Methodological limitations in the use of data on federal medical schools created under Brazil’s More Doctors ProgramDear Editor,
The article “Teacher development or provision programs? A portrait of the federal schools participating in the More Doctors Program”1) addresses a relevant topic when discussing faculty development programs in the federal medical schools created under the Brazil’s More Doctors Program (PMM, Programa Mais Médicos). After reading it, we pointed out methodological limitations in the text that we deem pertinent to qualify the debate on the subject and ensure greater precision in the records on these medical schools.
First, it is noteworthy that the main empirical basis of the study is the Health Education Panel of the Ministry of Education (MEC)2, whose public version records the date of 04/16/2024 as the last update. This lag, by itself, restricts its use as the only source to characterize the situation of the analyzed courses. As a consequence, conclusions that depend directly on the current status of the data are compromised, such as the recognition status of the courses and the effective offer of vacancies.
An illustrative example is the Medicine course at Universidade Federal do Rio Grande do Norte based in Caicó, which appears in the article as “not recognized” by the Ministry of Education, although it obtained the recognition in April 2023, information available in the e-MEC3 system, an official and updated database on higher education courses in the country. A similar situation occurs with other courses, such as those at Universidade Federal do Vale do São Francisco (Paulo Afonso campus) and Universidade Federal de Alagoas (Arapiraca campus), which, at the time of the manuscript submission (December/2024), were also already officially recognized by the Ministry of Education. A systematic consultation of the e-MEC and the institutional pages would have avoided such inconsistencies.
These inaccuracies have a relevant impact on the narrative constructed in the article. By omitting the recognition and good results obtained by several schools in official evaluation processes, the text fails to highlight one of the most significant findings of the expansion policy linked to the Brazil’s PMM: the fact that many of the new federal courses achieved high ratings in a short time of operation. The authors themselves state, in the item “Material and Method”, that “for a better detailing of the activities, other publications in institutional spaces (documents, ordinances, websites) were analyzed”. However, a simple search on public platforms - including official records and institutional channels - allows one to readily identify news and widely disseminated information about the recognition of these courses. This reinforces the presence of methodological limitations in the article and points to the need for greater rigor in the checking and triangulation of the sources used.
Although the article briefly recognizes the limitation regarding the availability of data, the methodological option of basing the entire analysis on potentially outdated information directly impacts the validity of the presented inferences. This point would deserve more careful treatment, since the MEC2 panel is a dynamic database, subject to frequent reviews and updates.
With regard to the number of student places and teaching and technical-administrative staff positions, the authors associate the observed deficits mainly with “open competitive examinations in progress” and the “loss of position codes to other programs”, stating that these codes, once lost, “will not be recovered by the medical programs already in operation.” This inference is not consistent with the actual functioning of personnel management in federal universities, which enjoy administrative autonomy to manage and redistribute positions among programs according to their academic needs and strategic demands. Therefore, considerations of this kind require greater contextualization and dialogue with institutional realities; otherwise, they risk conveying to the reader oversimplified interpretations of complex administrative processes.
Likewise, the inference that the supposed “lack of qualified professionals in the localities” is a central explanation for the absence of faculty development programs warrants careful consideration. Although the interiorization of medical schools does pose challenges in terms of faculty recruitment and development4, the scarcity of structured pedagogical training programs is a well-documented phenomenon even in traditional medical schools with long institutional trajectories and stable faculty bodies. This is widely recognized as a systemic challenge in Brazilian medical education, rather than a peculiarity of schools created under the PMM. Attributing the problem primarily to geographical location and to an alleged deficit in professional qualifications, besides lacking empirical support and contextual analysis, may reinforce stigmatizing interpretations of historically underserved regions.
Other specific inconsistencies also merit attention. In Graph 1, the article indicates a deficit in the total number of available places and cites the state of Amazonas, stating that despite having “almost” 50 authorized places (the actual number is 48), none were offered. This information does not correspond to the facts. The Medicine program in Coari (Federal University of Amazonas) did offer places, although student admissions were temporarily suspended for a certain period and had already been resumed by the time the article was submitted. Likewise, the article reports that Rio Grande do Norte had a deficit of 40 offered places, without clarifying that this figure refers to the original projection for the opening of three programs (Caicó, Mossoró, and Assu), of which only two were actually implemented. The omission of all host cities from Table 1 further hinders understanding of this scenario, as these details are essential to the analytical accuracy of a study of this nature.
The title of the article also warrants critical reflection. By contrasting “faculty development” with “provision programs,” it suggests a dichotomy that may lead readers to infer that the schools analyzed invested primarily in provision policies at the expense of faculty development, an interpretation that is not supported by the empirical evidence presented. This framing, reinforced by the abstract, may encourage a biased and derogatory view of these institutions, reproducing a stigma that has historically accompanied medical schools created under the Brazil’s PMM, which are often regarded with suspicion in relation to their quality. In part, this reflects broader structural resistance to the PMM itself. The abstract further reinforces this reading by emphasizing only negative aspects-such as the absence of structured programs and the supposed lack of qualified professionals-without balancing the analysis by acknowledging successful experiences in several of these institutions. This ultimately impoverishes the debate and inadvertently contributes to maintaining a hierarchical and asymmetrical view of Brazilian medical schools.
It is important to note that these programs were planned and implemented in accordance with the National Curricular Guidelines, incorporating student-centered methodologies, teaching-service-community integration, and competency-based education. It is therefore inconsistent to assume that such transformations occurred without adequate investment in faculty development.
Finally, analyses of the new federal medical schools require contextual sensitivity and dialogue with those who build them on a daily basis. The maxim often invoked in debates on representativeness - “Nothing about us without us” - seems particularly appropriate here: understanding the impact of the Brazil’s PMM on medical education requires listening to the managers, faculty, students, and health service partners involved in these institutions. The absence of such a perspective may lead to distorted or incomplete inferences about the relevance of these schools and their contribution to medical education in Brazil.
We acknowledge the relevance of the topic and the authors’ effort to systematize data on federal medical schools created under the PMM. At the same time, we hope that the considerations presented here will help strengthen future analyses by encouraging the use of updated data sources, the triangulation of information, and greater appreciation of the diversity of contexts and achievements that characterize the recent expansion of federal medical education in Brazil.
References
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1 Silva MACN, Amorim GH, Fraiz IC, Moura ATMS. Programas de desenvolvimento ou de provimento docente? Retrato das escolas federais do Programa Mais Médicos. Rev Bras Educ Med. 2025;49(4):e155. doi: https://doi.org/10.1590/1981-5271v49.4-2024-0180.
» https://doi.org/https://doi.org/10.1590/1981-5271v49.4-2024-0180 -
2 Ministério da Educação. Painel da Educação em Saúde. Brasília: Ministério da Educação [acesso em 21 nov 2025]. Disponível em: Disponível em: https://app.powerbi.com/view?r=eyJrIjoiOTI3Mjg4MjYtZGUzOS00OTk4LWI4MWItOWRmMDA4Y2YwNjY0IiwidCI6ImI4YzI1OTMyLTVlNzYtNGIyYi05YzUzLWQ0MTc0NWU5YzkyZCJ9
» https://app.powerbi.com/view?r=eyJrIjoiOTI3Mjg4MjYtZGUzOS00OTk4LWI4MWItOWRmMDA4Y2YwNjY0IiwidCI6ImI4YzI1OTMyLTVlNzYtNGIyYi05YzUzLWQ0MTc0NWU5YzkyZCJ9 -
3 Ministério da Educação. Cadastro Nacional de Cursos e Instituições de Educação Superior Cadastro e-MEC. Brasília: Ministério da Educação [acesso em 21 nov 2025]. Disponível em: Disponível em: https://emec.mec.gov.br/emec/nova
» https://emec.mec.gov.br/emec/nova -
4 Cyrino EG, Sordi MRL de, Mendes GSCV, Luna WF, Mendonça CS, Alexandre FLF, et al. Mapeamento das características da implantação de novos cursos de Medicina em universidades federais brasileiras. Rev Panam Salud Publica. 2020;44:117. doi: https://doi.org/10.26633/RPSP.2020.117.
» https://doi.org/https://doi.org/10.26633/RPSP.2020.117
Research data are available in the body of the document.
