title: An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil.
abstract: OBJECTIVE
  To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life.
  
  
  METHODS
  Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil.
  
  
  RESULTS
  Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p<0.01), worked exclusively in prehospital care (18.0 vs 7.7%; p<0.001), with workloads >48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU.
  
  
  CONCLUSIONS
  The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital emergencies. A disrespectful labor scenario was also found; the evaluation of quality of life showed a notable presence of pain on the SF-36 among physicians at SAMU and especially among doctors who had worked for a longer length of time at SAMU.
authors.affiliation: Departamento de Cirurgia, Escola Paulista de Medicina (UNIFESP/EPM), Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fernando Sabia
authors.initials: FS
authors.lastname: Tallo
authors.affiliation: Departamento de Cirurgia, Escola Paulista de Medicina (UNIFESP/EPM), Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Simone de
authors.initials: Sd
authors.lastname: Campos Vieira Abib
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina de São José do Rio Preto, São Paulo, SP, Brazil.
authors.forename: André Luciano
authors.initials: AL
authors.lastname: Baitello
authors.affiliation: Division of Cardiology, School of Medicine, Duke University, Durham, EUA.
authors.forename: Renato Delascio
authors.initials: RD
authors.lastname: Lopes
mesh_terms: D000328:Adult; D001938:Brazil; D002983:Clinical Competence / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data*; D008875:Middle Aged; D016272:Occupational Health; D010147:Pain Measurement; D011788:Quality of Life; D013997:Time Factors; D016526:Workload