Opposing views on the shortage or surplus of doctors

In his last meetings, which were later much cited by his members, Conference of the State Council of Deans of Medicine and Medical Students they argued against the shortage of doctors and the opening of new medical schools. His arguments were as follows. On the one hand, they reminded that despite the increase of MIR positions in recent years, during the last calls there were more than two candidates who graduated in the field of medicine for each position (remember that practically all students who want to practice medicine have to go through the MIR system). The other argument, although accurate, was more risky. it said that increasing the number of vacancies or faculties (many of the recently created ones private) would compromise the quality of training. The central idea will be the following. more doctors should not graduate than the system can absorb.

Parallel to these positions emerging from the university world, which are not new and clear Ministry of Universities, Ministry of Health and Conference of Rectors stand firm and wait Increase medical graduate places by 15 percent And so it is in the budget.

Different levels vary considerably in the amount of these effects. In addition, the differences in assessment of the situation and possible solutions are wide.

Although these approaches seem special because they specifically affect medical schools, they apply not only to the university, but also to the health of Spain, which is undergoing a significant deterioration due to the stress test of the epidemic, which affects the confidence of citizens. , to which can now be added the question about the quality of education provided.

We are on some fronts where we are daily verifying the dissatisfaction caused by the lack of dialogue between the various administrations and the governed, especially in the field of primary care, as well as the working conditions of health workers. As a background, we can single out the imbalance between professions, the unstable state of elementary school and the disbelief in choosing a profession. Another important significance is added to all this. As a result of the real catalyst of digital transformation, the coronavirus, the situation has worsened. Thus, if we do not subordinate digitalization to technological humanism, much will continue to be written and in many different ways about the deterioration of the level of health care, and the crisis will not stop appearing in the media, not only the positions most interested in its deterioration.

It must be borne in mind that health and human or material resource needs will never be fully met.

Because at the moment, along with the (post)pandemic, the signs of the crisis are quite visible (the pandemic has really wreaked havoc in the West). In this regard, the lack of financing of the entire system, the unstable employment of specialists, the working conditions of internal medical residents and the highly emphasized tendency to forget public health are among the special and long-standing problems. , the dismantling of primary care and the strengthening of privatization, which is felt more strongly in some autonomous communities, led by Madrid.

The reaction of the coalition government so far, although it has launched legislative initiatives such as the law of justice or the public health agency, together with the stabilization of temporary staff and the agreement of additional budgets for primary care and public health, seems to be: below the challenge size.
In the same area, we need to increase the approval of a primary care plan and a mental health strategy.

The need to make a radical turn and direct human resources to other goals that provide guarantees of stability to young professionals remains strong.

In summary, with regard to the cyclical shortage of medical and nursing professionals, which justifies the continuous opening of new faculties, we have already commented that most of those opened in recent years are private, in parallel already; the dynamics of privatization of the healthcare system were discussed. Having seen what we have seen over the years, these are faculties that in many cases do not meet the minimum requirements of research laboratories, libraries and hospitals to provide practical training with full guarantees.

In short, what we mean by all this is that the origin of the public health problem is a mixture of human resource management failure with high volatility of junior contracts, high funding deficits and high priority. hospital medicine versus primary care, which generates a high burden of hospital emergencies.

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

Finally, it must be borne in mind that health and human or material resource needs will never be fully met. The reasons for this are many, but the main one is that social unrest is reflected in the health care system, and the tendency will always be to medicalize it rather than to solve it. A resolution that will always be partial.

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