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Brazil Hits Record Number of Medical Graduates, But Excess of Courses Pressures Salaries of New Doctors While Inland Cities Remain Without Adequate Care.
Being a doctor has always been synonymous with prestige and stability in Brazil. But this reality has changed in recent years. The explosion in the number of medical courses, combined with the accelerated growth of graduates, has created a curious phenomenon: there are increasingly more doctors available in large cities, but the salaries paid to recent graduates have fallen, while thousands of municipalities in the countryside still lack sufficient professionals.
The Expansion of Medical Courses
According to the Ministry of Education (MEC), Brazil has surpassed 390 medical courses in operation, the highest number in the world in absolute terms. Between 2013 and 2022 alone, more than 100 new courses were authorized and about 15,000 additional annual slots were opened.
This increase was driven by federal programs such as More Doctors and the opening of slots in private universities. The goal was to expand access to health care, but the side effect was market saturation in certain urban areas.
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Fiocruz has opened a selection process with vacancies for nurses, dentists, and psychologists, with salaries that can reach nearly R$ 8,000 including the preceptorship grant.
Falling Salaries for New Doctors
With more professionals competing for opportunities, clinics and hospitals in the capitals began to offer increasingly lower amounts for shifts and basic care.
- In some cities, 12-hour shifts in private urgent care pay less than R$ 800 to recent graduates, an amount considered low given the level of responsibility.
- Popular clinics offer medical consultations at reduced prices, often passing only R$ 30 to R$ 50 per appointment to the professional.
- The excess supply in capitals creates an environment of precariousness, where young doctors accept inferior conditions to gain experience.
According to the Federal Council of Medicine (CFM), although the national average medical remuneration is still high compared to other professions, new entrants feel the difference: the higher the concentration of courses in a region, the lower the starting salaries tend to be.
The Countryside Remains Underserved
Meanwhile, the situation is completely different outside the capitals. A study by the CFM itself reveals that only 21% of doctors work in municipalities with fewer than 30,000 inhabitants, where nearly a third of the Brazilian population lives.
The reason is clear: lack of hospital infrastructure, precarious working conditions, and often delayed salary payments.
Even when offering more attractive remuneration in some municipal programs, many doctors prefer to work in metropolitan areas, where they have access to specializations, better schools, and opportunities for their families.
The result is a structural imbalance: an excess of doctors in certain cities and a critical shortage in others.
The Weight of New Generations
The profile of the doctor has also changed. Among younger doctors, there is a growing interest in specializations in areas of greater prestige or financial return, such as dermatology and plastic surgery. Meanwhile, fundamental areas such as general practice, family medicine, and pediatrics face relative scarcity, despite being the entry point into the health system.
Moreover, the costs to graduate are extremely high. Private medical courses can exceed R$ 10,000 per month, leading many new graduates to accept any available job to pay off student debts.
A Ticking Time Bomb for the Health System
Experts warn that this contradiction could lead to serious consequences:
- Saturation in urban centers, with decreasing remuneration and quality of care.
- Care gaps in the countryside, where simple diseases become serious due to lack of medical follow-up.
- Inequality in health, reinforcing the contrast between those living in capitals and those relying on small health units in remote cities.
The solution involves structural measures:
Reassessing the policy for opening courses, prioritizing regions with proven deficits.
Encouraging the medical career in the countryside, with scholarships, residency programs, and adequate hospital infrastructure.
Valuing basic care, making family medicine an attractive and well-paid career.
Monitoring employment contracts, to prevent abusively low remuneration in popular clinics and urban shifts.
Brazil faces a glaring paradox: it trains more doctors than ever, but fails to distribute them evenly.
The result is a system where there are surplus professionals in some regions, salaries drop, and at the same time thousands of Brazilians in the countryside continue without adequate care.
Unless there are policies that reconcile training, valuation, and regional retention, a profession that has always symbolized stability and prestige may become synonymous with precariousness for the younger generation — and abandonment for millions of patients living far from the capitals.
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