The objective is to describe and discuss some findings on university education and learning of recent graduated doctors in their Rural and Marginal Urban Health Service (SERUMS) in the Junin region. Young doctors’ training is basically hospital based and their expectations after graduating are inclined to cure complex diseases rather than to develop primary health care activities. There is a recurrent lack of knowledge of management of health prevention and promotion programs in health posts and centers. How to communicate, give confidence, restore and support the decisions of patients are difficult in emergency situations or uncertainty about their illnesses. The emphasis on how to achieve humane care in which both professionals and patients can hear themselves and agree on joint decisions is a challenge in construction.

Background: The practice of quaternary prevention leads to avoid unnecessary health interventions. Objective: To evaluate the relevance given to the concepts of quaternary prevention (P4), to describe the influence of training in Evidence Based Medicine on its practice and to present the barriers and facilitators of the practice of P4. The Study: Mixed methods study during 2018 and 2019. We surveyed 133 physicians working in primary care and conducted semi-structured interviews with 20 participants. The principles of phenomenology were used for transcript analysis. Findings: 94% consider the practice of P4 to be important. From our interviews, barriers, and facilitators for the practice of P4 at the first level of care were identified. Conclusion: Physicians consider the practice of quaternary prevention to be important. Relevant barriers and facilitators are the specific characteristics...