A Residência Médica: articulações entre a prática e o ensino

Abstract

The purpose of this doctoral thesis is the survey of medical residency and its connections with education and health. A historical-dialectical analysis is presented addressing the medicine/education interrelationship in the social structure. The starting point is the assertion that the practice and knowledge in the fields of education and health are related to the historical transformation of the economic production process. This understanding refers us to the so-called last resort determination: i.e. the economic structure determines where and how medicine and education are interlinked within the social structure. The health care system is described here in order to understand the aspects of medical teaching and residency in Brazil, especially regarding the role played by the State in the configuration there of: to begin with, the adoption of a system in which the State is responsible for providing basic health care on a universal basis through its own health services, or in partnership with non-governmental organizations; secondly, specialized health care services requiring further technological breakthrough would be provided by the private sector, using State incentives. The bottom line of this division is today s design: instead of a unique system, two or more health care systems coexist, where the resulting segmentation brings about different practices. The effects of such labor market segmentation are felt in medical school and residency programs. It can be concluded that medical residency in particular, due to its on-site training features, responds in a consistent way to the labor environment conditions, replicating the practice-hegemony model.