Lawyer specializing in Educational Law and Management analyzes issues related to the dispute over the creation of new vacancies.
The Ministry of Education (MEC) announced this Thursday (06/27) that it will soon make a new amendment to notice no. 1/2023, to authorize new medical courses. The deadline for submitting proposals, which was scheduled to end on July 5, is likely to be extended for another 90 days due to the tragedy in Rio Grande do Sul.
The amendment also aims to clarify frequently asked questions, an initiative that, according to the MEC, seeks to prevent this extension from impacting the date of publication of the results.
Long-standing problem
Resumed in 2023, after a five-year ban on the creation of vacancies, the authorization for new Medicine courses has presented a series of obstacles due to its relationship with public policies.
“The biggest issue is the link between the course authorization process and the prior existence of a public call. The process is not very different. However, for Medicine, institutions do not have the same freedom as for other courses,” explains Ana Claudia Ferreira Julio, specialist in Law and Educational Management at Barcellos Tucunduva Advogados.
In early June, the Federal Supreme Court (STF) ruled that a “public call” is necessary for Medicine, and that new courses must comply with the Mais Médicos Law (see “Chronology”).
Courses under judicial review
Another point addressed by the STF was about “ongoing” requests, with it being defined that requests that had already passed the initial stage of analysis of the documentation by the MEC could follow the regular authorization process.
The next steps also include: on-site assessment by the National Institute of Studies and Research (INEP); opinion by the National Health Council (CNS); analysis by the Secretariat for Management of Work and Health Education (SGTES); decision and publication of the authorization ordinance by the MEC.
This definition was important because, during this period of “freezing” of new courses, several educational institutions obtained authorization, via court order, for their applications to be received and analyzed by the MEC. Some even opened new classes based on these decisions, and the delay in approval by the MEC created a climate of fear for both students and institutions.
“I understand the students’ concerns, but I see it as unlikely that they will lose the credits they have already studied. The STF itself, in its ruling, says that courses authorized based on court decisions should be maintained,” says Ana Cláudia.
Regarding educational institutions, the BTLAW specialist sees the same logic: “I do not foresee a scenario of ‘student exodus’ due to the STF decisions, which were expressed in protecting the rights of institutions that had courses authorized by court decision or even for those that, also by court decision, had their authorization requests received by the MEC, and went beyond the document analysis phase”.
Mais Médicos and the change in criteria
In 2013, the Mais Médicos Law was enacted, with the aim of reducing regional inequalities in the health area, reducing the shortage of doctors in priority SUS regions.
For the lawyer, there are positive aspects to the legislation: “there was a significant impact on the national scene, with an increase in primary care coverage, a reduction in avoidable deaths and hospitalizations, and a milestone of 18,500 medical professionals working under the Program was achieved”.
However, there are also negative aspects: “graduating from a certain city does not guarantee that he or she will remain in that location, working professionally. And the priority criterion by location is not recommended by the WHO itself, which recommends a study with other criteria, such as population density, per capita income, among other aspects.”
Finally, the expert also highlights economic side effects: “It is a criterion that interferes with free competition. This can result in a shortage of vacancies, an increase in tuition fees and, eventually, a drop in quality.”
Chronology
In 2013: the Mais Médicos Law (Law 12,871/2013) was created, which stipulated that new medical courses would be opened through public calls. These notices determine that vacancies would only be opened in specific health regions, aiming to serve municipalities with a low number of doctors – to give you an idea, the OECD establishes 3.73 doctors per thousand inhabitants, Brazil has 2.7 doctors/thousand inhabitants (2023 data) and Mais Médicos aims to operate in municipalities with less than 2.5 doctors/thousand inhabitants.
In 2018: a moratorium was declared, prohibiting the creation of new undergraduate medical courses, which led to lawsuits in court to ensure the continued creation of vacancies. To make this possible, court decisions resorted to the general system of accreditation of new undergraduate courses at the MEC, provided for in law 10.861/04.
In 2023: reopening of new Medicine courses with a notice published in October and the requirement to comply with the rules of the Mais Médicos Law. However, around 360 requests were in progress – eight institutions, for example, began offering undergraduate courses through a preliminary injunction, but still without final approval from the Ministry of Education (MEC).
In June/2024: STF rules that the “public call” is necessary and that new courses must comply with the Law. And that “ongoing” requests could only obtain authorization if they had already passed the initial stages. Around 160 colleges fit into these cases.
