Learning the clinic of social suffering: Narratives of internship in primary health care

Abstract

In Brazil, the mismatch between medical education and care needs in primary health care, especially for the most vulnerable popula-tions, required changes in the National Curriculum Guidelines of the Medical School, with an in-creased workload of the internship in PHC. This work is exploratory, qualitative research, which investigated documents of the formative evaluation of the Integrated Internship in Family and Community Medicine and Mental Health of the Federal University of Rio de Janeiro, which serves vulnerable populations in the city of Rio de Janei-ro. The documents produced by 55 students were analyzed, and dialectical hermeneutics was used as a method of analysis. The investigation showed different levels of sensitivity to social distress ex-perienced by users of Family Clinics during the 22 weeks of internship. The narratives were grouped into five axes: highlighting the Medicine-socie-ty split; extreme vulnerability and health; daily structural violence and health; health service as a resource or intruder; territory as the power of life. The internship contributed to improve clinical views focused on users’ needs, and further studies are required to evaluate the effective in-corporation of these competencies into professio-nal practice.