Medical Workforce in the State of São Paulo: evidence for planning the supply, distribution and training of specialist physicians

• Grant number: 24/17428-8
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: November 01, 2024
• End date: October 31, 2026
• Field of knowledge: Health Sciences - Collective Health - Preventive Medicine
• Principal Investigator: Mário César Scheffer
• Grantee: Paola Soledad Mosquera
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 23/10124-0 - Medical Workforce in the State of São Paulo: evidence for planning the supply, distribution and training of specialist physicians, AP.PP

Abstract

The project's starting point is a concrete management problem - the lack or shortage of specialized physicians in the Public Health System ( Sistema Único de Saúde - SUS) in the State of São Paulo - which hinders the expansion of specialized healthcare services in the public health system. Developed by a research group from the Medical School at the University of São Paulo (Faculdade de Medicina da USP - FMUSP) and the management group of Human Resources Coordination (CHR) at the State Secretary of Health (SES-SP), the project aims at generating scientific content to support public policies that are existing and under execution, driven towards the education and supply of specialized physician for the State's public health system. Three undergoing policies (target-audience) were previously identified as potential beneficiaries of the results: Medical Residency Program of the State Secretary of Health (Programa de Residência Médica da SES/SP; Healthcare Regional Allocation Project of São Paulo (Projeto de Regionalização da Saúde de São Paulo); and the State Plan to Reduce Healthcare Queues in the State of São Paulo (Plano Estadual de Redução das Filas da Saúde de São Paulo). Three management questions were defined and then translated into specific study objectives: 1) What is the profile of the offer and distribution of specialized physicians in the State of São Paulo? 2) What is the existing and potential capacity of the State of São Paulo of educating specialized physicians? 3) What is the offer and demand of specialized physicians according to regions and medical specialties strategic to the Public Health System in the State of São Paulo and to the population's healthcare needs? Mixed research methods are expected for the analysis of secondary bases on physicians: from the Brazilian Medical Association (Associação Médica Brasileira - AMB), the National Commission of Medical Residency (Comissão Nacional de Residência Médica - CNRM) and the State Secretary of Health (SES-SP), manager of programs, seats, and scholarships for Medical Residencies. The dual role of the SES-SP will be analyzed as an educator and direct or indirect employer of specialized physicians, due to services and hospitals that it manages or funds. Quantitative and qualitative research with those responsible for the education (178 Learning Institutions that maintain Medical Residency Programs in the State of São Paulo, and State representatives from the 55 Medical Specialty Entities affiliated with the AMB) will aim at identifying the factors that cause idleness or limited capacity of the State in educating specialized physicians. Having as a conceptual basis the System Dynamics, the projection model will seek to integrate the offer, demand, and need for specialized physicians in the State of São Paulo. The study's execution will initially have six researchers experienced in the subject, including international cooperation, and four technicians from management, thus ensuring the project's technical and scientific excellency profile. The study foresees a Research Follow-up Committee (Comitê de Acompanhamento de Pesquisa - PEC); Knowledge Dissemination Plan (Plano de Disseminação do Conhecimento - PDC); and Strategic Planning (PES), the latter aiming at identifying organizational, financial and political resources needed for the viability of redesigns and the implementation of the outcomes in the sphere of the policies targeted by the project. Decisions that require a higher hierarchical level in the state government, budgetary availability, and agreements between the different parties from the state healthcare system that are involved in the policies targeted by this study are potential risks in the feasibility of implementing the outcomes.