Mário C Scheffer1, Aline G A Guilloux1, Alicia Matijasevich1, Benjamin B Massenburg2, Saurabh Saluja3, Nivaldo Alonso4. 1. Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. Icahn School of Medicine at Mount Sinai, New York, NY; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA. 3. Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA; Department of Surgery, Weill Cornell Medical College, New York, NY. 4. Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: Nivalonso@gmail.com.
Abstract
BACKGROUND: A critical insufficiency of surgeons, anesthesiologists, and obstetricians exists around the world, leaving billions of people without access to safe operative care. The distribution of the surgical workforce in Brazil, however, is poorly described and rarely assessed. Though the surgical workforce is only one element in the surgical system, this study aimed to map and characterize the distribution of the surgical workforce in Brazil in order to stimulate discussion on future surgical policy reforms. METHODS: The distribution of the surgical workforce was extracted from the Brazilian Federal Medical Board registry as of July 2014. Included in the surgical workforce were surgeons, anesthesiologists, and obstetricians. RESULTS: There are 95,169 surgeons, anesthesiologists, and obstetricians in the surgical workforce of Brazil, creating a surgical workforce density of 46.55/100,000 population. This varies from 20.21/100,000 population in the North Region up to 60.32/100,000 population in the South Region. A total of 75.2% of the surgical workforce is located in the 100 biggest cities in Brazil, where only 40.4% of the population lives. The average age of a physician in the surgical workforce is 46.6 years. Women make up 30.0% of the surgical workforce, 15.8% of surgeons, 36.6% of anesthesiologists, and 53.8% of obstetricians and gynecologists. CONCLUSION: Brazil has a substantial surgical workforce, but inequalities in its distribution are concerning. There is an urgent need for increased surgeons, anesthesiologists, and obstetricians in states like Pará, Amapá, and Maranhão. Female surgeons and anesthesiologists are particularly lacking in the surgical workforce, and incentives to recruit these physicians are necessary. Government policies and leadership from health organizations are required to ensure that the surgical workforce will be more evenly distributed in the future.
BACKGROUND: A critical insufficiency of surgeons, anesthesiologists, and obstetricians exists around the world, leaving billions of people without access to safe operative care. The distribution of the surgical workforce in Brazil, however, is poorly described and rarely assessed. Though the surgical workforce is only one element in the surgical system, this study aimed to map and characterize the distribution of the surgical workforce in Brazil in order to stimulate discussion on future surgical policy reforms. METHODS: The distribution of the surgical workforce was extracted from the Brazilian Federal Medical Board registry as of July 2014. Included in the surgical workforce were surgeons, anesthesiologists, and obstetricians. RESULTS: There are 95,169 surgeons, anesthesiologists, and obstetricians in the surgical workforce of Brazil, creating a surgical workforce density of 46.55/100,000 population. This varies from 20.21/100,000 population in the North Region up to 60.32/100,000 population in the South Region. A total of 75.2% of the surgical workforce is located in the 100 biggest cities in Brazil, where only 40.4% of the population lives. The average age of a physician in the surgical workforce is 46.6 years. Women make up 30.0% of the surgical workforce, 15.8% of surgeons, 36.6% of anesthesiologists, and 53.8% of obstetricians and gynecologists. CONCLUSION: Brazil has a substantial surgical workforce, but inequalities in its distribution are concerning. There is an urgent need for increased surgeons, anesthesiologists, and obstetricians in states like Pará, Amapá, and Maranhão. Female surgeons and anesthesiologists are particularly lacking in the surgical workforce, and incentives to recruit these physicians are necessary. Government policies and leadership from health organizations are required to ensure that the surgical workforce will be more evenly distributed in the future.
Authors: Benjamin B Massenburg; Saurabh Saluja; Hillary E Jenny; Nakul P Raykar; Josh Ng-Kamstra; Aline G A Guilloux; Mário C Scheffer; John G Meara; Nivaldo Alonso; Mark G Shrime Journal: BMJ Glob Health Date: 2017-05-18
Authors: Aline Gil Alves Guilloux; Jania A Ramos; Isabelle Citron; Lina Roa; Julia Amundson; Benjamin B Massenburg; Saurabh Saluja; Bruno Alonso Miotto; Nivaldo Alonso; Mario César Scheffer Journal: BMC Med Educ Date: 2019-05-08 Impact factor: 2.463
Authors: Thiago Augusto Hernandes Rocha; Joao Vissoci; Nubia Rocha; Dan Poenaru; Mark Shrime; Emily R Smith; Henry E Rice Journal: BMJ Open Date: 2020-03-24 Impact factor: 2.692