Offer and occupation of residency positions in family and community medicine in Brazil, 2020

Abstract

Introduction: Idle positions are a growing problem, undermining the effectiveness of the expansion of the residency in family and community medicine in Brazil, an expansion that has intensified over the last ten years. It is unknown to what extent the idle positions are being effectively offered by residency programs. Objective: To describe the offer and occupation of positions in family and community medicine residency programs in Brazil, seeking to estimate to what extent the non-offering of positions explains their idleness. Methods: Data were obtained from the Brazilian Society of Family and Community Medicine (SBMFC) from a survey on residency programs in 2020, including the number of first-year (R1) positions offered and occupied. Supervisors of residency programs were asked about the number of R1 positions authorized for the same year, and publicly available government data were consulted. The offer and occupation of residency positions were described according to the location of the residency program, the legal nature of the proposing institutions, and the supplementation of the residents’ grant. Results: Of the 72 programs that responded to the SBMFC survey, 28 informed us the number of authorized positions. The latter totaled 506 authorized positions, of which 417 (82%) had been offered. The 72 programs had offered a total of 948 positions, 651 of which (69%) had been filled. Among the idle positions (authorized but not occupied), 42% had not been offered by the respective programs. The latter percentage was higher in the Southern region; in programs based in municipalities with smaller populations; in state/district or private proposing institutions; and in programs without supplementation of the residency grant. Conclusions: To better elucidate the reasons for the inactivity of residency positions in family and community medicine, future research should consider the offer and occupation of positions separately. Likewise, policies for training professionals for the Brazilian Unified Health System could benefit from monitoring the effective offer of authorized positions.