Evaluation of the rural medical internship in Family and Community Medicine at the Universidade de Caxias do Sul: reflections on medical education and health policies
DOI:
https://doi.org/10.5433/1679-0367.2022v43n1p51Keywords:
Medical education, Primary Health Care, Family practice, Rural areas, Human resources in healthAbstract
Medical education has undergone constant transformations throughout history and in Brazil it takes on specific characteristics. Recently, among other aspects, there has been debate about the importance of the variety of teaching scenarios and of an integral and generalist approach to the design of an egress profile closer to the population’s health needs. This study presents a qualitative and quantitative evaluation of the experience of medical students, professors and health professionals involved in the rural medical internship in Family and Community Medicine at the Universidade de Caxias do Sul, Rio Grande do Sul state, Brazil. Profile of participants, internship motivators, influences on work options future, impact on health teams and positive and negative aspects of the experience are presented and discussed in the light of international literature on the subject. The rural internship appears as a positive experience in medical training, with qualitative aggregating potential for those involved and influence on the future work option, helping to reduce the gap in human resources in rural areas. Dialogue between communities, health teams, universities and local managers is essential to overcome daily challenges and to maintain activities, as well as institutional support for students and qualification of the teaching staff. Suggestions for future lines of research in the area are presented.Downloads
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References
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Dubé T, Schinke R, Strasser R. It takes a community to train a future physician: social support experienced by medical students during a community-engaged longitudinal integrated clerkship. Can Med Educ J [Internet]. 2019 [citado 2021 mar 10];10(3):e5-e16. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681930/pdf/CMEJ-10-e005.pdf
Escalante-Romero L, Cueva-Chaves L, Linares Reyes E, Blossiers-Mazzini C. Experiencias de trabajo en actividades en Atención Primaria de Salud realizadas por estudiantes de medicina de Peru. Cienc Investig Méd Estud Latinoam [Internet]. 2010 [citado 2021 mar 10];15(1):14-8. Disponible en: https://www.cimel.felsocem.net/index.php/CIMEL/article/view/68/51
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Holst J, Normann O, Herrmann M. Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care. Rural Remote Health. 2015;15(4):3563. doi: https://doi.org/10.22605/RRH3563
Huicho L, Molina C, Diez-Canseco F, Lema C, Miranda JJ, Huayanay-Espinoza CA, et al. Factors behind job preferences of Peruvian medical, nursing and midwifery students: a qualitative study focused on rural deployment. Hum Resour Health. 2015;13(1):90. doi: 10.1186/s12960-015-0091-6
Kapadia RK, McGratb BM. Medical school strategies to increase recruitment of rural-oriented physicians: the Canadian experience. Can J Rural Med [Internet]. 2011 [cited 2021 Apr 0];16(1):13. Available from: https://srpc.ca/resources/Documents/CJRM/vol16n1/pg13.pdf
Lima MC, Cuadrado M, Horta TCG, Almeida M, Pinheiro A, Maia PCGGS, Melo CP, et al. Manifesto de Natal-por uma política afirmativa no recrutamento, formação, provimento, retenção e suporte para as médicas de família em contexto rural e remoto. Rev Bras Med Fam Comunidade. 2016;11(38):1-5. doi: https://doi.org/10.5712/rbmfc11(38)1247
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Mcwhinney IR, Freeman T. Manual de medicina de família e comunidad. Porto Alegre: Artes Médicas; 2010.
Millán K, Vargas C, Madrid CN. Internado rural en la carrera de medicina de la Universidad de Chile; una experiencia de aprendizaje significativo. Educ Med [Internet]. 2006 [citado 2021 mar 05]; 9(3):20-1. Disponible em: https://scielo.isciii.es/pdf/edu/v9n3/original3.pdf
Morrison T, Brown J, Bryant M, Nestel D. Benefits and challenges of multi-level learner rural general practices–an interview study with learners, staff and patients. BMC Med Educ. 2014;14 (234):1-12. doi: 10.1186/1472-6920-14-234.
O’Sullivan BG, McGrail MR, Russell D, Chambers H, Major L. A review of characteristics and outcomes of Australia’s undergraduate medical education rural immersion programs. Human Resour Health. 2018;16(1):8. doi: https://doi.org/10.1186/s12960-018-0271-2
O'flynn N, Spencer J, Jones R. Does teaching during a general practice consultation affect patient care? Br J Gen Pract [Internet]. 1999 [cited 2021 Mar 20];49(438):7-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1313309/pdf/10622008.pdf
Orzanco MG, Lovato C, Bates J, Slade S, Grand'Maison P, Vanasse A nature and nurture in the family physician's choice of practice location. Rural Remote Health. 2011;11(3):1849. doi: https://doi.org/10.22605/RRH1849
Peña S, Ramirez J, Becerra C, Carabantes J, Arteaga O. The Chilean Rural Practitioner Programme: a multidimensional strategy to attract and retain doctors in rural areas. Bull World Health Organ. 2010;88(5):371-8. doi: http://dx.doi.org/10.2471/BLT.09.072769
Pereyra-Elías R, Mayta-Tristán P, Montenegro-Idrogo JJ, Mejia CR, Abudinén AG, Azucas-Peralta R, et al. Differences on primary care labor perceptions in medical students from 11 Latin American Countries. PLoS ONE 2016;11(7):e0159147. https://doi.org/10.1371/journal.pone.0159147
Polignano MV, Melo EM, Nascimento LE, Santana AMP, Rodrigues Junior IA. Internato rural da faculdade de medicina da UFMG: 25 anos de integração docente-assistencial. Anais do 2º Congresso Brasileiro de Extensão Universitária; 2004 set 12-15; Belo Horizonte, MG, Brasil. [citado 2021 mar 10]. Disponível em: https://www.ufmg.br/congrext/Educa/Educa107.pdf
Pontillo AF, Torrealba MLV, Fuentes L. Percepción de las competencias adquiridas por los egresados de la escuela de medicina para el ejercicio como médico rural. Universidad de Carabobo, Nùcelo Valencia. Comunidad y Salud [Internet]. 2014 [citado 2021 abr 12];12(1):37-45. Disponible em: http://ve.scielo.org/pdf/cs/v12n1/art06.pdf
Price R, Spencer J, Walker J. Does the presence of medical students affect quality in general practice consultations? Med Educ. 2008;42(4):374-381. doi: 10.1111/j.1365-2923.2008.03016.x
Ramírez M. Expectativas profesionales de internos de medicina y su inclinación por la atención primaria de salud. An Fac Med [Internet]. 2008 [citado 2021 mar 10];69(3):176-81.Disponível em: http://www.scielo.org.pe/pdf/afm/v69n3/a06v69n3.pdf
Rego RM, Marques NA, Monteiro PC, Oliveira CLB, Lins NAA, Caldas CAM. O perfil atual do estudante de Medicina e sua repercussão na vivência do curso. Pará Res Med J. 2018;2(1-4):e05. doi: http://dx.doi.org/10.4322/prmj.2018.005
Royston P, Mathieson K, Leafman J, Sheehan O. Medical student characteristics predictive of intent for rural practice. Rural Remote Health. 2012;12(3):2107. doi: https://doi.org/10.22605/RRH2107
Ruiz DG, Farenzena GJ, Haeffner LSB. Internato regional e formação médica: percepção da primeira turma pós-reforma curricular. Rev Bras Educ Méd. 2010;34(1):21-7. doi: https://doi.org/10.1590/S0100-55022010000100004
Saini NK, Saini NK, Sharma R, Roy R, Verma R. What impedes working in rural areas? A study of aspiring doctors in the National Capital Region, India. Rural Remote Health. 2021;12(1):242. doi: https://doi.org/10.22605/RRH1967
Sánchez Del Hierro G, Remmen R, Hendrickx K. We need better medical undergraduate education in Ecuador. The case of perinatal mortality. Aten Primaria. 2017;49(3):195-6. doi: 10.1016/j.aprim.2015.11.009.
Scheffer M, Cassenote A, Guerra A, Guilloux AGA, Brandão APD, Miotto BA, et al. Demografia médica no Brasil 2020. São Paulo, SP: FMUSP, CFM; 2020.
Silveira RP, Pinheiro R. Internato rural na Amazônia: aspectos históricos, contexto atual e principais desafios. Hist Ciênc Saúde-Manguinhos. 2017;24(2):371-90. doi: https://doi.org/10.1590/S0104-59702017000200004
Stagg P, Prideaux D, Greenhill J, Sweet L. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health. 2012;12(1):1832. doi: https://doi.org/10.22605/RRH1832
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2022-01-13
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Targa LV, Camargo TS de. Evaluation of the rural medical internship in Family and Community Medicine at the Universidade de Caxias do Sul: reflections on medical education and health policies. Semin. Cienc. Biol. Saude [Internet]. 2022 Jan. 13 [cited 2024 Nov. 21];43(1):51-74. Available from: https://ojs.uel.br/revistas/uel/index.php/seminabio/article/view/44075
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