[The Portuguese Physicians' Perspective regarding the Restructuring of the Medical Career: A Cross-Sectional Study]

The medical career (MC) has been, in Portugal, a pillar and a guarantee of quality in the organization and provision of healthcare. Currently, it consists of two levels and three categories, with progression possible by two ways, both related to the remuneration system. However, we are currently witnessing a concerning stagnation in the career progression of doctors in Portugal. The main aim of this study was to evaluate the perception, opinion, and challenges related to the MC in Portugal.

A questionnaire was applied to doctors registered in the Portuguese Medical Association (n = 61 317) between December 2024 and January 2025. Both quantitative and qualitative analyses were performed.

A response rate of 9.36% was obtained. The majority of doctors were aged between 30 and 40 years, were women, held the category of senior attending physician, worked in the public sector, and in hospital-based specialties. There was consensus on the relationship between the MC and the quality of healthcare (91.45%), the need for restructuring the MC (87.57%), the integration of residency into the MC (92.58%), the cross-sector nature of the MC (78.1%), and the association of career progression with remuneration progression (95.86%). Most doctors felt that the MC should have more levels (55.63%).

The results support the perception of the importance of the MC for the quality of care provided. A consensus is evident among doctors regarding the need for restructuring the MC, with proposals such as the reintegration of the residency program and the creation of new technical-scientific levels. Although most doctors who responded to the questionnaire work in the public sector, there was a clear consensus about the cross-sector nature of the MC. However, the implementation of this cross-sector nature proves to be a challenge, especially when combined with the consensus that career progression should always involve a pay rise, which is crucial for the recognition of medical work.