Observância das competências da Matriz Curricular Nacional na formação dos residentes de oftalmologia na Bahia

Abstract

Introduction: Competency-based medical education is consolidated in national/international guidelines; in Brazil, National Commission on Medical Residency (CNRM) issued a specialty-specific Competency Matrix. Local evidence on adherence in Ophthalmology is needed. Objective: To assess adherence to the CNRM Matrix in Ophthalmology residency programs in Bahia, describe strengths and gaps by year, and test whether prior reading of the Matrix is associated with higher mastery. Methods: A cross-sectional study including residents from seven services. A Matrix-based questionnaire classified items as ‘mastered’, ‘partially mastered’, or ‘not mastered’. We performed overall, year-wise and institution-wise descriptive analyses; readers vs. non-readers were compared with a two-tailed Mann–Whitney test. Results: Forty-nine residents responded (R1=22; R2=16; R3=11). Overall, ‘mastered’ 36.06% (95%CI 29.11–43.01), ‘partially mastered’ 48.53% (43.21–53.85), and ‘not mastered’ 15.61% (12.11–19.11); ‘mastered’ was stable across years (R1 35.82%; R2 36.06%; R3 36.55%). Stronger areas included “Cataract and Lens”, “Uveitis and Ocular Inflammation” and “Cornea and External Diseases”; recurrent gaps appeared in Contact Lenses, Low Vision Rehabilitation and Refractive Surgery. Institutional profiles suggested some complementary coverage across services. Prior reading of the Matrix was associated with higher (total and partial) mastery per respondent (90.5% vs. 83.1%; Δ=7.4%; p=0.049, two-tailed). Conclusion: We observed high overall adherence to the national Competency Matrix, alongside gaps clustered in specific subareas that could be mitigated through inter-institutional cooperative arrangements. Embedding competencies into day-to-day residency practice (with explicit goal alignment, curriculum mapping, and programmatic assessment) is recommended to enhance mastery across training. Multicenter longitudinal studies with larger samples are warranted to confirm these findings and to quantify the impact of structured interventions.