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Medicine beyond Bars – an Experience of the University of São Paulo in Ribeirão Preto

ABSTRACT

The health of the population deprived of liberty has unusual aspects, due to the high prevalence of sexually transmitted diseases, dermatological injuries, and mental disorders aggravated by the overcrowding and precarious conditions in the penitentiary units. The health care offered is of poor quality, based on resolving specific complaints, but with difficulty accessing other health services. Integration between teaching and service is one of the guidelines for medical courses, which have the role of training critical and reflective physicians who are aware of the social needs. It was out of this approach of the university to the prison system that the discipline of Confinement Medicine emerged, in 2011, at the Ribeirão Preto Medical School of the University of São Paulo. The present report describes the process of conception and formation of the discipline and its theoretical-practical structure, and offers a reflection on the learning and its particular characteristics in confinement. This optional discipline has 30 hours and is offered twice a year, with places for forty students per year. Up until 2016, 188 medical students took this discipline. Besides the academic program, the discipline also includes practical activities, carried out in penitentiaries in the region of Ribeirão Preto. The different realities experienced by the undergraduate students in the university and penitentiary scenarios enables them to reflect on the importance of integrating these two worlds that, when in contact, contribute both to the qualification of the medical care provided and to students’ sense of responsibility as citizens, and their role as professionals. The discipline helps strengthen ties between society and marginalized populations, promoting the resocialization of people deprived of liberty. It also prompts reflections about the dimensions of illness, and their influence on the life context of these patients, enabling us to reflect on how the construction of a proper project based on these social realities can guarantee the principles of universality, equity and integrally of care.

–Delivery of Health Care; –Prisons; –Social Vulnerability; –Education Medical

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