Is there a need for more doctors in Spain?

In its last meetings, which its members have often cited later, Conference of the Deans of Medicine and the State Council for Medical Students They thought about the lack of doctors and against the opening of new medical colleges. His arguments were as follows. On the one hand, they noted that despite the increase in MIR positions in recent years, in recent calls, there were more than two medical graduate candidates for each position (remember that in practice all students who wish to practice medicine must go through the MIR system ). The other argument, though subtle, was more serious: she said that as the number of vacancies or colleges increased (many private jobs created recently), the quality of training would be at risk. The central idea would be: No more doctors should graduate than the system can accommodate.

In parallel with these attitudes that come from the university world, which are not new and obvious, the The Ministry of Universities, the Ministry of Health and the Deans Conference I stood firmly and expected Increasing the number of medical graduates by 15 percent So it is conceivable in the budget.

Different levels vary greatly in estimating these effects. In addition, the differences in assessing the situation and possible solutions are wide.

Although these methods seem private, because they affect medical schools in a special way, they are not only related to the university but also to Spanish health, when, as a result of the epidemiological stress test, they are greatly deteriorated, affecting the confidence of citizens, to which the question can now be added about The quality of the training provided.

We are on some front where we check daily the discontent caused by the lack of dialogue between different departments and those managed, particularly in primary care and also due to the working conditions of health workers. As a background we can highlight the imbalance between disciplines, the precarious situation in primary school and the frustrating when choosing a major. Added to all this is another issue of great importance. As a result of the coronavirus, a real catalyst for digital transformation, the situation has worsened. So if we do not subdue the digital humanity of technology, much will continue to be written in very different ways about the deterioration of the standard of health care, and the crisis will not stop appearing in the media, and not only from the situations most concerned about its deterioration.

It must be borne in mind that the needs for health and human or material resources will not be fully satisfied.

Because at this point, parallel to the epidemic (post-pandemic), the signs of the crisis are quite visible (the epidemic has wreaked real havoc in the West). In this sense, notable and long-standing issues include underfunding the entire system, precarious employment of professionals, working conditions for internal medical residents, and a marked tendency toward forgetting public health, dismantling primary care, and promoting privatization that is seen more strongly in some Autonomous Communities, chiefly Madrid.

The reaction of the coalition government so far, though it has launched legislative initiatives such as the Equity Act or the government’s Public Health Agency, along with agreeing to stabilize temporary staff and additional budgets for primary care and public health, appears to be less than the challenge.
In the same area we must add the approval of the primary care plan and the mental health strategy.

There is still a strong need to take a radical turn and direct human resources towards other goals that provide guarantees of stability for young professionals

In summary, regarding the periodic shortage of medical and nursing professionals that served as a justification for the continued opening of new colleges, we have already commented that the majority of those opened in recent years are private, in parallel with already discussed the dynamics of health system privatization. Given what has been seen in these years, in many cases these faculties do not meet the minimum requirements of research laboratories, libraries and hospitals to do practical teaching with full guarantees.

In short, what we mean by all of this is that the origin of the public health problem is a combination of failures in human resource management with respect to significant instability in the smaller contracts, a large funding shortfall and a large preponderance of hospital medicine over primary care that causes a large burden of hospital emergencies.

For this reason, there is still a strong need to take a radical turn and direct human resources towards other goals that provide guarantees of stability for young professionals. It is necessary, more than ever, to design a map of professionals, a register of all health professionals to know where they are, and to know the current number and retirement projections for 2025.

Finally, it must be borne in mind that health, human or material resource needs will not be fully met. The reasons for this are manifold, but the main reason is that social unrest is reflected in the health system and that the tendency will always be to medicalize it rather than solve it. A decision will always be partial.