José Eduardo Lutaif Dolci

SUMMARY OBJECTIVE: This study aimed to describe the design and linkage procedures of the Career, Autonomy, Rights and Equity among Doctors Brazil survey coordinated by the Brazilian Medical Association, and to assess the composition and geographic coverage of its analytic sample against national benchmarks. METHODS: This national cross-sectional online survey was conducted from January 29 to September 10, 2026. The invitation frame came from Demografia Médica no Brasil, a census-based investigation of the physician workforce conducted since 2010. Four nonoverlapping random samples totaling 110,000 physicians were invited; participation was voluntary. Survey records were audited, deduplicated, linked to professional sources through a restricted key, compared with 2024 national benchmarks, and calibrated for sex, region, and age group. RESULTS: Of 4,437 submissions, 4,002 physicians formed the analytic sample. Women accounted for 51.6%, mean age was 48.3 years, and 70.9% had at least one recognized specialty, compared with 49.3%, 44.8 years, and 59.1% in the observed 2024 national benchmark. Calibration weights ranged from 0.396 to 3.134; the Kish weight-based design effect was 1.259, and the effective sample size was 3,180. CONCLUSION: Career, Autonomy, Rights and Equity among Doctors Brazil documents a linked physician sample and quantifies differences from national benchmarks. The low matched participation fraction and voluntary response create substantial potential for selection bias. Random invitations, linkage, and calibration do not establish population representativeness or remove unmeasured nonresponse bias. The findings primarily characterize the analytic sample and inform the interpretation of subsequent thematic studies.

SUMMARY OBJECTIVE: To develop a national consensus catalog of essential psychomotor competencies and establish the minimum expected competence levels for graduating medical students across anesthesiology and surgical specialties in Brazil using a modified Delphi process. METHODS: This national consensus-development study used a two-round modified Delphi process coordinated by the Brazilian Medical Association. Scientific Committees representing anesthesiology and 14 surgical specialty societies developed preliminary specialty-specific catalogs and proposed the expected competence level for each competency. Board-certified specialists evaluated the competency–competence-level combinations using a five-point Likert scale. Consensus was predefined as ≥75% combined agreement. RESULTS: A total of 802 specialists participated in the first Delphi round, and 622 completed the second round. The preliminary catalogs comprised 343 competency statements. Of these, 273 (79.6%) achieved consensus, whereas 70 (20.4%) were excluded. During the first Delphi round, participants proposed 103 additional competency statements, of which 90 (87.4%) achieved consensus after evaluation during the second Delphi round. The final consensus catalog comprised 363 specialty-specific psychomotor competencies, corresponding to 244 unique psychomotor competencies after harmonization. Most competencies were classified as Perform independently (n=274), followed by Perform under supervision (n=55) and Master the technique (n=34). CONCLUSION: This modified Delphi study established a national consensus catalog of psychomotor competencies and expected competence levels for graduating medical students across anesthesiology and 14 surgical specialties. The catalogue provides a national consensus-based reference for competency-based undergraduate medical education. Future studies should evaluate its implementation and educational impact.

SUMMARY OBJECTIVE: To develop Part II of the National Consensus Catalogue of essential psychomotor competencies and establish the minimum expected competence levels for graduating medical students across 11 clinical and diagnostic support specialties in Brazil using a modified Delphi process. METHODS: This national consensus-development study used a two-phase, two-round modified Delphi process coordinated by the Brazilian Medical Association. Preliminary specialty-specific catalogues were developed between February and June 2025 by Scientific Committees from 11 specialty societies, which also proposed the minimum expected competence level for each psychomotor competency statement. Round 1 of the modified Delphi process was conducted from August to December 2025, and Round 2 was conducted from February to June 2026. Board-certified physicians evaluated each competency-competence level combination using a five-point Likert scale. Consensus was predefined as ≥75% agreement. Statements achieving <60% agreement were excluded after Round 1, whereas those achieving 60.0–74.9% agreement were revised and reassessed in Round 2. Additional competency statements proposed during Round 1 were evaluated in Round 2. RESULTS: A total of 667 physicians participated in Round 1, and 499 completed Round 2. The preliminary catalogues comprised 346 psychomotor competency statements; 240 (69.4%) achieved consensus and 106 (30.6%) were excluded. Participants proposed 38 additional statements, of which 36 (94.7%) achieved consensus in Round 2. The Part II catalogue comprised 276 specialty-specific psychomotor competency statements, corresponding to 229 unique psychomotor competencies after harmonization. Most competency statements were classified as perform independently (n=195), followed by perform under supervision (n=62) and master the technique (n=19). CONCLUSION: This modified Delphi study established Part II of the National Consensus Catalogue of essential psychomotor competencies and minimum expected competence levels for graduating medical students, encompassing 11 clinical and diagnostic support specialties in Brazil.

OBJECTIVE: The aim of this study was to analyze the provision of lato sensu postgraduate courses within the context of specialist medical training in Brazil.

SUMMARY OBJECTIVE: Since a significant number of professionals in Brazil did not hold a specialist title, the aim of this study was to describe and analyze the supply of Lato Sensu Postgraduate courses in medicine. METHODS: Lato Sensu Postgraduate courses offered between February and May 2024 were surveyed using the e-MEC platform (Ministry of Education) and the websites of the offering institutions. The variables considered were medical specialty, number of places, workload, price, teaching modality, and public or private nature. Descriptive analyses and statistical tests of association were performed. RESULTS: A total of 2,148 Lato Sensu Postgraduate courses aimed at doctors were identified and offered by 373 institutions, the majority (60.7%) of which were located in the Southeast, with half having a total workload of up to 420 h. The average duration was 13.3±7.4 months; there were 30.6±59.6 vacancies on offer, and the average total price was R$15,782.44±35,372.88. Approximately 90% were paid for, and 41.2% were distance-learning courses, the latter of which had a shorter duration, lower cost, and more places than other types of education. CONCLUSION: Lato Sensu Postgraduate courses in medicine in Brazil reflect a heterogeneous, predominantly private universe with great variation in the characteristics of the courses on offer. This dispersion indicates the need for better regulation of Lato Sensu Postgraduate supply and marketing in Brazil, and in this way, the current study has important implications for education improvement.

RESUMO O editorial discute a necessidade de valorização do Título de Especialista pelas Sociedades Médicas, como etapa posterior à conclusão da residência médica e pré-requisito obrigatório para prestar as provas. Por fim, mostra a experiência de sete Sociedades Médicas para suas provas de título de especialista.

RESUMO Este artigo mostra os dados mais recentes da evolução do número total de médicos residentes e vagas de R1 a R5, bem como do número de programas e instituições credenciadas pela Comissão Nacional (CNRM). Também discute os tipos e modalidades de avaliação da residência médica, com foco na avaliação das competências ao longo do treinamento em serviço, que foram incorporadas na mais recente resolução da Comissão Nacional de Residência Médica (CNRM) do final de 2023, que alterou atualizou as determinações de 2006. Por fim, mostra a experiência de seis Sociedades Médicas que fazem a avaliação periódica dos médicos residentes que foi apresentada em evento na Associação Médica Brasileira.

RESUMO Este artigo de reflexão pode ser dividido em duas partes complementares. A primeira mostra o contexto atual da formação médica no Brasil trazendo os dados mais recentes do número de graduandos e sua crescente defasagem em relação ao número reduzido de vagas de residência médica que, mesmo sendo a modalidade mais adequada para formar especialistas, tem sido preterida ao número excessivo de cursos de pós-graduação Lato Sensu. A segunda parte discute as possibilidades de avaliação da formação médica, que é terminal no Brasil, possibilitando que o médico recém-formado possa ter o registro profissional para exercer a medicina, sendo avaliado apenas pelo seu próprio curso médico. A evolução histórica das iniciativas de avaliação da formação médica é mostrada e discutida em termos técnicos acerca dos prós e contras, envolvendo os médicos formados no Brasil e no exterior.

This article shows the most recent data on the evolution of the number of resident physicians and vacancies from R1 to R5, as well as the number of programs and institutions accredited by the National Commission for Medical Residency (CNRM). It also discusses the types and modalities of evaluation of medical residency, with a focus on the assessment of competencies throughout in-service training, which were incorporated into the most recent CNRM resolution, at the end of 2023, which amended and updated the 2006 directives. Finally, it shows the experience of six Medical Societies that conduct periodic evaluation of resident physicians, presented at a Brazilian Medical Association event.

The editorial discusses the need for the Specialist Title to be valued by Medical Societies, as a stage after the conclusion of medical residency and a mandatory prerequisite for taking the tests. Finally, it shows the experience of seven Medical Societies with their specialist title exams.