When you are little and you dream of being a doctor, what you really think about is family medicine, the doctor who attends, treats and monitors the patient. But later…”. And that ‘later’ hides a reality with which the majority of those who yesterday took the MIR tests in Oviedo, to choose the specialty to which they will dedicate their lives as medical professionals, have already come across in their practices and what does , in many cases, that their interests decant away from Primary Care. As far as possible from health centers and from a working day marked by “saturation” and that has little to do with the work that a family doctor should do.
Leire Canibe is one of those future doctors who is clear that family medicine is “mistreated”. Like many of her colleagues – more than 1,400 people took the Specialized Health Training exam yesterday at the Law School (Medicine, Pharmacy, Nursing, Psychology, Biology, Chemistry and Radiophysics); almost 28,000 in all of Spain-, she considers that this specialty is the basis of the health system. “We must improve the conditions in which family doctors work, it is not so much about increasing the places but that those that exist have good conditions,” pointed out Íker Duque, from Bilbao.
“When you see what that specialty really consists of, the bureaucracy that it implies generates rejection,” he adds. “We would all choose family medicine if it was as it says on paper: teamwork, preventive strategies… But the reality is different,” remarks Daniel Lozano, from Tenerife, who is clear about the steps that should be taken to improve Care Primary school and make it an attractive destination for doctors: promote the independence of health centers, have psychiatrists, increase the oral health portfolio and “not only dedicate themselves to pulling teeth”, include performing eye funduses to avoid having to go to the private, spirometry… In short, “that health centers are more independent.” And it is that, insists Diana Batín, from Barcelona, ”it is the basis of health.” “It’s the former and it’s facing brutal overload,” she says. Like them, many more of those who took the exam that puts 11,171 Specialized Health Training places at stake in Spain as a whole, of which 256 are in Asturias, are clear that family medicine and health centers in general are the great forgotten of the system. “If a pediatrician even charges less in a health center than in a hospital,” they lamented.
Thus, they see it as essential to improve the conditions of these places to avoid the flight of professionals. “You have to ensure that when you tell your grandmother that you are going to be a family doctor, she is as happy as if you achieved another specialty,” remarks Leire Canibe.
This flight of professionals also worries these young people. They consider that the training they receive in Spain is of high quality, generally superior to that of other countries. To study the specialty, they have no doubt: Spain is the chosen place. But when the time comes to channel the professional destiny, the problems do begin.
“Black, I see everything very black, the employment situation is very bad throughout Spain.” This is the opinion of Sara Batista and Elena Hernández, from the Canary Islands. They see France and Italy as two desirable destinations and they almost rule out the United Kingdom due to Brexit. “It is not that we want to leave, but here it is complicated,” they point out. Along with them, while they wait to enter the exam, which began about twenty minutes late, two Asturians, Carmen Cristina Álvarez, from Avilés, and Rosana González, from Oviedo, tried to take pressure off their future, although they did point out that the training and the MIR is of quality in Spain. “Asturias is not one of the worst places”, they highlight about the situation of medical professionals. Lucía Bueno arrived from Melilla to prepare for the MIR exam in Oviedo and she assures that she would like to stay in Spain to work. Ella Lucía knows first-hand the ‘market’ in the United Kingdom and although she does assume that “there is work for everyone” there, she prefers to try it in Spain.
Those complicated professional conditions that everyone believes should change, not only in Primary, make it very clear to some people. «I think about going to an Anglo-Saxon country, to England or the United States. Above all because of the working conditions”, exposes Javier Pardo from the Canary Islands.
In Germany, a first-year resident earns between 4,600 and 5,100 euros gross per month. In Belgium, between 2,000 and 2,100 euros net. An attending physician in Denmark receives between 90,000 and 100,000 euros per year. In Asturias, just over 16,000 euros, even below the average in Spain, which stands at just over 17,000. With these figures on the table, it is not surprising that Pilar Martínez and María Mainer, from Zaragoza, who would like to become a traumatologist, think about going abroad. “We do not like the future of Spain, although we do like the quality of life in this country,” they explain. Something in which a good part of those who are training to be doctors agree, such as Ana Lago, from Ferrol, and Héctor Manso, from Tenerife. “We would like to stay and it is our idea, but if they do not give us good conditions…”, they point out. While Carlota Lamadrid from Santander is committed to staying in Spain. Of course, they all insist that working conditions must be improved. Not so much because of the salaries, but also because of the workload they have to face. Otherwise, they believe, the flight of doctors will not stop despite the lack of professionals in Spain.
The Simpa calculates that given the retirements planned until 2025 in the Principality, Asturias would need at least 400 doctors to cover the staff of the health centers of its public health service.