In the lack of medical residences, specialization courses grow and worry

With the number of medical schools growing up to a higher pace than places in medical homes, the market has increased on the market for newly graduated courses as an alternative to those who want to follow a specialty. The proliferation of this type of postgraduate degree, however, has aroused concern among representatives of the sector, which point to lack of control over the quality and function of these programs.

Medical demography in Brazil 2025, prepared in partnership between the Ministry of Health, the Faculty of Medicine of the University of São Paulo (FMUSP) and the Brazilian Medical Association (AMB), showed that the accelerated growth of medical medical degree in Brazil, especially in the private network, was not accompanied by a proportional increase in medical residency – the main means of training of experts.

In the last ten years, the number of vacancies authorized in medical courses more than doubled, from 23.5 thousand in 2014 to 48.4 thousand in 2024. The private network concentrated about 80% (38.4 thousand) of the total vacancies in the area last year. Meanwhile, the offer of medical homes has been increasing in recent years, from 22.1 thousand in 2018 to 24,200 in 2024.

In 2020, there were 13.7 thousand vacancies for 20.3 thousand graduates. In 2024, the mismatch increased: there were 16.1 thousand direct access vacancies for 32.6 thousand graduates. In addition, most residents (62%) were concentrated in the capitals.

Without getting a place at the residence, many newly graduated opt for medical postgraduate courses. However, despite offering professional training, these courses do not confer the title of expert, which is only recognized by two ways: the medical residency accredited by the National Commission of Medical Residency (CNRM), linked to MEC, or approval by examination performed by specialty companies affiliated to AMB.

By 2024, according to medical demography, the country already had 2,100 medical specialization courses, almost half of the total number of residency programs in the same year. Of the total, 41.2% are fully offered at a distance, and another 11.1% in a semi -presential format.

Sought to comment on the increase of these courses, the Ministries of Health and Education did not speak.

Courses of up to R $ 30 thousand

Most of the offer is concentrated in the Southeast and South regions, and the average duration of the course is 13 months – much lower than two to five years required at the residence. In addition, 90% are paid: the average cost is $ 15,000 for the entire course, and may reach up to $ 30,000, according to estimates from the sector.

Representatives of medical entities heard by the report state that the sport has little supervision and that its presentation – especially the nomenclature – induces the mistaken idea that it gives the title of expert. Therefore, they advocate a more rigid action by the federal government.

– These courses that are proliferating promise a specialization title that do not check. In fact, they are nothing more than improvement courses. In my assessment, the MEC and the Ministry of Health need to act to regulate this market and avoid inadequate training – says Antonio José Gonçalves, president of the Paulista Medical Association (APM).

Today, the Ministry of Education defines these courses as continuing education programs intended for graduates, focusing on professional updating. To be offered, they only require the institution’s accreditation and the registration of general information. There is no need for prior authorization from MEC or the Ministry of Health.

One possibility, according to Gonçalves, would be that specialty companies linked to AMB began to evaluate the proposals of the courses, analyzing the curriculum and issuing opinions on the quality of the formation offered.

– The doctor who takes this course does not need to be an expert in endocrinology, for example, but may have an improvement in thyroid disease, which is something more limited. But that would have to be chanceled by the specialty society – explains.

The professor at USP School of Medicine, Mário Scheffer, argues that a possible new regulation should involve public institutions or medical civil society, establishing minimum quality criteria such as faculty, pedagogical project and infrastructure.

– Who wants to do, can do. Sometimes they can learn things. These are update courses, can recycle knowledge. These are not illegal courses, many are recognized by MEC, which they are not expert trainers – says AMB president César Fernandes.

New vacancies

Earlier this month, Health Minister Alexandre Padilha announced the opening of three thousand vacancies for medical residences, focusing on unassisted regions, plus 500 for training specialists. The measure is part of the government’s efforts to accelerate the results of the SUS specialized line reduction program, the now has experts.

“What had already been done with a lot of effort was not enough to handle the problem. We will not resolve all the issues, but we will advance during this period – said Padilha about the insufficiency of SUS -specialist doctors.