The departure of young doctors threatens to trigger a staffing crisis in Spanish healthcare
Experts, speaking about Spain's rapid loss of positions, cite several reasons. The main one is the policy of reducing the public sector in the healthcare system and increasing private clinics. For several years now, the industry has been constantly shaken by endless rallies and demonstrations by Spanish doctors and nurses protesting against healthcare reform and the privatization of state centers and hospitals in a number of autonomous communities.
The most massive unrest caused by privatization occurred in Madrid. Doctors' protests have been aptly dubbed 'marea blanca' (white wave) by journalists – to attract public attention, medics appear at demonstrations in white coats.
Moreover, within the country, the situation with access to medical care is very uneven. For example, in the north, in Aragon, the percentage of doctors is high (46.6 doctors per 10,000 people), while in the south, in Andalusia, and in the central part, in Castile-La Mancha, it is low (30.1 doctors).
In recent years, Spain has developed a paradoxical situation: university medical faculties are graduating more and more qualified specialists every year, yet the number of doctors in the country is decreasing. The reason is that graduates cannot find work – the number of jobs is shrinking, there are almost no vacancies for young professionals, and unemployment among medics is rising. Due to lack of prospects at home, Spanish doctors are leaving for other countries. The trend of 'professional emigration' in the medical sector has intensified especially in the last three years.
There is another reason for the worsening situation with personnel in Spanish healthcare – innovations in the education system, specialization and obtaining medical diplomas. The number of places in the national system for training medical specialists (MIR) – internship – has significantly decreased. Everyone now knows about the hard working days of interns thanks to the TV series of the same name. But not everyone understands that without becoming an intern, a medical school graduate will never become a gynecologist, urologist, cardiologist, allergist, neurologist, or any other doctor...
Today, to work in a public clinic or start a private practice in Spain, a medical student must spend 11 years mastering the profession: 6 years of university study, one year of preparation for admission to the MIR internship, and another 4 years of internship.
But the number of places in the internship does not correspond to the number of medical school graduates. 'According to official data, there are currently 35,000 medical students in the country, although in reality there are more – about 40,000; universities are underreporting,' says Juan Pablo Carrasco, president of the Coordinating Council of Medical Students. 'Each year, medical faculties graduate 7,000 people, while the number of internship places today does not even reach six thousand. One in seven of us will not be able to complete education and become a specialist doctor.'
So every year at least a thousand graduates of Spanish medical faculties are left idle and face a dilemma: either change profession and then six years of study go down the drain, or wait until next year and try to apply again, or take fate into their own hands and go abroad – to continue studying and working.
And there are more and more of those leaving. By the summer of this year, more than 3,400 newly minted heirs of Hippocrates and Asclepius, having decided to emigrate, received a special professional competence certificate confirming that they studied medicine at university. Most of them are young doctors without professional specialization, that is, those who did not get into the internship.
The place of departing Spaniards is taken by immigrant doctors – mainly from Central and Latin America. However, experts seriously say that the industry is facing a serious staffing crisis in the coming years.
Natalia TIMASHOVA.
Novye Izvestiya