Was there a change in perception of medical students of what good doctors are and what it would take to train them across a 14-year span? A mixed methods panel

Abstract

Background Although overall cultural differences exist between individuals from the X and Y generations, to our knowledge few previous studies have contrasted their expectations regarding what good doctors are, and their perceptions on the training processes they undergo. Aims To conduct a study exploring perceptions on what good doctors are and their perceptions about training among a sample of Brazilian medical students at the University of Sao Paulo Medical School, comparing groups from 2000 and 2014. We aimed to provide information that can be used to guide curriculum development in medical schools. Methods We conducted a mixed methods study of a series of open questions asked to medical students from the University of São Paulo, Brazil, in 2000 and 2014. This qualitative analysis focused on uncovering emerging themes related to students’ perceptions regarding what good doctors are and how they see their training process. A subsequent quantitative analysis through Natural Language Processing was undertaken. Results Gender distribution was balanced between the 2000 and 2014 groups, with most students being in the early 20s. Our main emerging concepts involved four themes: Skills and qualities of a good doctor, positive and negative aspects of the curriculum, as well as expectations related to students’ future career. From a qualitative perspective, the 2014 group focused their criticisms on the School of Medicine itself and the study overload, while the 2000 group focused its criticism on the faculty and competition. Therefore, the 2014 group experienced more criticism and less idealization in relation to the School and the medical training process. There were no statistically significant differences between the 2000 and 2014 groups, as well as across genders. Discussion Students in this sample have demonstrated little change over time in relation to their characterization of what good doctors are and how they should be trained. Their preferences for a practical, patient-centered education should guide future curriculum development in medical schools.

Ser médico no Brasil na concepção de graduandos de Medicina

“…O efeito da "pejotização" dos médicos no sistema privado de saúde e a perda de direitos trabalhistas como registro em carteira de trabalho, férias remuneradas, FGTS (Fundo de Garantia do Tempo de Serviço) e 13º salário são percebidos desde os ciclos iniciais do curso médico e, principalmente, pelos formandos. A insuficiência de recursos e a dificuldade de integração entre os serviços se afiguram como fatores de insegurança para o exercício profissional, além da sensação de despreparo técnico-científico e psicológico (Maeno, 2011;Jannuzzi, 2013;Albuquerque et al, 2017;Lewin et al, 2019;Wahba & Lotufo, 2018).…”

“…Instituições com modelos de ensino baseados em metodologias ativas parecem oferecer um ambiente que propicia maior motivação, menores fontes de estresse e menor sofrimento psíquico. Oferecem, ademais, uma maior aproximação entre o professor e o estudante, o que é relatado como benéfico para ambos, corpo docente e corpo discente (Frenk at al., 2010;Wahba & Lotufo, 2018;Tenorio et al, 2016).…”

“…Diversos empregadores, constituídos nos serviços hospitalares privados, com o intuito de fraudar o contrato de emprego, exigem do profissional a constituição de pessoa jurídica para a contratação e fragilizam a proteção laboral conferida ao trabalhador (Maeno, 2011; Jannuzzi, 2013). Esse movimento provocou uma grande perda de direitos trabalhistas dos médicos do sistema privado e aumento de custo junto aos conselhos de classe pela exigência de pagamento de anuidades como pessoa física e como pessoa jurídica, causando grandes tensões entre os médicos, os conselhos que os representam e os sistemas de saúde privados (Maeno, 2011;Jannuzzi, 2013;Lewin et al, 2019;Wahba & Lotufo, 2018).…”