EDUCATION-BRAZIL: Poorly Trained Professionals Glut the Market

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Oct 20 1999 (IPS) - Brazil is a paradox when it comes to medicine. The population lacks access to health services and thousands of people die every year from malaria, diarrhea, tuberculosis, measles and other preventable diseases, but there is an excess of doctors: one for every 673 inhabitants.

Doctors are rebelling this week in Brazil against the growing number of medical schools and the corresponding increase in inadequately prepared physicians, while attorneys continue protests for similar reasons in their field.

With the slogan “New medical schools are a health hazard,” Sao Paulo’s Regional Medical Council and Union of Physicians launched a campaign against the rising number of poorly trained students and called for medical school reforms.

The World Health Organisation considers one physician for every 1,000 people a satisfactory ratio. In European countries, where medical services are practically a model of perfection, there is less than half the number of physicians per capita than in Brazil.

Doctors are concentrated in Brazil’s most developed states. Rio de Janeiro has one physician for every 473 inhabitants and Sao Paulo reports one for every 479. Meanwhile, the smaller cities of the country’s interior and poorer regions, like the north and northeast, do not have enough doctors.

Some 8,000 physicians graduate each year from Brazil’s medical schools. Too many, says Pedro Roque Monteleone, president of the Medical Council of Sao Paulo. But the number of medical schools keeps rising.

An estimated 20 to 30 percent of doctors are unable to complete their period of residency, meaning they do not finish their practical training in a hospital – and they become health risks, argues Monteleone.

The Council, an official regulatory body, has seen the consequences. Last year it received 55 percent more complaints for medical malpractice than in 1993.

The alarm caused by “irresponsible” growth of professional schools was issued earlier by Reginaldo de Castro, president of the Attorneys’ Association of Brazil (OAB). Law schools are “deforming” most of their students, he accused.

Brazil has 370 law schools with a total of approximately 300,000 students, most studying at privately run institutions.

But in the field of law, where distorted numbers have a longer history, graduates have to take an OAB exam in order to practice the profession. A large portion of graduates do not pass this exam.

The poor quality of legal education can also be seen in the hiring process for court judges: the Judiciary has never been able to fill all available judgeships. Brazilian justice is hobbled by a chronic lack of judges, with one for every 26,000 inhabitants, compared with one for every 3,000 in Germany.

The excess of attorneys in Brazil means that, of the total 450,000 in the country, only half make their living exclusively from practicing law. The rest work in other areas.

Doctors face a similar situation because most insist on living in Brazil’s larger cities. Low pay often forces them to work several jobs. As a result, they are the professional group with the highest rates of stress, cardiac problems and drug-addiction.

Despite market saturation, medical schools are many students’ first choice in the selection exams of most universities. At the State University of Rio de Janeiro (UERJ) there were 63 medical school applicants for each space available this year.

Young people’s idealism and immaturity, their solidarity with those in need and the search for prestige explain the choice, says Humberto Peixoto, director of UERJ’s School of Medical Sciences.

Despite all the obstacles, medicine is the only profession that ensures stable, permanent work and where there is no unemployment, explained Daniel da Gama Chaves, a doctor who graduated three years ago, completed his residency and began his career in Rio de Janeiro.