2023-06-20 15:18:00
In the next single residency exam to cover 5,848 vacancies in medicine, nursing and biochemistry starting in September in hospitals and private centers in the country, the loss of interest of Argentine graduates in following this paid postgraduate training is already having an impact. According to official records, the proportion of foreigners to fill these positions rose to almost a third in the midst of an unprecedented human resources crisis in the Argentine health system.
31% (2,280) of the 7,312 candidates eligible to take the exam next week are from other countries, which coincides with the growth of foreign students in universities that offer careers in health sciences. Last year, they were 22% of the 7,170 that had been qualified for the national evaluation, according to the data from the official online list that compared THE NATION.
It is unknown not only how many stay or return to their countries once their residency is finished, but also which path Argentines prefer to follow once they finish college.
Through this exam, most of the places in the country are covered for some 70 medicine specialties and all biochemistry and nursing specialties. Other professions and post-basic residencies -in a specialty after completing the basic residency- have their exams separately, according to the contest chosen).
The estimated percentage this year is the highest since before the COVID-19 pandemic. Covid-19. And with only 1.9% more qualified applicants than last year, this year there are 43.6% more registered from other nationalities.
Most graduated between 2020 and 2022, although there are titles obtained from 2010 (the requirement is that they be locally validated from Argentine or foreign universities).
By registrants, regardless of the specialty chosen when registering for the exam on the 28th of this month, the most sought-after residencies are nursing, with more than a thousand applicants –more than double the positions offered–, followed by general surgery, anesthesiology, pediatrics, clinical medicine, obstetrics, diagnostic imaging, and orthopedics/traumatology.
Among the 5,028 Argentines, the most demanded is, in order, nursing, anesthesiology, general surgery, pediatrics, clinical medicine, obstetrics, cardiology, ophthalmology, general/family medicine, and diagnostic imaging.
Meanwhile, the main search of foreigners is inclined to general surgery, diagnostic imaging, nursing, orthopedics/traumatology, cardiology, pediatrics, otorhinolaryngology, dermatology and medical clinic.
Pediatrics, one of the specialties in critical condition, is the one with the most offer of positions this year: 837, including the articulated quotas with neonatology or intensive care. But even if all the applicants passed the exam, 40% of the positions offered would remain vacant, as the Argentine Society of Pediatrics (SAP) had anticipated in this medium. The same applies to clinical medicine, general and/or family medicine, intensive therapy, child and adolescent psychiatry or neonatology, a specialty in which 36 vacancies are offered and there are only six applicants.
how is he posting THE NATION In the series of notes “Who is going to take care of us?”, a healthcare system that is less and less attractive to professionals is quietly creaking, while the staff tries to respond to the needs of the population. Overwhelmed doctors, who go through stressful situations on a daily basis and receive salaries that do not pay off explain the exodus and other ways that professionals find to improve their income and quality of life. A crisis that is also reflected in the public sector, with hospitals that suffer massive resignations of professionals and institutions where guards stop working.
“Health care is requiring a stimulation of the training of professionals, especially in intensive care, neonatology, internal medicine and psychiatry,” he says. Luis Ignacio Bruscodean of the Faculty of Medical Sciences of the UBA, one of the main contributors of residents to the contests.
“When surveys are carried out, we see that more than academic success, a young person today wants well-being and quality of life. The faculty does not want to generate suffering professionals, but to fulfill their vocation with quality of life and well-being. Luckily, we have a health system and an educational system for graduate and postgraduate courses desired by foreigners from different countries. This, as it is happening in the faculties and health systems in the world, raises the level ”, he adds in dialogue with THE NATION.
In that faculty, a change to the residence regulations is being proposed that contemplates, among other points, 12-hour shifts or a day off after shift. “It is for the benefit of the resident, but also of the patient. A tired doctor cannot work well”, defines Brusco, who is a member of the Argentine Forum of Public Faculties and Schools of Medicine of the Argentine Republic (Fafemp).
“Throughout the world – he continues – health systems are having problems. We are receiving orders from professionals [en la UBA] from Europe, which speaks of the need to encourage the training of doctors, especially undergraduate and postgraduate. In this case, the training is being through the specialist career, not by residency, due to the economic difficulty in which the health systems are seen, the low income and, also, the overdemand that there is.”
Working conditions, one of the causes of the loss of interest in residency among young doctorsLara Sartor TELAM
Already last year, the number of graduates who finally took the exam was below the vacancies to be filled in 17 provinces. As this medium published at the time, in the eight specialties considered to be a priority, barely half attracted more candidates than the positions offered: general surgery, obstetrics, anesthesiology, and nursing.
“The residency is the method of consolidating the knowledge received and, precisely because it is supervised service learning, it is the best of all. But this demands that young people think so and, in that, we teachers who do not transmit it must have a bit of responsibility, ”he says. Hugo Catalanodirector of the Medicine career of the Salvador’s university (USAL) and the Medical Clinic Residency program of the german hospital.
“That a high percentage of graduates begin to care for people without a residence jeopardizes the quality of care and that is where you have to consider whether or not the degree is qualifying,” he completes from his 50-year experience in medical education at the UBA and daily dealings with students and resident doctors.
He considers that “it should alert” that there are fewer and fewer graduates who want to go to the residences, either because they do not know what they are going to do once they graduate or because the conditions are bad (a 12-hour guard, for example, is is paying less than $2000 an hour). “This is a wake-up call. It tells us that there is an arduous educational work ahead that involves a diagnosis of the care needs in the country, a unified national examination of residences and a health map to define where and which professionals are needed, ”she proposes.
With the resignations of specialists, the difficulties for the generational renewal of positions in a large part of the districts and the multi-employment of professionals, the working conditions of residents and attendees exceed what they should be in a stage of supervised training, with services already at mid-morning in which there are only residents attending to patients.
With respect to the national average, this loss of interest among Argentines who graduate from health careers for paid training within the health system is even greater in the unified competition shared by the Ministry of Health of the Nationthe Buenos aires city and the Buenos Aires province.
Without too much difference in the number of registered with respect to previous years, as specialists who work with those jurisdictions agree, the proportion of foreigners is 42% among the 5,258 applicants to fill vacancies in the hospitals and health centers administered by these three jurisdictions.
The National Ministry of Health did not authorize the Directorate of Human Talent and Knowledgethe area that coordinates the Unified Contest and the Single Exam, to answer the questions in this medium.
Official reports indicate that the majority of foreign professionals who apply come from Bolivia, Ecuador, Brazil, Venezuela, Colombia, Peru, Paraguay y Chile. There are beginning to be universities from those countries that are among the main contributors of residents to some jurisdictions.
Catalano attributes a greater presence of foreigners to the cost and quality of education and postgraduate training compared to their countries. There are residences that are associated with the university degree, which, as he explains, allows them to access the title of university specialist.
Of course not all who apply ultimately take the exam, nor do all who pass ultimately take office. That is why readjudications are called last September: in the last two years, between 30 and 40% of the seats have remained vacant.
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