摘要：Introdução: Os limites da carga horária (CH) de saúde coletiva (SC) antes do internato (AI) não estão definidos nas Diretrizes Curriculares Nacionais, nem em outros documentos, e não foram investigados de forma abrangente em estudos nacionais. Objetivo: Analisar a CH de SC AI em escolas médicas (EM) brasileiras. Método: Estudo transversal, com escolas reconhecidas pelo Ministério da Educação que iniciaram as atividades até 31 de dezembro de 2017. Os sites das 323 escolas existentes foram consultados, e foram incluídas aquelas que disponibilizavam seus currículos na internet com detalhamento de CH de SC AI. As variáveis foram região geográfica e administração da escola, CH do curso de medicina e CH de SC AI, incluindo também as CH de epidemiologia, bioestatística e saúde do trabalhador. Os dados foram analisados usando-se estatística descritiva, teste de qui-quadrado (Ӽ 2 ) de Pearson para variáveis categóricas e testes Mann-Whitney-U (U) e Ӽ 2 de Kruskal-Wallis para variáveis contínuas. Resultados: Foram incluídas 222 das 323 EM existentes (68,7%), sendo 83 gratuitas (37,4%) e 139 não gratuitas (62,6%). A mediana da CH total de SC AI foi de 440,0 horas (P 25-75 = 300,0 - 640,0), equivalente a 5,4% (P 25-75 = 3,5 - 7,8) da CH total do curso. A mediana da CH de SC AI em horas das escolas privadas e municipais foi de, respectivamente, 480,0 (P 25-75 = 330,7 - 679,2) e 576,0 (P 25-75 = 360,0 - 766,0); no caso das estaduais e federais, a mediana foi de, respectivamente, 337,0 (P 25 - 75 = 281,2 - 524,2) e 370,0 (P 25-75 = 300,0 - 480,0), Ӽ 2 (3) = 11,48, p = 0,009. As escolas não gratuitas tiveram mediana de CH total de SC de 500,0 horas (P 25-75 = 336,0 - 690,0) e as gratuitas de 364,0 horas (P 25-75 = 285,0 - 504,0), U = 4.259,0, z = - 3,26, p = 0,001. A mediana da CH, em horas, de epidemiologia e bioestatística AI entre 124 escolas foi de 88,0 (P 25-75 = 60,0 - 120,0) e de saúde do trabalhador entre 63 foi de 40,0 (P 25-75 = 33,0-60,0). Conclusões: A CH de SC AI apresenta grande variação, sendo maior em escolas não gratuitas.
其他摘要：Introduction: The limits of the Community Health (CH) course load (CL) before medical clerkship (MC) in undergraduate medical courses are not defined neither in the National Curriculum Guidelines nor in other documents, and have not been investigated in a comprehensive way in national studies. Objective: To analyze the community health course load before clerkship in Brazilian medical schools. Method: Cross-sectional study of schools acknowledged by the Ministry of Education, which started activities until December 31, 2017. The sites of the 323 existing schools were accessed and the schools that had their curricula available in the internet with details of the CH CL before MC were included. The variables were school geographic region and administration type, medical course CL and CH CL before MC, also including epidemiology, biostatistics and occupational health course loads. Data were analyzed using descriptive statistics, Pearson chi-square (Ӽ 2 ) for categorical variables and Mann-Whitney-U (U) and Kruskal Wallis Ӽ 2 tests for continuous variables. Results: Out of 323 existing medical schools, 222 were included (68.7%). Among the included schools, 83 were tuition-free (37.4%) and 139 were not (62.6%). The median of the CH CL before MC was 440.0 hours (P 25-75 = 300.0 - 640.0), equivalent to 5.4% (P 25-75 = 3.5 - 7.8) of the medical course CL. The median of the CH CL before MC in hours in private and municipal schools was, respectively, 480.0 (P 25-75 = 330.7 - 679.2) and 576.0 (P 25-75 = 360.0 - 766.0), and of state and federal schools, respectively, 337.0 (P 25-75 = 281.2 - 524.2) and 370.0 (P 25-75 = 300.0 - 480.0), Ӽ2(3) = 11.48, p = .009. The median of the total CH CL in non-tuition-free schools was 500.0 hours (P 25-75 = 336.0 - 690.0) and in the tuition-free schools, it was 364.0 hours (P 25-75 = 285.0 - 504.0), U = 4.259.0, z = -3.26, p = .001. The median of epidemiology and biostatistics CL in hours before MC in the 124 schools was 88.0 (P 25-75 = 60.0 - 120.0), whereas the occupational health CL in 63 schools was 40.0 (P 25-75 = 33.0 - 60.0). Conclusions: The CH CL before clerkship varies widely, being higher in non-tuition-free medical schools.
其他关键词：Medical Education; Curriculum; Public Health; Course Load; Community Health
