Este estudo desenvolveu-se como subprojeto de uma investigação denominada: “A interface entre a ocorrência e o atendimento de violência de gênero entre mulheres usuárias dos serviços públicos de saúde de Ribeirão Preto". A violência contra a mulher é um fenômeno complexo e muito prevalente no Brasil, atingindo todas as classes, raças, etnias e culturas. Mulheres nesta situação freqüentemente buscam os serviços de saúde para tratar sintomas associados à violência. Entretanto, os profissionais de saúde apresentam uma série de dificuldades. Desenvolvemos este estudo, entendendo que a violência de gênero é reconhecida como um problema de saúde pública por afetar a integridade física e mental da mulher, e que existe necessidade de acolher essa mulher no serviço de saúde. O estudo teve por objetivo de verificar a percepção dos médicos atuantes nas Unidades Básicas e Distritais de Saúde sobre a violência praticada contra mulheres por parceiros íntimos. Realizamos uma pesquisa de cunho qualitativo com 14 médicos ginecologistas e clínicos gerais, utilizando como instrumento entrevistas semi-estruturadas. Realizamos análise de conteúdo temática utilizando como referencial teórico as teorias de gênero. A análise dos resultados permitiu-nos definir os seguintes temas: 1. Percepções dos médicos sobre as relações de gênero; 2. Percepção dos médicos sobre a violência; 3. Papel dos médicos diante da violência doméstica contra a mulher; 4. Conhecimentos e informações sobre a violência doméstica contra a mulher; que foram divididos em várias subcategorias. De acordo com os médicos, a mulher atual conquistou sua liberdade e independência sexual, no entanto, a hegemonia masculina ainda é muito presente. Compreendem que a violência de gênero ocorre devido às desigualdades que pautam o sistema social que acabam por justificar os eventos violentos como atitudes educativas e punitivas, aceitas pela posição social ocupada pela mulher. Constatamos que alguns desses profissionais detêm conhecimentos sobre os tipos de violência de gênero, são capazes de identificar e muitas vezes acolher essas mulheres e também conhecem os procedimentos para o atendimento e o encaminhamento. Entretanto, muitas vezes não dão andamento aos casos, ignorando-os, ou porque não acreditam que este fenômeno seja de sua responsabilidade, ou ainda devido a uma série de barreiras pessoais e institucionais que impedem uma adequada atuação. Além disso, verificamos a existência de uma invisibilidade institucional que prejudica a qualidade do serviço prestado. Por fim, destacamos a importância do desenvolvimento de treinamento voltado para o profissional da área da saúde, com o objetivo de prepará-lo para melhor assistir à mulher em situação de violência, condição muito presente em seu cotidiano. / The present study was carried out as a subproject of an investigation named: “The interface between the occurrence of gender violence and its treatment among women users of the public health services of Ribeirão Preto". Domestic violence against women is a complex and highly prevalent phenomenon in Brazil, where it reaches all classes, races, ethnic groups, and cultures. Women who are victims of this violence frequently seek health services in order to treat the symptoms associated with it. However, health professionals have a series of difficulties in this situation. This study was conducted considering that gender violence is recognized as a public health problem affecting the physical integrity and mental health of women and there is a need to assist these women in the health service. This study has as objective to determine the perception of doctors working in the Basic and District Health Units about the violence inflicted on women by intimate partners. We carried out a qualitative investigation with 14 Gynecologists and General Clinicians using a semi-structured interview as instrument. Data were submitted to thematic content analysis and gender theories were used as the theoretical framework. Analysis of the results permitted us to define the following themes: 1. Perception of gender relations by the physicians; 2. Perception of violence by the physicians. 3. Role of the physicians regarding violence against women. 4. Knowledge and information about domestic violence against women. These themes were divided into various subcategories. According to the doctors, today women have conquered their liberty and sexual independence, but male hegemony continues to be strongly present. They understand that gender violence occurs due to the inequalities of the social system, which end up by justifying violent events as educational and punitive attitudes accepted by the social position occupied by women. We observed that some of these professionals have knowledge about the types of gender violence, are able to identify and often shelter these women, and are also aware of the procedures involved in treatment and referral. However, they often do not initiate the proper steps regarding these cases, ignoring them either because they do not believe this phenomenon to be their responsibility, or because of a series of personal and institutional barriers that prevent an adequate attitude. In addition, we observed the existence of institutional invisibility that hampers the quality of the care provided. Finally, we emphasize the importance of training programs for the health professional in order to improve the assistance to women in violent situation which is very frequently in the daily practice.

Made available in DSpace on 2016-04-26T18:16:15Z (GMT). No. of bitstreams: 1 COS - Luciana Nogueira Gontijo Amed Ali.pdf: 1341750 bytes, checksum: 9db9b6caec16ea5ee20c63315e15c235 (MD5) Previous issue date: 2006-10-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present research aims to examine the semiotics nature of the Doutores da Alegria (Doctors of Joy) brand, to understand the communicative strategies used by enunciator of this brand to construct values and meaning produced in the relationship with a target audience, the children (enunciatee). Doutores da Alegria is a non-profit civil-society organization working with hospital humanization among hospitalized children in São Paulo, Rio de Janeiro and Recife. Their focus is also extended to parents and healthcare professionals involved in the young patients hospitalization processes. The NGO design their performances by means of different plays, incorporating clown art, music and dance, and even inventing what they call a filosofia da besteirologia ( philosophy of nonsense ). This research studies the communication strategies used by Doutores da Alegria directed towards children, aimed at understanding how those strategies play a role in the construction of meaning obtained from their discourse. An observed performance by the clowns with a hospitalized child, based on situational semiotics analysis (French Semiotics), is used as a corpus. Further, we are going to carry out the analysis of the work Poemas Esparadrápicos ( Band-aid Poems ), created by the NGO. The results of this research will be presented in four chapters. In the first, we introduce the Doutores da Alegria brand, with a brief history of clown art, the North American organizations that started this work and the management and operation of the Brazilian entity being studied. We will also highlight some similar programmes and address their differences in comparison with this NGO. In chapter two we will review a situation syncretic text: a performance by the actors for a hospitalized child. Chapter three is developed based upon reading contract analyses, focusing on the verbal text of Poemas Esparadrápicos. The study ends with the conclusions obtained from the two analyses, discussing the Doutores strategies and the meaning effect produced on the children / A presente pesquisa visa examinar a natureza semiótica da marca Doutores da Alegria , a fim de compreender as estratégias comunicativas empregadas pelo enunciador dessa marca para construir os valores e os sentidos produzidos na relação com um público específico, o infantil. Doutores da Alegria é uma organização da sociedade civil sem fins lucrativos, que trabalha com a humanização hospitalar junto as crianças hospitalizadas em São Paulo, Rio de Janeiro e Recife. Seu foco de atuação também é estendido aos pais e aos profissionais de saúde envolvidos nos processos de internação dos pacientes mirins. A ONG constrói suas performances por meio de uma diversidade de atuações, que incorporam a arte clown, música e dança, chegando a inventar o que eles chamam de filosofia da besteirologia . A presente pesquisa estudará as estratégias comunicativas dos Doutores da Alegria, visando compreender como elas participam na construção dos sentidos obtidos nos discursos produzidos. Será utilizada como corpus uma situação de performance dos atores-palhaços junto a uma criança hospitalizada, com base em análise semiótica em situação, observada presencialmente. Além disso, realizaremos a análise da obra Poemas Esparadrápicos, criada pela ONG. A apresentação dos resultados desse trabalho será realizado em quatro capítulos. No primeiro, faremos uma apresentação da marca Doutores da Alegria, a partir de um breve histórico sobre arte clown, sobre as organizações norte-americanas que iniciaram esse trabalho e sobre a gestão e o funcionamento da entidade brasileira estudada; faremos também uma apresentação de alguns programas semelhantes e abordaremos suas diferenças diante da ONG em questão. No capítulo dois, faremos a análise de um texto sincrético em situação: a perfomance desses atores junto à criança hospitalizada. O capítulo três será desenvolvido com base nas análises dos contratos de leitura, focando o texto impresso, chamado Poemas Esparadrápicos . Finalizaremos o estudo a partir da reunião de conclusões obtidas com as duas análises, discutindo as estratégias dos Doutores e os efeitos de sentido produzidos junto ao público infantil

Esta dissertação é fruto da inserção da pesquisadora na Rede-Observatório do Programa Mais Médicos, cujas pesquisas permitiram conhecer além do que os objetivos de um projeto são capazes de prescrever. Composta por narrativas, esta dissertação tem por objetivo tornar visíveis os conhecimentos evocados pela experiência de pesquisa que tendem a não compor os relatórios finais e que não são reconhecidos como produções científicas. Trata-se, então, da visibilidade da dimensão micropolítica do fazer pesquisa e do conhecimento sobre a implantação do Programa, de fragmentos sobre o pesquisar e sobre o próprio Programa Mais Médicos. É com inspiração nas produções brasileiras no campo da Saúde Coletiva, nas proposições de pistas metodológicas da cartografia, na Análise Institucional de Lourau, na narratividade de Benjamin, na Esquizoanálise de Gilles Deleuze e Félix Guattari, entre outras obras e autores, buscando disjunções e interfaces entre eles, que esta dissertação constrói seu alicerce teórico. Flanando por Brasília, pelos interiores das salas da universidade e pela imensidão da Floresta Amazônica, as narrativas que compõem esta dissertação foram construídas a partir de quatro cenas-narrativas, que buscam apontar o desvio do majoritário na ciência, descolar a produção de conhecimento de uma subordinação ao cartesiano. As cenas-narrativas tornaram visíveis efeitos do Programa Mais Médicos na produção de cuidado e no cotidiano de trabalho das equipes de saúde, que os indicadores epidemiológicos não conseguiram revelar, bem como dimensões do fazer pesquisa que são apreendidas em ato. / This work is the result of the researcher’s participation in the Observatory-Network of the More Doctors Program (Rede-Observatório do Programa Mais Médicos), whose studies allowed me to encounter more than what the objectives of a project can prescribe. Composed by narratives, this work aims to make visible the knowledge evoked by the research experience which tend not to compose the final reports and which is not recognized as scientific production. It regards, therefore, to the visibility of the micropolitical dimension in research practices and the knowledge about the implementation of the Program, fragments of the act of researching and of the More Doctors Program itself. It is inspired by Brazilian productions in the field of Saúde Coletiva (Public Health), the cartography’s indications of methodological tracks, Lourau’s Institutional Analysis, Benjamin’s narrativity, Gilles Deleuze and Félix Guattari’s schizoanalysis, among other works and authors, pursuing disjunctions and interfaces between them, that this work builds its theoretical grounds. Wandering through Brasília, the interiors of university rooms or the immensity of the Amazon Forest, these narratives aim to indicate a detour from the majoritary in Science, liberating the production of knowledge from a subordination to the Cartesian.

Este estudo desenvolveu-se como subprojeto de uma investigação denominada: “A interface entre a ocorrência e o atendimento de violência de gênero entre mulheres usuárias dos serviços públicos de saúde de Ribeirão Preto”. A violência contra a mulher é um fenômeno complexo e muito prevalente no Brasil, atingindo todas as classes, raças, etnias e culturas. Mulheres nesta situação freqüentemente buscam os serviços de saúde para tratar sintomas associados à violência. Entretanto, os profissionais de saúde apresentam uma série de dificuldades. Desenvolvemos este estudo, entendendo que a violência de gênero é reconhecida como um problema de saúde pública por afetar a integridade física e mental da mulher, e que existe necessidade de acolher essa mulher no serviço de saúde. O estudo teve por objetivo de verificar a percepção dos médicos atuantes nas Unidades Básicas e Distritais de Saúde sobre a violência praticada contra mulheres por parceiros íntimos. Realizamos uma pesquisa de cunho qualitativo com 14 médicos ginecologistas e clínicos gerais, utilizando como instrumento entrevistas semi-estruturadas. Realizamos análise de conteúdo temática utilizando como referencial teórico as teorias de gênero. A análise dos resultados permitiu-nos definir os seguintes temas: 1. Percepções dos médicos sobre as relações de gênero; 2. Percepção dos médicos sobre a violência; 3. Papel dos médicos diante da violência doméstica contra a mulher; 4. Conhecimentos e informações sobre a violência doméstica contra a mulher; que foram divididos em várias subcategorias. De acordo com os médicos, a mulher atual conquistou sua liberdade e independência sexual, no entanto, a hegemonia masculina ainda é muito presente. Compreendem que a violência de gênero ocorre devido às desigualdades que pautam o sistema social que acabam por justificar os eventos violentos como atitudes educativas e punitivas, aceitas pela posição social ocupada pela mulher. Constatamos que alguns desses profissionais detêm conhecimentos sobre os tipos de violência de gênero, são capazes de identificar e muitas vezes acolher essas mulheres e também conhecem os procedimentos para o atendimento e o encaminhamento. Entretanto, muitas vezes não dão andamento aos casos, ignorando-os, ou porque não acreditam que este fenômeno seja de sua responsabilidade, ou ainda devido a uma série de barreiras pessoais e institucionais que impedem uma adequada atuação. Além disso, verificamos a existência de uma invisibilidade institucional que prejudica a qualidade do serviço prestado. Por fim, destacamos a importância do desenvolvimento de treinamento voltado para o profissional da área da saúde, com o objetivo de prepará-lo para melhor assistir à mulher em situação de violência, condição muito presente em seu cotidiano. / The present study was carried out as a subproject of an investigation named: “The interface between the occurrence of gender violence and its treatment among women users of the public health services of Ribeirão Preto”. Domestic violence against women is a complex and highly prevalent phenomenon in Brazil, where it reaches all classes, races, ethnic groups, and cultures. Women who are victims of this violence frequently seek health services in order to treat the symptoms associated with it. However, health professionals have a series of difficulties in this situation. This study was conducted considering that gender violence is recognized as a public health problem affecting the physical integrity and mental health of women and there is a need to assist these women in the health service. This study has as objective to determine the perception of doctors working in the Basic and District Health Units about the violence inflicted on women by intimate partners. We carried out a qualitative investigation with 14 Gynecologists and General Clinicians using a semi-structured interview as instrument. Data were submitted to thematic content analysis and gender theories were used as the theoretical framework. Analysis of the results permitted us to define the following themes: 1. Perception of gender relations by the physicians; 2. Perception of violence by the physicians. 3. Role of the physicians regarding violence against women. 4. Knowledge and information about domestic violence against women. These themes were divided into various subcategories. According to the doctors, today women have conquered their liberty and sexual independence, but male hegemony continues to be strongly present. They understand that gender violence occurs due to the inequalities of the social system, which end up by justifying violent events as educational and punitive attitudes accepted by the social position occupied by women. We observed that some of these professionals have knowledge about the types of gender violence, are able to identify and often shelter these women, and are also aware of the procedures involved in treatment and referral. However, they often do not initiate the proper steps regarding these cases, ignoring them either because they do not believe this phenomenon to be their responsibility, or because of a series of personal and institutional barriers that prevent an adequate attitude. In addition, we observed the existence of institutional invisibility that hampers the quality of the care provided. Finally, we emphasize the importance of training programs for the health professional in order to improve the assistance to women in violent situation which is very frequently in the daily practice.

Thesis (Ph. D. (Translation Studies)) -- University of Limpopo, 2014 / The study focuses on communication during consultations between English-speaking foreign medical doctors, patients and nurses as interpreters in the Limpopo province. It aims to identify and describe the communication strategies, politeness strategies, influence of gender on the communication process as well as a review of the policy on language practice in the hospitals with a view to suggesting amendments. Through a field work carried out in 10 public health facilities in Limpopo province, the study adopts an eclectic research method of semi-structured interviews, audio recording, and observation in the collection of data. Thirty-five patients, thirteen nurses and nineteen medical doctors are involved in the study. All the interviews and audio recordings were transcribed and translated wherever needed. Collected data was analysed using the Statistical Package for Social Sciences (SPSS) and Nvivo softwares. Results showed that many foreign doctors were frustrated that they could not communicate directly with patients because they could not speak the indigenous language and the assumption that most patients could communicate in English often turned out to be erroneous. The hospitals are ill equipped to deal with the language problems. The linguistic barrier made it difficult to give equal medical care to all patients and doctors resorted to avoidance strategies in selecting patients. Five consultations types based on the turn-taking were identified. These are clarification, continuation, convergence, knowledge and avoidance strategies. The study also reveals that the doctors use more positive politeness strategies when communicating with the patients and nurses. Gender was found to influence the choice of communication strategies by the foreign doctors. The inadequacies of the National Department of Health Language Practice Policy are highlighted and suggestions are made towards its amendment. KEY CONCEPTS English-speaking foreign medical doctors, communication strategies, politeness strategies, gender, language policy, interpreters.

A quantitative survey was conducted in two Canberra hospitals that aimed at ascertaining the impact of information provided by medical libraries on clinical decision making. Specifically, this research study investigated clinical, cognitive and quality value of information provided by the medical librarians to the management of patients and doctors' ability to handle clinical cases differently as a result of such information. Furthermore, the relative value of information received from the library was assessed by comparing it to the value of information received from other sources in dealing with clinical problems. The research involved medical specialists and registrars affiliated with these hospitals. Doctors were asked to select any clinical situation which they frequently or currently encounter and for which further information would be useful to them. Once their information requests were identified, they were then asked to present such requests to the hospital library. In order to avoid any special treatment, participants were urged not to identify themselves to the library staff as partaking in the study. It was important that participants did not search for the information themselves. The doctors were asked to evaluate the material provided by the library in relation to clinical care and, thereafter, complete a short questionnaire. This research took place between October 1994 and March 1995. The questionnaires were sent to 288 doctors. This represented the total population of specialists and registrars affiliated with both hospitals at the time of the study. Analysis of the results is based on a 34% useable response rate. Medical specialists were by far the higher number of respondents (70%) as compared with registrars (30%). Eighty-one per cent of the doctors said that the information provided by the library refreshed their memory and 82% said that it would contribute to better quality of medical care. Eighty-six per cent indicated that some of this information was new to them and 99% said that the information provided was up to date. Ninety-four per cent said that the information provided by the library was of clinical value to them. As the result of the information provided by the library 75% of respondents would either definitely or probably handle some aspects of the clinical situation differently than they would have done it otherwise. The level of importance of the change for the optimal care of patients was assessed with 54% regarding it as important, 42% as moderately important. Specifically, as the result of the information provided, the doctors were able to change the following: diagnosis 10%, choice of lab tests 20%, choice of other diagnostic investigations 24%, choice of drugs 27%, choice of other management 58%, reduce length of hospitalisation 10%, post-operative care of patients 25%, advice given to patients 47%. On the basis of the received information the doctors were able to avoid the following: hospitalisation of patients 11%, risk of hospital acquired infection 8%, surgical intervention 19%, tests or other investigation 23%, additional out-patient visits 12%. Discussions with colleagues were reported to be most valued sources of information for the purpose of clinical decisions (59%), followed by diagnostic imaging (49%), librarian (45%), lab tests (42%) and patients' medical records (30%). The librarian's role as contributing to the process of clinical decisions was rated highly with 88% ranking it as either important or moderately important. The results of significance p test statistic performed at 0.05 significance level suggested that, for this study, there was a significant relationship between the frequency of library use and doctors' ability to change the choice of laboratory tests, diagnostic investigations, and the choice of prescribed drugs. The results of this research study demonstrate that medical librarians can positively contribute to clinical management of patients by providing timely and accurate information. Further research is recommended in order to determine the impact of the whole range of library services on health care outcomes.

The purpose of the study was to examine if intrinsic motivation and work commitment to the organization differs between permanent doctors and hired doctors. The total of 63 doctors who participated in the study made an internet-based survey with 21 questions taken from the Basic Need Satisfaction at Work Scale and 3 questions from the section “work commitment” in QPS Nordic. The main results of the study showed that permanent doctors perceived a higher level of intrinsic motivation on all the three needs autonomy, competence and relatedness. Furthermore the result showed a tendency that permanent doctors perceived a higher level of work commitment to the organization then hired doctors. / Syftet med studien var att undersöka om inre arbetsmotivation samt engagemang i organisationen skiljer sig mellan tillsvidareanställda och inhyrda läkare. Det gjordes genom en internetbaserad enkät som skickades ut till fem av Sveriges landsting. De totalt 63 läkarna som deltog i studien fick besvara totalt 21 frågor hämtade från Basic Need Satisfaction at Work Scale och 3 frågor från delen “engagemang i organisationen” i QPS Nordic. Studiens huvudresultat visade på att tillsvidareanställda läkare upplever en högre grad av inre motivation på alla tre behoven autonomi, kompetens och samhörighet. Resultatet visade också på en stark tendens till att tillsvidareanställda läkare upplevde högre grad av engagemang i organisationen än inhyrda läkare.

This thesis is about medical doctors with immigrant backgrounds who work in Sweden. Based on 15 qualitative interviews with medical doctors with immigrant backgrounds, this thesis explores the medical doctors’ feeling of professional belonging and boundary work. This thesis focuses mainly on the doctors’ experiences of being part of the Swedish medical profession while, at the same time, being regarded as ‘different’ from their Swedish medical counterparts. It starts off with the idea that medical doctors with immigrant backgrounds may have, or could be regarded as having, contradictory social positions. By virtue of being part of the Swedish medical profession, they belong to one of the most privileged groups in Swedish society. However, due to their immigrant background these doctors do not necessarily occupy a privileged position either within their profession or in society in general. This thesis shows that doctors with immigrant backgrounds feel that they are not perceived as full-fledged doctors, which seem related to how they are somewhat ‘othered'. The results show that these doctors cope with being seen as different from doctor with non-immigrant backgrounds, by using the notion of ‘migranthood’ as a resource in negotiations in everyday work life but they also do what they can to overcome the boundaries of ‘Swedishness’. Belonging should therefore be seen as having a formal and an informal side, as getting a Swedish license does not automatically mean that you feel belonging to, in this case, the Swedish medical profession. This seems to put doctors with immigrant backgrounds in a somewhat outsider within position, which seems having to do with boundaries between who is included in the ‘us’ and in the ‘them’. Lastly, these findings indicate that sociologists need to expand the understanding of professional groups to also include boundary work within these groups. In order to do so, this thesis argues that sociological theory on professional groups could be combined with sociological theory about social positions as that is one way to understand the outsider-within position that these doctors (and presumably other skilled migrants) have to cope with.

This thesis reports on the development of an Australian Government English as a Second Language test for health professionals, the Occupational English Test (OET) , and its validation using Rasch Item Response Theory models. / The test contains sub-tests of the four macroskills, each based on workplace communication tasks. The thesis reports on the creation of test specifications, the trial ling of test materials and the analysis of data from full test sessions. / The main research issues dealt with are as follows: / 1. The nature of the constructs involved in communicative language testing. The term proficiency is analysed, and its relationship to a number of models of communicative competence examined. The difficulty of incorporating into these models factors underlying test performance is identified. / 2. The nature of performance tests. A distinction is introduced between strong and weak senses of the term performance test, and related to the discussion in 1 above. / 3. The content validity of the OET. This is established on the basis of a questionnaire survey, interviews, examination of relevant literature, workplace observation and test data. / 4. The role of classical and Rasch IRT analysis in establishing the qualities of the test. Classical and Rasch IRT analyses are used to establish the basic reliability of the OET sub-tests. The Writing sub-test is shown to be somewhat problematic for raters because of the nature of the writing task involved. Analysis of data from the Reading subtest demonstrates the superiority of the Rasch analysis in the creation of short tests with a specific screening function. / 5. The role of Rasch IRT analysis in investigating the construct and content validity of the test and hence of communicatively-oriented tests in general. Rasch analysis reveals that the sub-tests are satisfactory operationalizations of the constructs 'ESL listening/ speaking/ reading/ writing ability in health professional contexts. For the Speaking and Writing sub-tests, the analysis reveals that responses of raters in categories associated with perceptions of grammatical accuracy have a more important role in the determination of the candidate's total score than was anticipated in the design of the test. This finding has implications for the validity of communicatively oriented tests in general, and illustrates the potential of IRT analysis for the investigation of the construct validity of tests. / 6. The appropriateness of the use of Rasch IRT in the analysis of language tests. The nature of the debate about 'unidimensionality' in Rasch analysis is reviewed. It is argued that the issue has been substantialy misunderstood. Data from the two parts of the Listening sub-test are analysed, and statistical tests are used to confirm the unidimensionality of the data set. It is concluded that Rasch analysis is appropriate for a language test of this type. / 7. The behaviour of raters in the rating of oral and written production in a second language. The findings reported in 5 above suggest that the behaviour of raters is crucial to understanding what is being measured in a communicative test of the productive language skills. / The research demonstrates the value of Rasch IRT analysis in the empirical validation of communicatively oriented language tests, and the potential of large-scale test development projects for theoretical work on language testing.

CONTEXTUALIZAÇÃO: No Brasil, a exemplo do que ocorre em outros países, os médicos estão distribuídos de forma heterogênea, concentrando-se principalmente nas regiões Sudeste e Sul do país (Povoa; Andrade, 2006), o que faz com que a distribuição adequada do trabalho médico seja um dos principais desafios à garantia da equidade em saúde. A desigualdade na distribuição de médicos é um problema mundial, e esta distribuição deve ser adequada tanto geograficamente como entre as especialidades. Entretanto, faltam parâmetros para identificar onde há carência e excesso destes profissionais. Embora não exista um modelo de distribuição ideal do trabalho médico, vários fatores podem interferir na necessidade deste profissional, e a avaliação da necessidade de médicos deve levar em conta o contexto no qual seu trabalho será desenvolvido. No Brasil, a busca por melhores níveis de saúde e promoção da equidade em saúde são objetivos importantes, que passam pelo fortalecimento do SUS e da Atenção Primária à Saúde (APS), sendo necessário avaliar a adequação da oferta e distribuição de médicos no país a estes propósitos. OBJETIVOS: Identificar a adequação da oferta de médicos no Brasil, total e por especialidade, segundo parâmetros assistenciais do Ministério da Saúde e em comparação com um sistema de saúde orientado para APS. Identificar as carências e excessos de médicos, conforme estes parâmetros de comparação, nas cinco regiões brasileiras. MÉTODOS: A oferta de médicos, registrada no Cadastro Nacional de Estabelecimentos de Saúde (CNES) em julho de 2009, total e por especialidades, foi comparada à necessidade de médicos, conforme parâmetros assistenciais da Portaria MS 1101/2002 e parâmetros de produtividade das resoluções n.º 01/2005 e n.º 04/2005 do Conselho Regional de Medicina de Pernambuco (CREMEPE). Também foi comparada à oferta de médicos no Canadá, conforme o Southam Medical Database 2009 (SMDB). Tais comparações foram realizadas, ainda, para as cinco Regiões do País. RESULTADOS: A cobertura médica total no Brasil contempla os parâmetros assistenciais recomendados pelo MS, mas, comparado com o modelo canadense, apresenta insuficiência de médicos e desigualdade na distribuição entre as especialidades. Em relação à distribuição regional, o Norte não apresenta cobertura suficiente para oferecer a assistência médica recomendada pelo MS, e a região Nordeste consegue atender apenas os parâmetros referentes a 2 consultas.habitantes/ano. Por outro lado, na comparação com o Canadá, a única região onde não foi identificada insuficiência na cobertura médica total foi a Região Sudeste. Na avaliação da cobertura médica por especialidades, nenhuma região apresenta distribuição adequada ao atendimento das recomendações do MS, e todas as regiões apresentam inadequação nesta distribuição quando comparadas ao Canadá. Em algumas especialidades há excesso em todo o país. CONCLUSÕES: A cobertura médica no Brasil não está adequada nem aos parâmetros assistenciais do MS nem a um sistema de saúde orientado para a APS, reforçando a necessidade de sistemas regulatórios da formação de médicos no Brasil. / BACKGROUND: In Brazil, the doctors are distributed unevenly, concentrating mainly in the Southeast and South, which makes the proper distribution of doctor work is a major challenge of equity in health. Although the unequal distribution of doctors is a global problem, missing parameters to identify where there is a lack and excess of these professionals. Moreover, it is necessary that this distribution is suitable both geographically and between specialties. Although there isn‟t a model of ideal distribution of medical and several factors may interfere with the need for this training, and evaluating the need for professional to take into account the context in which their work will be developed. In Brazil, the strengthening of the SUS and Primary Health Care (PHC) are important strategies in the quest for improved health and promoting health equity, is necessary to evaluate the adequacy of supply and distribution of doctors in the country for these purposes. OBJECTIVES: To identify the adequacy of the supply of doctors in Brazil, total and by specialty care within the parameters of the Ministry of Health and compared with a health system oriented APS. Identifying deficiencies and excesses of doctors, according to these benchmarks in the five Brazilian regions. METHODS: The offer of doctorsr, registered in the National Register of Health Facilities (CNES) in July 2009, total and by specialty, was compared to the need for medical care based on the parameters of HD decree 1101 / 2002, considering the productivity parameters resolutions No. 01/2005 and No. 04/2005 of the Conselho Regional de Medicina de Pernambuco (CREMEPE). We also compared the offer of doctors in Canada, as the Southam Medical Database 2009 (SMDB). Comparisons are made also for the five regions of the country. RESULTS: The total medical coverage in Brazil provides assistance to meet the recommendations of the HD according to the parameters adopted, but the distribution among the specialties is not suitable for these recommendations. The regional distribution, are observed deficiencies in the North, where coverage is insufficient to provide medical care recommended by HD, and the Northeast, where coverage is sufficient to meet only the recommendations for two medical appointment.inhabitant / year. Compared to the Canadian model, the Brazilian medical coverage is inadequate. The only region where failure was not identified in this comparison was the Southeast. The evaluation of medical coverage for specialty identifies that there are specialties with shortages in all regions, with other excesses in all regions. Some specialties have adequate general coverage, but they are poorly distributed across regions. For some specialties were conflicting results between the two models for comparison. Conclusions: Medical coverage in Brazil is not adequate care or the parameters of HD nor a health system oriented to the PAH, reinforcing the need for regulatory systems of training doctors in Brazil.