Suffers from a deficit of health professionals compared to other countries with universal health care systems and it is worse on PHC. Given this situation, provision policies have been articulated, proposed and funded by the Brazilian Goverment, in an attempt to meet the demands of increasing access to health care. Among these policies, the Programa de Valorização da Atenção Básica (PROVAB) stands out and is the focus of this study. It aims analyze and discuss the relationship between training and care practices and wonder whether the proposed changes to the current training model have an impact on care practices. The field work consisted of the application of 48 questionnaires and 05 semistructured interviews with physicians who were ending their period in the PROVAB. Questionnaires and interviews covered the experiences regarding medical practice in PHC, the face-to-face supervision, the participation in Distance education program, their thoughts about care and the primary health care tools. The research concluded that the PROVAB sensitizes those who participate in it, however, unprotected and almost solitary exposure of such inexperienced doctors to so complex contexts has limitations and may produce adverse effects. And the program supervision plays a central role in this process.