GLOBAL EM
How the COVID-19 Pandemic Highlighted the Need for More EM Specialists in Brazil SAEM PULSE | JANUARY-FEBRUARY 2023
By Marcos Campos, MD; Lucas da Matta, MD; and Anjni Joiner, DO, MPH on behalf of the SAEM Global Emergency Medicine Academy
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A Personal Story
During my first year as an internal medicine resident working in the emergency department in Brazil, I experienced firsthand the emotional and physical toll that the COVID-19 pandemic brought to health care providers. The combination of fear and doubt in caring for patients with respiratory failure coupled with hospital capacity issues, staffing, and resource shortages, and the all-too-frequent deaths followed by the inevitable difficult family conversations, gave me an appreciation for some of the intricacies and challenges involved with
emergency medicine. I've witnessed other colleagues working in these settings develop anxiety, depression, and substance use disorders while living through the chaos of providing critical care in the Brazilian health system during the pandemic. The Brazilian public health system, the largest in the world, had its breaking points tested over the last few years. With emergency medicine still in its infancy in Brazil, there are few emergency medicine specialties and specialties such as internal medicine has been forced to fill this gap and become part of the front lines of the pandemic.
The Brazilian Health System and Emergency Medicine as a Specialty
Sistema Único de Saúde (SUS), or the Unified Health System, is the Brazilian government-run health care system. As the largest public health care system in the world, coverage is available to the entire population of Brazil, over 220 million people. SUS provides multiple services, from community-based primary care, to heart transplants, as well as epidemiological surveillance programs and professional training. The system aims to improve the health of