Yesterday, the eighth day of assigning places. The procedure to grant 8,768 specialized training positions to doctors began on the 5th and will conclude next Thursday. According to the forecasts and the model of previous editions, dermatology and plastic surgery were sold out on the first day. At yesterday's closing, 30 of the 46 specialties had been completed. Of the 2,272 places still vacant, 1,848 correspond to family and community medicine, which for the moment has only managed to place 26% of the offer. It is one of the most deficient branches, also the one that presents the most opportunities (2,492). The bad reputation of this specialty among recent graduates persists, essentially due to working conditions, say professionals.
Conditions that have not discouraged Jimena Riesco, number 17 among the 11,755 graduates who passed the mir exam and the first to opt for family medicine, a specialty to which her parents are dedicated and to which, consequently, she knows the strengths and weaknesses. After six years at the Complutense University, on May 7 – like the rest of the class – she will begin her residency, in her case at the San Carlos clinical hospital, in Madrid.
Roberto Pinto Lorente could also have chosen any specialty (except dermatology and plastic surgery, sold out in numbers 648 and 827), who got order number 1,082. And he opted for family medicine, the first of the 371 places that must be assigned in Catalonia, the community with the most vacancies behind Andalusia (434).
Hero or unconscious? The trajectory of this new R1 (first-year resident), born in Salamanca and living in Barcelona for years, is particular. A biotechnologist by training, he worked in the proteomics laboratory of the CSIC / UAB and at the same time studied medicine. He finished the 2021-2022 academic year, passed the MIR and chose a position in gynecology, but he understood that he had made a mistake and decided to leave. “Gynecology is the most beautiful specialty, but in clinical practice I didn't see myself as a surgeon, I saw myself more as a doctor. Since I left residency I thought about family because in this specialty you don't focus only on organs, you see the person as a whole, it is medicine in its essence: the doctor, the stethoscope, the clinical assessment... "
He took the mir exam again on January 20 and got a better number than last year. So, on May 6, at 39 years old, Pinto will join the multiprofessional family and community care teaching unit Barcelona Ciutat (UDM) and will visit different health centers to choose and begin a four-year residency. It will not be in Vall d'Hebron, because she studied there and intends to see other work environments. She sees it as a reward for the vocation and effort that she has dedicated to her studies outside of working hours – “if you don't like this career, it is almost impossible to get out of it” – although she admits that she had doubts. Doubts that end up making hundreds, thousands of applicants give up: “In the end, family medicine is very mistreated. Resources are needed. But without good primary care the public health system collapses. I think we really have to strengthen the primary school, and we are part of this reinforcement.”
“I have chosen family because it is very complete and I can do good for society. Primary care needs motivated doctors who value the specialty,” she proclaims. Although he admits that it is a stigmatized branch and the bets indicate that, for the third consecutive year, there will be empty places at the end of the ordinary assignment process.
This stigma, which in Pinto's opinion extends from medical students to the general population, “is not based on real facts.” “People don't know a lot about what primary care doctors do. They're not just about prescribing ibuprofen. In one morning you have 30 patients and you are either looking at an ear or making a bandage. It is a very dynamic specialty and you have to know a lot about medicine.” In his environment, he says, they ask him how, having been able to choose anything else, he opted for primary school. The stigma.
According to David Arribas, deputy secretary general of Metges de Catalunya and family doctor, the rejection does not respond to remuneration. The new ICS agreement contemplates a homogenization of salary tables between all specialties. In Arribas' opinion, “the initial priority of all specialists is to work in the public sector, but let's say that this love for the public sector lasts 15 years. Because our public system is so abusive, people want to have options with high private potential, and for family medicine the private exit is more difficult than cardiology, plastic surgery or dermatology.”
Students learn about the suffering of family medicine professionals. For this reason, according to Arribas, it is not attractive: “From minute zero you enter into a very high quota of work and the Administration has zero recognition of the work you are doing.”
Roberto Pinto hopes to be able to dedicate himself to work thinking about his patients and not their working conditions: “Getting to know people, having people talk about me as their doctor.” “I would encourage those who are still undecided to go for the primary, although the important thing is to be a good doctor whatever they choose.”
