A ordem médica e a desordem do sujeito na formação da identidade profissional médica
Data
2009
Autores
Almeida, Marilia de Toledo 
Orientadores
Sarti, Cynthia Andersen
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Este trabalho teve como objetivo investigar a construção da identidade profissional de médico, considerando a diversidade de relações envolvidas nesse processo, em particular a relação médico-paciente, dentro da problemática da “desumanização da medicina”, questão trabalhada no âmbito da Saúde Coletiva. Adotando como referência a noção de habitus, tal como formulada pelo sociólogo Pierre Bourdieu e as noções de “identificação” e de “mecanismos de defesa” da teoria psicanalítica, buscamos investigar os mecanismos sociais e psíquicos envolvidos na construção da identidade médica, por meio da análise do processo de internalização e exteriorização dos elementos que caracterizam o “ser médico”, durante a formação profissional em medicina. Foram sujeitos da pesquisa
estudantes de todos os anos do curso de graduação em medicina, médicos recém-formados e professores e preceptores médicos do curso de medicina de uma universidade pública da cidade de São Paulo. Dado o caráter compreensivo e interpretativo, intrínseco ao fenômeno estudado, optamos pela utilização da metodologia qualitativa. Como técnicas para o trabalho de campo, elegemos a observação das atividades dos estudantes que envolvessem contato com o paciente e entrevistas abertas com sujeitos selecionados a partir dos dados de observação (estudantes, residentes e professores). A análise dos dados foi realizada com base na leitura exaustiva do material de campo (registrado em diário de campo e pela transcrição das entrevistas) e na construção de categorias analíticas. Revelou-se a existência de mecanismos institucionais que promovem uma indiferenciação
entre os alunos e que impõem aos mesmos elementos relacionados à dimensão social que a figura de médico representa, anulando suas características singulares. Da mesma forma, estes mecanismos estabelecem relações de poder e imputam um saber absoluto como exigência para a pertinência no lugar de médico. Ao anular a subjetividade do aluno, desorganizar sua identidade pessoal e exigir dele condições impossíveis de serem correspondidas na prática, estes mecanismos obrigam o estudante a lançar mão de mecanismos de defesa que o impedem de viver relações saudáveis com o outro.
This work investigates the construction of professional identity of the doctor, considering the range of relationships involved in this process, in particular, that between the doctor and the patient, within the investigation of the “dehumanization of medicine”, a topic pertaining to the area of Collective Health. Adopting as a framework the notion of habitus, formulated by the sociologist Pierre Bourdieu, and the notions of “identification” and “defense mechanisms” of psychoanalytical theory, it seeks to investigate the social and psychic mechanisms involved in the construction of the doctor’s identity, through an analysis of the process of internalization and externalization of the elements that characterize what it means to be a doctor, during the professional training in medicine. The research subjects were: students in all years of the graduation course in medicine, recently graduated doctors, interns, teachers, and medical preceptors of the course in medicine of a public university in the Brazilian city of São Paulo. Given the comprehensive and interpretative nature that is intrinsic to the phenomenon in question, we opted to use a qualitative methodology. For the field work, we used the techniques of observation of students' activities involving contact with the patient and open interviews with selected subjects, based on data from the observation (students, interns and teachers). The data were analyzed based on an exhaustive reading of the material gathered in the field research (information recorded in a field diary, and transcription of the interviews) and on the construction of analytical categories. The existence of institutional mechanisms that promote indifference among the students, imposing on them elements related to the social dimension represented by the figure of the doctor and overriding their unique characteristics was revealed. Similarly, these mechanisms establish relations of power and attribute absolute knowledge as a requirement for belonging to the profession of doctor. By overriding the student’s subjectivity, reconfiguring their personal identity, and requiring conditions that are impossible to put into practice, these mechanisms oblige the student to resort to defence mechanisms that prevent them from forming healthy relationships.
This work investigates the construction of professional identity of the doctor, considering the range of relationships involved in this process, in particular, that between the doctor and the patient, within the investigation of the “dehumanization of medicine”, a topic pertaining to the area of Collective Health. Adopting as a framework the notion of habitus, formulated by the sociologist Pierre Bourdieu, and the notions of “identification” and “defense mechanisms” of psychoanalytical theory, it seeks to investigate the social and psychic mechanisms involved in the construction of the doctor’s identity, through an analysis of the process of internalization and externalization of the elements that characterize what it means to be a doctor, during the professional training in medicine. The research subjects were: students in all years of the graduation course in medicine, recently graduated doctors, interns, teachers, and medical preceptors of the course in medicine of a public university in the Brazilian city of São Paulo. Given the comprehensive and interpretative nature that is intrinsic to the phenomenon in question, we opted to use a qualitative methodology. For the field work, we used the techniques of observation of students' activities involving contact with the patient and open interviews with selected subjects, based on data from the observation (students, interns and teachers). The data were analyzed based on an exhaustive reading of the material gathered in the field research (information recorded in a field diary, and transcription of the interviews) and on the construction of analytical categories. The existence of institutional mechanisms that promote indifference among the students, imposing on them elements related to the social dimension represented by the figure of the doctor and overriding their unique characteristics was revealed. Similarly, these mechanisms establish relations of power and attribute absolute knowledge as a requirement for belonging to the profession of doctor. By overriding the student’s subjectivity, reconfiguring their personal identity, and requiring conditions that are impossible to put into practice, these mechanisms oblige the student to resort to defence mechanisms that prevent them from forming healthy relationships.
Descrição
Citação
ALMEIDA, Marilia de Toledo. A ordem médica e a desordem do sujeito na formação da identidade profissional médica. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2009.