Modelos de preceptoria de residências em Medicina de Família e Comunidade no cenário de aprendizagem em atenção primária no Brasil

Abstract

The specialty of Family and Community Medicine began in Brazil in 1974. The first three residency programs began in 1976, but despite this, there has always been a low demand for the specialty. Several policies have been used for reorientation and medical training focusing on Primary Health Care, with emphasis on the More Doctors Program. There has been an increase in the number of annually residency vacancies from 218 in 2003 to 3,587 in 2019. Given the increasing demand from residents, in a scenario of few preceptors, different models are being tested in Brazil. There is scarce national and international literature comparing these models of preceptorship and insertion of residents and preceptors in the primary care practice setting. The aim of this review was to identify the models of preceptorship in the Family Practice residency setting in the primary care learning scenario, associated with the identification of strengths and weaknesses of each model. An integrative literature review was performed in electronic databases, expanded by thorough search in all issues of the Brazilian Journals of Family and Community Medicine and Medical Education. Fourteen articles were included in the review, resulting in three general models of preceptorship, with seven different configurations. The mode of linking the preceptor to teams and health facilities was the most determining factor in configuring the models. The studies included in this review came from different locations in the country, especially from the southeast region. Preceptor models influence the quality of care, preceptor work routine, and residents' learning. It was also observed that the preceptor models where the resident makes up the team and the preceptor is linked to one more team was a strategy used to provide Primary Health Care doctors and expand residency programs. It was emphasized that the teacher training of preceptors is central to the education of the resident physician, regardless of the preceptorship model adopted. The quality of the articles was a limiting factor, as only three articles refer to original research data. Further research on this topic is needed to determine if there are more models, in addition to accessing or affecting these models in learning and health care of the population.