Histórias de vulnerabilidade socioeconômica na graduação de medicina: narrativas que choram e sorriem

Abstract

In Brazil, the production and reproduction of social inequalities permeate multiple institutional fields, including the university. The undergraduate program in Medicine, marked by a long-standing elitist tradition, sharply reflects the asymmetries of class, race, and territory that shape Brazilian society. Based on a qualitative and narrative approach, this study analyzed the experiences of medical students from Federal Institutions of Higher Education (IFES) in Piauí, originating from socioeconomically vulnerable backgrounds. The objective was to understand how their trajectories reveal tensions related to access, retention, and the subjective experience of medical training. The narratives showed that, although access has been expanded through affirmative policies, retention remains hindered by material and symbolic barriers, with significant repercussions on students' mental health. Informal support networks and strong individual agency were identified as key strategies of survival and resistance. The analysis revealed a “clash of worlds” experienced by the students and the persistence of subtle forms of discrimination intersecting markers such as race, gender, and sexuality in academic life. It was concluded that, while these trajectories denounce structural inequities, they also point to paths toward social justice through recognition, redistribution, and participation. It becomes imperative that universities transcend their merely selective role, fostering inclusion and equity through enhanced student assistance, continuous assessment of affirmative actions, strengthened psychosocial support, and the deconstruction of prejudices – towards a medical education that is more ethical, pluralistic, and socially grounded.