Profile and distribution of orthopedic residency graduates in Pará: training and challenges in the Brazilian Amazon

Abstract

ABSTRACT Introduction: Medical residency in Orthopedics and Traumatology is essential for the training of specialists and for strengthening healthcare in Northern Brazil, where there are significant challenges related to the distribution and retention of these professionals. Objective: To analyze the professional profile of graduates from the Orthopedics and Traumatology medical residency program of a public institution in the state of Pará, considering geographic distribution, healthcare delivery, subspecialization, and academic involvement. Method: This is an observational, descriptive study with a quantitative and qualitative approach. Data were collected through an electronic questionnaire containing both open and closed questions, sent to all program graduates from 2010 to 2024. Quantitative data were analyzed using descriptive statistics, while open responses underwent thematic content analysis. Results: A total of 40 graduates participated, of whom 82.5% currently practice in the state of Pará, with 67.5% located in the capital city. Most graduates (95%) pursued at least one subspecialization, primarily in knee surgery (18.8%), hand and wrist (14.6%), foot and ankle (10.4%), and orthopedic trauma (10.4%). Only 18.4% completed subspecialization within the state. The average monthly patient volume was 260.5 consultations per physician, with 35.6% in the public health system (SUS) and 64.4% in the private sector. The average surgical production was 24.7 procedures per month, fairly distributed between the SUS (47.0%) and the private sector (53.0%). Half of the graduates are involved in medical education, working as preceptors or residency supervisors. The main motivations for choosing the program included emotional and geographic ties, recognition of the training quality, and logistical factors. Conclusion: The residency program contributes significantly to training and retaining orthopedic surgeons in the Amazon region, strengthening the local healthcare network. However, challenges remain, such as the concentration of professionals in the metropolitan area, limited availability of local subspecialty training, and insufficient integration into the public health system (SUS). Public policies promoting the decentralization of medical practice and the expansion of training opportunities are essential to consolidate orthopedic care in the region.