Análise das escolhas de especialidades médicas no Ceará sob o olhar da psicologia sócio-histórica

Abstract

The medical residency (MR) in Brazil, established by Decree No. 80,281, of September 5, 1977, Federal Law No. 6,932, of July 7, 1981, constitutes a lato-sensu postgraduate course aimed at doctors aiming to improve their professional performance and facilitate insertion into the job market. Admission to RM takes place through a selection process approved by the National Medical Residency Commission (CNRM). Currently, unified selections are allowed in the States, covering all medical residency vacancies at their educational institutions. In Ceará, on December 13, 2011, SURCE – Unified Selection for the Medical Residency of the State of Ceará was established, under the coordination of the Federal University of Ceará, aiming to optimize the selection process, reducing waste and unused vacancies in residences in the entire State. After ten years of unified selection for the Ceará Medical Residency Program (PRM/CE), this comparative study has as its main objective to analyze the choices for medical specialties in Ceará from the perspective of socio-historical psychology in two historical moments, the years from 2012 and 2018, comprising a six-year period of the unified selection. This research uses a secondary base, having as its main database and information the study carried out in RIBEIRO's doctoral thesis (2020), as well as articles from a bibliographic review carried out from April to May 2023 from the platforms PubMed and SciELO. For analysis, this research uses the quantitative method with due statistical treatment on the data presented in the thesis (RIBEIRO, 2020) only from the years 2012 and 2018, as well as qualitative analysis of the information found throughout the bibliographic review on the profile of the choices of medical specialties, based on the fundamental categories of socio-historical psychology. It was found in the comparison of the two periods of unified selection of the PRM/CE that there is strong evidence of the feminization and elitization of medicine in the State, as well as there is also significant evidence of the use of the bonus from the Basic Care Professional Valorization Program for insertion in training in medical specialties focused on secondary and tertiary care. Evidence of a greater fixation of doctors in their place of origin and the importance of Federal Universities for the insertion of doctors in postgraduate studies were also relevant in this period. There are also indications that by working on awareness processes from the beginning to the end of medical training, including postgraduate studies, much of the market reality and health care may undergo significant changes. It is inferred that in the reality of medical education, where technique and scientific knowledge are predominant, all choices in training and professional performance are mediated by affections that need to be identified and considered in the training process. It is concluded that it is possible to improve the educational processes of medical residency in the State by introducing psychological strategies. It is suggested the introduction of transversal contents and practices contemplating the development of the higher psychic structures Identity, Consciousness and Affectivity during medical training, to this end, it will be necessary to diagnose feelings and emotions through affective maps and, mainly, the use of Paulo Freire's Liberating Education as a strategy to be adapted to the PRM/CE, aiming for progress in collective health. Following the terms of law no. 12,527 (11/18/2011) and resolution no. 510/2016-CNS, being a search with public databases and/or bases whose information is aggregated, without the possibility of individual identification, does not apply to the evaluation of the Research Ethics Board.