Up to 90% of family medicine MIRs leave the specialty after completing their training. Society

There is a shortage of primary care doctors in Spain. According to medical societies, about 5,000, which causes a lack of resources in health centers, which affects four out of every ten Spaniards (according to the CIS) and which depletes the system at critical times,.. .

There is a shortage of primary care doctors in Spain. According to medical societies, about 5,000, which leads to a lack of resources in health centers, which affects four out of every ten Spaniards (according to the CIS) and which collapses the system in critical periods, such as the flu. The peak of the epidemic. last Christmas. The Autonomous Communities, especially those of the PP, have demanded this Friday that the Government demand more posts for Family Internal Resident Doctors (MIRs) to solve the problem at the Plenary Session of the Interterritorial Council of the National Health System (CISNS). Do. , Health Minister Mónica García has committed to creating them, but reminded them that this is not the main problem: “According to the communities, 50% to 90% of MIRs (who do family medicine) do not do their residency.” Stay here after finishing.”

That is to say, although they train to become family doctors, they later choose other professional opportunities, such as working in hospital emergency rooms, in the private sector, going abroad, or here. Until acquiring another specialization with better conditions. There are many factors that influence this loss. But there is a vicious cycle that is wearing down the system and has accelerated during the pandemic: Doctors have less time to see patients, making working in a health care setting less attractive, which means that Less and less MIRs are added, leading to more and more patients per doctor…

“We need professionals to have appointments that are less than 48 hours, to be long, slow, contemplative, to have consistent, personal follow-up and a community approach. There is no primary care without time and without primary care we cannot have a strong system. Overwork, lack of professional recognition, uncertain contracts, consultation of 60 patients a day must be addressed. There is no point trying to prepare professionals in an environment where patients are expelled, Garcia said at a news conference after the council.

These are powers transferred to all autonomous communities. They are the ones who hire, they are the ones who incentivize and they are the ones who decide the size of the workforce. Consultants have reached a commitment to try to improve conditions, sustainability and make the specialization more attractive with, for example, incentives to go to rural areas that are usually difficult to cover. Also reduce bureaucracy and increase digitalization, so that doctors can focus on diagnosis, care and treatment. But in a plenary session dominated by PP ministries, those responsible focused on the government’s only direct competence: creating more MIR family spaces. He has asked for an increase of 1,000 places annually over the next four years.

The truth is that they have not stopped growing in recent years. In 2024, a historical record was broken with 8,772 places offered, of which 2,492 were in the specialization of Family and Community Medicine. In addition to poor working conditions that force doctors to leave their jobs, the current shortage of professionals comes from the reduction in positions that occurred during the crisis, reaching a low of 6,098 positions in 2016 with the government of Mariano Rajoy.

The increase in places also depends on which autonomous communities manage to give recognition. That is, those that their health systems are capable of producing. It is not just about making them, but making them demonstrate that they can serve these new doctors who are trained in the system. The ministry has agreed to reduce the accreditation requirements “as long as the quality is maintained”, but also reminded that there are communities, such as Extremadura and Castilla y León, which accredit twice as many places based on their higher than average population. . “We have to learn from them. If they all hit that average, we’ll be 70 doctors away from getting to the 1,000 doctors they’re asking for,” Garcia said.

removing masks

The CISNS Plenary Session also worked to withdraw the rule on the mandatory use of masks in health centers, as the pandemic wave of flu and other respiratory infections is “controlled”, in the words of García, who thanked “effort and responsibility”. . of communities, professionals and patients during these weeks.

The measure was implemented against the norms of the majority of councilors on January 10, when the peak of infections in Spain had already been passed. Health forced communities to put them in hospitals and health centers until infections declined for two consecutive weeks in each area, a situation in which some were already at that time and gradually everyone else was reaching. Were.

García reiterated that Health and Communities “has secured a commitment” at this Friday’s meeting to start working “right away” with data from this latest pandemic for respiratory virus planning for next winter.