Surgical education in Brazil

Area of Science:

• Medical Education
• Surgical Training
• Residency Programs

Background:

• Surgical residency in Brazil began in 1944, with programs overseen by the National Committee of Medical Residency.
• A significant challenge in Brazilian medical education is the disparity between the number of graduates and available residency positions.
• This shortage forces many graduates into alternative training, which may not be as effective as formal residency.

Purpose of the Study:

• To outline the structure and challenges of surgical residency programs in Brazil.
• To detail the progression and attrition rates within the general surgery residency.
• To describe the process for achieving specialist certification in surgery.

Main Methods:

• Analysis of the structure of the Brazilian surgical residency program, including duration and rotation requirements.
• Examination of the selection process and vacancy availability at different stages of training.
• Description of the certification process by the Brazilian College of Surgeons.

Main Results:

• The general surgery residency is 4 years, with an initial 2-year basic period followed by specialized training.
• A competitive examination after the initial 2 years results in 45% of residents leaving the program due to limited vacancies.
• Only 573 out of 1,040 initial surgical residents continue to advanced training.

Conclusions:

• Specialty boards, such as the Brazilian College of Surgeons, manage specialist title conferral.
• The certification process for general surgeons in Brazil mirrors that of the American Board of Surgery.
• The current system presents a bottleneck, with a substantial number of trained surgeons unable to complete formal residency pathways.