We need practical proposals to improve the quality of dental care in Brazil

Admin Dental Press

Edition V16N06 | Year 2011 | Editorial Editorial | Pages 6 to 7

Jorge Faber

We sell a dream and deliver a nightmare.? With this sentence the minister of the Brazilian Supreme Court, Marco Aurélio Mello, summed up his vote for the constitutionality of the bar examination of the Order of Attorneys of Brazil. He defined, in a sense, the process of formation of a law graduate in Brazil. The question of the constitutionality of this examination was presented as a legal recourse by a graduate in Law. Earlier in the day of the manifestation of the minister, the general-prosecutor of the Brazilian Republic, Roberto Gurgel, said that: ?The bar examination is, therefore, clearly adequate to ensure qualification of the professional and protect the rights of third parties.?1 This important fact, necessarily, makes us to reflect on the possibility of a examination for dentistry (and other healthcare areas, such as medicine): The examination of the Brazilian Federal Council of Dentistry (CFO). Many countries, like the UK and the USA, see the obligatoriness of these examinations for our profession as the only way to ensure the qualification of the professional and protect the health of the population. In Japan, graduates in dentistry are submitted to a qualification exam after a six years undergraduate course. It is very important to warn that healthcare professionals must have some minimum knowledge to act in this area, otherwise they will become ?disease professionals?. Obviously, this is not the only action needed to improve the quality of healthcare to our people. Mandatory continuing education is also one of them. In Italy, this apprehension is so intense that dentists needs to be out of service for nearly two weeks every year, to achieve the number of credits of continuing education that will enable them to keep their work permit valid. Perhaps this is an exaggerated number of hours. Some states, like Illinois, require 48 hours of continuing education every three years to renew the work permit.2 The continuing education credits can be obtained with both in-person classes and answering to questionnaires compiled from articles, as those present in DPJO. In Brazil, there is no legal requirement of any kind and it is common that many professionals will graduate and never seek for update. However, this discussion could not eclipse the main star of this issue, which is higher education in the dental field. There is a debate about the quality of this education. Surely it is not perfect, however, if we judge this quality from the objective point of view of knowledge production, it is among the best in the world. On the other hand, of course, good schools share space with the weak ones, not to mention the fact ? known by almost all the teachers in Brazil ? that several institutions of higher education pressure teachers to promote students who have not reached the required notes for approval. And the controversy do not end here. If there is currently so much evasion in our profession, it means that many schools are simply unnecessary. The student buys a worthless diploma, because he will not exercise the profession. So we have a problem underpinned, mainly, on a tripod. We have several weak schools ? which the Brazilian population does not need ? training professionals without verified qualification and, to make it worse, many of them do not maintain a continuing education. This scenario contrasts with the fact that we have dental professionals that are among the bests in the world and it means that a parcel of the population is attended with excellence and another, possibly, is attended by ?disease professionals?. What is the ideal model? Effective actions to close the unnecessary weak schools? The introduction of mandatory continuing education programs? The selection of those proven to be suitable for healthcare professionals, through a test conducted by the CFO and applied to graduates? Or adopt both of these actions? Any new proposal, since concrete and feasible, is welcomed. I?m open to criticism, suggestions and discussions.*

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