Resumo

IVON CARRERA, Larisa; TERESITA ENRIA, Graciela  e  ENRIQUE D'OTTAVIO, Alberto. Primary care and medical specialization: Complementary or mutually exclusive categories?. Educ. méd. [online]. 2004, vol.7, n.4, pp.36-43. ISSN 1575-1813.

Background and Objectives: Juan César García’s conclusions on specialization, reported in the late nineteen sixties, encouraged researchers to broaden their area of study and to investigate students’ expectations regarding the practice of primary care. Material and Methods: Qualitative and quantitative methods were used to assess the attitudes of new students, advanced undergraduates and postgraduates regarding primary care and specialization. Results and Discussion: Since the nineteen sixties, the intention to specialize has increased (from 52% to 74% in new students and from 66% to 100% in advanced undergraduates). The interest in becoming a general physician has fallen from 26% in the nineteen sixties to approximately 7% in 2001. New students are largely unattracted by primary care and only 0.5% of advanced undergraduates reported interest in this field of medicine. The inclination towards specializing thus precedes entry to medical school, and the actual choice of specialization tends to be made at the clinical stage, where the influence of specialists is particularly noticeable. The definitive choice tends to be made either during this clinical stage or after graduation. The reasons are multiple, and may change from group to group. A chaotic health care system and a debatable educational system may have an influence. Conclusions: Considering curricula as a minor influence and political decisions as major influences, we infer that an integral health care system and a compatible medical training could provide health for all in a fair framework and make primary care and medicalspecialization complementary instead of mutually exclusive, as they are presently perceived.

Palavras-chave : medical education; specialization; primary care; undergraduate; postgraduate.

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