Medical School, Universidade Vila Velha, Vila Velha, Brazil
Medical School, Universidade Vila Velha, Vila Velha, Brazil.
Fam Med Community Health. 2020 Sep;8(3). doi: 10.1136/fmch-2020-000321.
Our objective was to describe the postgraduate education trajectories of family and community physicians in Brazil, where neither primary healthcare nor family and community medicine is recognised as a knowledge area for the purpose of research and postgraduate education (master's and PhD degrees).
An observational, exploratory study, using administrative data. A nationwide list of family and community physicians as of late November 2018 was compiled from multiple sources. Data on the mode of specialisation was obtained from the same sources and were correlated with data on master's and PhD degrees, obtained from the curricula vitae on the Lattes Platform.
This study was set in Brazil.
6238 family and community physicians (58.3% female), of whom 2795 had earned a specialist certificate (identified from the list of physicians certified by Sociedade Brasileira de Medicina de Família e Comunidade) and 3957 had completed medical residency (identified from SisCNRM, the national information system for medical residency).
A master's degree was held by 747 (12.0%) family and community physicians, and a PhD by 170 (2.7%); most degrees were in collective health (47.0% and 42%, respectively). Men were more likely than women to hold a master's degree (adjusted odds ratio (aOR) 1.24, 95% uncertainty interval (UI) 1.07-1.45) and even more likely to a hold PhD (aOR 1.86, 95% UI 1.35-2.59). Family and community physicians were also less likely to hold a PhD degree if their master's degree was professional (oriented towards jobs outside academia) instead of academic (aOR 0.15, 95% UI 0.05-0.39) or in some area other than collective health or medicine (aOR 0.41, 95% UI 0.21-0.78, compared with a master's degree in collective health). The postgraduate degree was more likely to precede specialisation for family and community physicians specialising through certification (master's degree 39.9%, PhD 33%) than through medical residency (master's degree 9.1%, PhD 6%).
Family and community physicians in Brazil increasingly earn academic and professional master's and PhD degrees, with an emphasis on collective health, even though women seemingly face barriers to advance their education. The consequences of different postgraduate trajectories should be critically examined.
本研究旨在描述巴西家庭和社区医生的研究生教育轨迹，在巴西，无论是初级保健还是家庭和社区医学都未被视为研究和研究生教育（硕士和博士学位）的知识领域。
本研究为观察性、探索性研究，使用行政数据。从多个来源汇编了截至 2018 年 11 月底的家庭和社区医生全国名单。从同一来源获得有关专业资格认证模式的数据，并将其与从 Lattes 平台上的简历中获得的硕士和博士学位数据相关联。
本研究在巴西进行。
6238 名家庭和社区医生（58.3%为女性），其中 2795 人获得了专科证书（从巴西家庭和社区医学学会认证的医生名单中确定），3957 人完成了住院医师培训（从 SisCNRM，国家住院医师培训信息系统中确定）。
747 名（12.0%）家庭和社区医生获得了硕士学位，170 名（2.7%）获得了博士学位；大多数学位都与集体卫生相关（分别为 47.0%和 42.0%）。男性获得硕士学位的可能性高于女性（调整后的优势比（aOR）为 1.24，95%置信区间（UI）为 1.07-1.45），获得博士学位的可能性甚至更高（aOR 为 1.86，95% UI 为 1.35-2.59）。如果家庭和社区医生的硕士学位是专业（面向学术界以外的工作）而不是学术（aOR 0.15，95% UI 0.05-0.39）或集体卫生以外的其他领域（aOR 0.41，95% UI 0.21-0.78，与集体卫生硕士学位相比），则获得博士学位的可能性也较小。对于通过认证（硕士学位 39.9%，博士学位 33%）而不是住院医师培训（硕士学位 9.1%，博士学位 6%）成为专科医生的家庭和社区医生，研究生学位更有可能先于专科。
尽管女性在接受教育方面似乎面临障碍，但巴西的家庭和社区医生越来越多地获得学术和专业的硕士和博士学位，重点是集体卫生。应该批判性地检查不同研究生轨迹的后果。
