“OAB dos Médicos”: Projeto cria exame obrigatório de Proficiência em Medicina

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O Projeto de Lei (PL 2.294/2024), do senador Astronauta Marcos Pontes (PL-SP), será discutido em audiência pública na Comissão de Assuntos Sociais (CAS). Senadores e senadoras divergem sobre a proposta; CFM apoia a iniciativa

Por Bianca Mingote – Agência Brasil 61

Além dos advogados brasileiros, os médicos também deverão realizar uma prova ao final do curso para estarem aptos a exercer a profissão. É o que prevê o Projeto de lei (PL 2.294/2024), de autoria do senador Astronauta Marcos Pontes (PL-SP). A proposta estabelece que o Exame Nacional de Proficiência em Medicina seja obrigatório aos egressos do curso.

O texto estabelece que o exame deve ser aplicado pelo menos duas vezes ao ano em todos os Estados e no Distrito Federal. A prova avaliará competências profissionais e éticas, além de conhecimentos teóricos e habilidades clínicas. O objetivo é aferir a qualidade da formação dos futuros médicos.

O Especialista em Direito Médico, vice-presidente para as Américas da rede BGI Global e sócio do Fonseca Moreti Advogados, Washington Fonseca, avalia que a iniciativa é relevante para garantir a qualidade dos serviços prestados à população.    

“Isso vai trazer uma segurança muito grande para a população, com a disparada do número de Faculdades de Medicina que a gente tem hoje no Brasil. Essa medida é  muito importante, vai fazer com que se tenha uma melhor apuração dos médicos que são postos no mercado de trabalho e, óbvio, isso pode também trazer um reflexo muito positivo em termos de prestação de serviço para a população”, afirma Fonseca.

Pela proposta, ficam dispensados de realizar o exame os profissionais já inscritos no CRM e os estudantes de Medicina que tiverem ingressado no curso antes da Lei entrar em vigor.

Na justificativa do Projeto, o senador Astronauta Marcos Pontes (PL-SP) cita que, em 2005, o Conselho Regional de Medicina de São Paulo (Cremesp) passou a avaliar os formandos de Medicina por meio de Exame de Proficiência. Em 2012, a prova tornou-se obrigatória. Já em 2015, a Justiça Federal retirou a exigência para concessão do Registro Profissional. Apesar das idas e vindas, o senador destaca dados com baixos percentuais de aprovados nos exames em São Paulo.

Por exemplo, em 2012, entre 2.411 participantes, 54,5% foram reprovados. Em 2013, 59,2% dos 2.843 recém-formados também foram reprovados. O senador avalia o cenário como “quadro de precariedade na formação de médicos” e destaca, na justificativa do texto, que a medida garante proteção aos Sistemas de Saúde, seja público ou privado, e aos pacientes.

“Pois erros de diagnóstico, de prescrição ou de conduta podem não só gerar custos sociais para os Sistemas Público e Privado de Saúde, mas também causar danos irreversíveis aos pacientes e mesmo levá-los à morte”, afirma na justificativa.

Posicionamentos

Pela proposta, será de competência do Conselho Federal de Medicina (CFM) a regulamentação e a coordenação nacional do Exame e dos Conselhos Regionais de Medicina, a aplicação. Além disso, os resultados devem ser comunicados ao Ministério da Educação (MEC) e ao Ministério da Saúde pelo CFM – ponto criticado pelos parlamentares contrários ao Projeto.

Inclusive, a senadora Teresa Leitão (PT-PE) solicitou a realização de uma audiência pública para discutir o Projeto na Comissão de Assuntos Sociais (CAS). Na justificativa do Requerimento, aprovado pelos senadores, ela argumenta que o Projeto torna o CFM uma autarquia responsável por avaliar a qualidade da formação médica e habilitar os egressos ao exercício profissional. Para ela, a ação se apropria de competências do MEC.

“Possibilitando que o referido Exame induza mudanças nas diretrizes curriculares dos cursos de Medicina, dificultando ainda mais a trajetória dos estudantes em direção ao exercício profissional e instituindo um instrumento que, na prática, poderá significar a institucionalização da reserva de mercado”, diz Teresa em trecho da justificativa.

O Especialista em Direito Médico, Washington Fonseca, avalia como equivocada a posição da senadora Teresa Leitão sobre o exame usurpar as competências do MEC e defende a realização do exame para garantir a competência dos profissionais.

“O papel do Ministério da Educação é fiscalizar Universidades, a qualidade do Ensino que está sendo proporcionado, discussão relacionada à grade que está sendo ministrada, à grade de aulas e conteúdo, matéria que está sendo ministrada para os alunos. A realização de um Exame de Proficiência seria muito importante para fazer uma averiguação do profissional”, afirma Fonseca.

Para ele, o MEC tratará da formação do egresso e o Exame, de averiguar se o indivíduo tem condições ou não de exercer a Medicina.

“Um vai tratar da formação e o outro vai tratar de averiguar se aquela pessoa que está ingressando no mercado de trabalho vai ter, sim, condições ou não de atender a população. E, obviamente, implementando esse tipo de controle dos profissionais que vão ser inseridos no mercado de trabalho, a população que colhe os louros, porque a gente vai ter profissionais melhores preparados e, consequentemente, um reflexo na prestação de serviços à população como um todo em melhor e maior escala”, diz Fonseca.

A senadora Teresa Leitão também pontuou que a proposição não apresenta a estimativa de custos para realização periódica do Exame. Para ela, há possibilidade de onerar os estudantes.

O Requerimento foi subscrito pela senadora Zenaide Maia (PSD-RN), que também defende que o CFM não deve ser o responsável por certificar a capacidade para exercer a profissão de médicos, mas sim o MEC.

O senador Humberto Costa (PT-PE) também destacou que é de competência do poder público, ou seja, do MEC, atribuir diploma de graduação e avaliar os egressos.

A matéria é relatada pelo senador Dr. Hiran (PP/RR), que já se manifestou a favor da iniciativa. Ele enfatizou que há 390 Faculdades de Medicina no país, o que ele considera “um absurdo”.

O Especialista Fonseca afirma que é necessário ter esse tipo de controle dos egressos de Medicina no país, considerando a quantidade de Faculdades em território nacional. 

“É necessário, sim, ter esse tipo de controle. Até por conta da disseminação absurda de Faculdades de Medicina que hoje o Brasil tem”, pondera.

A matéria deveria ter sido relatada na última quarta-feira (9), mas alguns senadores, como o senador Marcelo Castro (MDB-PI), foram contra a leitura do relatório. Os parlamentares ponderaram ser preciso esperar a audiência pública. 

Conforme a Agência Senado, a previsão é de que o debate ocorra após a Semana Santa e de que o relatório seja lido apenas na próxima reunião da CAS. Caso seja aprovado na Comissão sem requerimento para análise em plenário, o Projeto poderá seguir diretamente para a Câmara.

Em nota, o CFM afirmou que o Projeto “representa um importante avanço para assegurar a qualidade da formação médica no Brasil e garantir à população um atendimento mais seguro e qualificado”, diz um trecho da nota.

O que muda para ser médico no país?

Hoje, após concluir a graduação em uma Faculdade reconhecida pelo MEC, o profissional solicita o Registro no Conselho Regional de Medicina (CRM). Após ser registrado, o profissional está habilitado a exercer a Medicina em todo o território nacional. 

A Médica Especialista em Medicina Legal e Perícia Médica, Caroline Daitx, destaca  que a etapa marca o fim da formação acadêmica e o início da responsabilidade de cuidar da vida e da saúde de outras pessoas. Na avaliação da Especialista, é preciso mais do que domínio técnico, mas também formação de responsabilidade social. 

Com o novo Exame, semelhante ao da OAB, ela esclarece que há necessidade de aliar outras medidas para garantir a formação completa dos egressos de Medicina, sem o foco exclusivo no meio acadêmico e em provas.

“A Medicina exige muito mais do que domínio técnico. Um bom médico precisa saber ouvir, acolher, comunicar más notícias com empatia, trabalhar em equipe, reconhecer seus limites e agir sempre com ética. Nenhuma dessas competências que são absolutamente fundamentais na prática pode ser totalmente avaliada por uma prova única aplicada ao fim do curso”, diz.

“A criação de um Exame Único para o acesso ao exercício profissional pode acabar estimulando um foco exclusivo na prova e no mercado de cursos preparatórios, ao invés de incentivar a construção contínua da responsabilidade médica ao longo da formação. Controlar a qualidade da Medicina no país é urgente, sim, mas isso não pode ser reduzido a um único exame de múltipla escolha”, completa.

Foto: Marcelo Camargo/Agência Brasil

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