Training Expectations in Latin American Medical Residency: A Critical Review of Motivations and Educational Conditions

Abstract

Introduction: Specialized medical training in Latin America takes place in settings where a persistent gap exists between formal educational goals and real working conditions, characterized by excessive workloads, insufficient supervision, and hierarchical educational climates. Understanding how these conditions shape residents' training expectations is essential to guide reforms adapted to the regional context.
Objective: To critically analyze the available evidence on the training expectations of medical residents in Latin America, identifying patterns, tensions, and gaps that may inform future research and the redesign of educational policies.
Method: Systematic review of original articles published between 2010 and 2025 in PubMed and SciELO on training expectations or needs of Latin American medical residents. Of 71 references screened, 30 studies were included. The information was coded and categorized inductively into two main axes: (1) vocational motivations, professional identity, and career projection; and (2) teaching quality, pedagogical dynamics, and educational climate.
Results: Residents show high intrinsic motivation, strong vocational commitment, and expectations of continuous professional development, but they train in programs with insufficient tutoring, scarce feedback, and poorly systematized assessment processes. Educational climates are frequently marked by rigid hierarchies, heavy workloads, lack of resources, and episodes of mistreatment, which undermine well-being, emerging professional identity, and career decisions. The coronavirus disease 2019 (COVID-19) pandemic intensified these tensions and exposed structural weaknesses in pedagogical organization, supervision, and mental health support.
Conclusions: Residents' training expectations converge around the demand for continuous tutorial support, explicit formative assessment, pedagogical models centered on clinical reasoning, safe and respectful educational climates, and coherence between vocational projects and real opportunities for professional development. Progress toward more equitable and genuinely educational residency programs requires integrating these expectations into curriculum design, assessment systems, and the organization of clinical work, so that daily care activities are explicitly structured as guided learning opportunities.