On January 19th, the release of the results of the National Medical Training Assessment Exam (Enamed) brought to the fore the debate about the quality of medical teaching in Brazil and its direct impact on patient care. Only 49 faculties achieved the maximum grade, while 99 were between grades 1 and 2, which reinforces the disparities in the quality of teaching.
The evaluated 89,024 participants, including graduating students (39,256) and trained doctors (49,768). According to a survey by the National Institute of Educational Studies and Research Anísio Teixeira (Inep), only 67% of students who were completing the course achieved a performance considered proficient.
This rate is much lower than that of already trained professionals, with 75% of candidates reaching the minimum recommended by the Ministry of Education (MEC). Now, the department must implement sanctions against courses with insufficient grades, which will undergo audits and have restrictions, such as a reduction in new vacancies for entrance exams.
Among the discussions raised by these results is the process of training Brazilian doctors. “In recent years, Brazil has had a large increase in medical schools. Some have difficulty providing students with a practical learning environment in hospitals and UBS [Unidade Básica de Saúde]which leads many students to graduate without as much contact with patients”, says doctor Elda Pires, coordinator of the undergraduate course in Medicine at Faculdade Israelita de Ciências da Saúde Albert Einstein, an institution that received top marks in the assessment.
In addition to allowing this training to be reviewed, they can also serve as a starting point for the patient to make more informed choices, without reducing professional competence to a grade or the name of the diploma.
How to choose your doctor
In a scenario of unequal medical training and excess information on social networks, patients must adopt objective criteria when choosing a doctor. The first step is to check whether the professional is actively registered with the Regional Council of Medicine (CRM) and whether he or she has the title of recognized specialist, which can be confirmed through the Specialist Qualification Register (RQE), available on the Federal Council of Medicine website.
Another important point is to evaluate the doctor’s relationship with recognized health institutions, such as hospitals, clinics or structured public services, which tend to adopt more rigorous criteria for accreditation and professional updating. Experience in medical residency and working in multidisciplinary teams are also relevant indicators of practical training and continuity of care.
In addition to technical training, the quality of the consultation must be observed. A trustworthy doctor is one who listens, explains the diagnosis and treatment options, answers questions clearly and considers the patient’s clinical history when making decisions. Relationships built over time, especially with clinicians, family doctors or reference specialists, tend to favor coordination of care and reduce the risk of fragmented behaviors.
Don’t choose based on likes
The search for a healthcare professional should not be based on the number of followers or likes on social media. “The way we seek medical care has changed a lot in recent years and perhaps this is an opportunity to rethink how we establish the doctor-patient relationship”, reflects Elda Pires. “We have seen more and more social media space being occupied by incorrect and incomplete information and professionals being valued for their number of followers.”
Amid content generated by and promoted on the web in a biased manner, the population must be even more attentive. “It is necessary to avoid this distorted information and look for doctors based on reliable records, such as the RQE”, advises the professor. “Focus on professionals with recognized professional competence or recommended by doctors who already treat you.”
Furthermore, the secret to trust between doctor and patient is establishing a long-term relationship with a professional who helps find the most appropriate and individualized care. “The relationship of trust is established eye to eye. Once you have a doctor who knows you, who is linked to an institution you trust, it is much easier to receive recommendations from him for new specialists, when necessary, who will be able to carry out this care appropriately”, assesses the specialist.
