2023-05-08 18:32:40
What does the specialty of Family Medicine have that does not attract the attention of young doctors who have just finished their studies? The answer is complex, because the problem is structural and occurs throughout Spain, but several health spokespersons consulted by this newspaper agree that three keys that lead the MIR to avoid this area: the ignorance of it, the negative perception of Primary Care and its Labor conditions and the mindset of professionals to tend to work in large population centers.
One more year, Family Medicine has returned to be the Ugly Duckling in the allocation of training places of the Ministry of Health for this 2023 because 202 vacancies have remained throughout Spain. With a full house in Biology, Chemistry, Nursing, Physics, Pharmacy and Psychology, Medicine has been the only one that has finished the term with open positions, all of them in the Family and Community area. In the rest of the medical specialties (such as Dermatology, Urology, various Surgeries, Oncology or Pediatrics) she has posted the complete poster.
“It would be necessary to consider that the students of the Degree in Medicine opt for a complete subject of Family Medicine, with the same credits as any other specialty, because I reiterate: we are specialists,” says Pilar Borraz, a rural doctor
Castilla y León (55 vacancies), Galicia (39) and Catalonia (36) are the communities with the most available places in Family Medicine, followed by Extremadura (27), Navarra (18), Aragón (15) Asturias (6), Cantabria (4) and La Rioja (2).
In the case of Aragon, 82 MIR places were offered for this 2023 in Family Medicine. That is, 67 positions have been covered of this specialty in the community. Of the 15 that have remained empty, 7 correspond to free places in Alcañiz (where only one has been covered); 5 in Calatayud (one covered); and 3 in Barbastro. “The problem is more serious than we can imagine. To the retirement of colleagues that will take place in the coming years, the fact that so many MIR positions in Family Medicine have been left unfilled forces us to reconsider what are the problems that prevent future specialists from opting for it as a way of practicing their profession» reflects Pilar Borraz, spokesperson for Rural Primary Care of the Fasamet union.
Alcañiz and Teruel, two opposite situations
Borraz, who works as a family doctor in Mas de las Matas, believes that the choice of places electronically “has done a disservice” to the process award of training. «Professionals defend a return to the previous method of face-to-face election. It would be necessary to consider that the students of the Degree of Medicine choose to a complete subject of Family Medicine, with the same credits as any other specialty, because I reiterate: we are specialists», considers Borraz. «Right now the teaching time does not make future colleagues feel attracted. And we are no longer talking about the employment situation, another of the issues that would have to be addressed forcefully and it would be before the future that is yet to come,” he says.
“Right now, the teaching time does not make future colleagues feel attracted. And we no longer talk about the employment situation, another of the issues that would have to be addressed,” says Pilar Borrar, spokesperson for Fasamet Rural Primary Care .
In the city of Teruel, contrary to what has happened in Alcañiz, this year all the places in Family Medicine have been completed. “I think that It is not as valued as a specialty due to a lack of knowledge. Here we have filled and the good thing about a hospital like Obispo Polanco is that the training is very close because, being small, the relationship between the tutor and the MIR is greater», explains Paco Rodilla, spokesman in Teruel for the Cesm medical union. «This very direct relationship facilitates training, which ends up being very enriching. The MIR not only goes through the ER, but also has access to all specialties and that is an advantage here», reiterates.
“In Teruel we have filled and here the relationship between the MIR and the tutor is close as it is a small hospital, but the mentality of young people is different. Nobody wants to go to a small city and even less to a town,” says Paco Rodilla, Cesm spokesperson in Teruel.
In the case of Polanco, many of the MIRs this year come from Valencia, due to its proximity. «The mentality of young people has changed because now they tend to want to be in more populated nuclei and there Family Medicine loses because Primary Care in smaller towns is greatly affected. Nobody wants to go to a small town let alone a village» adds Rodilla. Added to this situation are the working conditions offered by Family Medicine beyond the big cities, so many times denounced by the unions for being “precarious” and “unattractive” contracts for young.
“Here we form them and others take it away”
The problems that Primary Care has been showing in recent years, with delays in dating, saturations due to lack of staff or high workload that make the MIR shy away from that job in the future. «If they come from other countries to take these professionals, it will be for a reason. Here we line them up and then they go outside. Something is failing, “says Pepe Borrell, president of the Huesca College of Physicians. «Family Medicine is the great unknown and also the most beautiful specialty there is because you cover the pathologies of a patient from top to bottom. In addition, a close and pleasant treatment is generated, very familiar », he adds.
And if this is so, what is wrong? Borrell is clear: «Among other things, that Most of the training is hospitalized and, when it comes to applying this learning in Primary Care, there is a significant clash because it is not the same», dice.
“Most Family Medicine training is hospitalized and when the professional arrives at the health center they realize that it is not the same,” says Pepe Borrell, president of the Huesca College of Physicians.
In this sense, he explains that The professional realizes when he arrives at the health center “that what he has learned in his MIR is nothing like it” at your work. And he adds: “He sees himself doing bureaucratic work or doing a lot of business for his hospital colleagues, with a lot of demand and few professionals. With everything, a feeling of contempt towards Family Medicine is generated that is transmitted and, in the end, is evidenced year after year in the allocation of places», says Borrell. “The system is very resentful and positions must be filled with the same quality as before, it is not enough just to fill the vacancies and then go abroad because the problem is that we do not have generational replacement,” says the spokesperson for the doctors. from Huesca.
The Department of Health of the Government of Aragon is confident that the 15 free places in the community will be covered in the extraordinary period that the ministry has opened until this Thursday. What these results reveal is the little interest of Medicine students for training in regional or provincial centers”, they pointed out.
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