Have you seriously considered going to work abroad after graduation? Almost seven out of ten resident doctors (during specialized training) in Catalonia answer this question in the affirmative. In fact, 40% do not see themselves working in the public health system ten years from now. These are data from an opinion study among hundreds of residents carried out by Metges de Catalunya (MC).
Àlex Mayer, secretary of residents and young doctors of the union, considers the lack of adherence expressed by doctors in training to be worrying, which is basically attributed to the working conditions and the difficulties of reconciliation. 68% describe the workload as overwhelming or very overwhelming and up to 81% state that it exceeds the 48 hours of work per week stipulated by European standards.
In Catalonia, around 4,000 nurses are trained in 18 primary care teaching units and 48 hospital units. MC surveyed 767 of them between February and March in order to find out their opinion about the working conditions and future prospects within the public health system when they obtain the specialist title.
The outlook is not optimistic. “At a time when the retirements of professionals from the baby boom generation make it more necessary than ever that professionals who are trained in the public system remain in the public system, lately there is a lot of demand and a lot of ease of access to doctors in the private environment of Catalonia”, according to Mayer.
77% of residents say they have problems balancing family life. “We cannot rest as we should between working days and we are more dependent on work than on training. I see that we are not cheap labor and we don’t have to accept labor exploitation”, denounced resident Marc Albiol. And he replied: “The overload of the assistant doctors is not lower than ours”.
The accumulation of guards and the feeling of not giving the scope cause stress and discomfort in the residents, explained Mercè Gil, fourth-year mir of family and community medicine. In this sense, 37% of residents have considered leaving training for mental health reasons, according to the survey.
Up to 85% declare themselves in favor of abolishing 24-hour guards, which they identify as one of the most important attrition factors.
With the results of the survey, Metges de Catalunya raises the need for the future government of the Generalitat to draw up and apply a statute to improve adherence to the public system for doctors in training. “It’s about regulating and unifying working conditions and setting attractive and favorable minimums so that they want to stay in the system,” Mayer specified.
The surgical and medical-surgical specialties are the ones that accumulate the most complaints from residents for non-compliance with rest days. “As far as family medicine is concerned, the main core of discomfort does not come from the residency period, but afterwards”, already in the work environment, explains Gil.
It’s not all negative data in the MC survey. Residents’ working conditions improved significantly under the agreements resulting from the 2020 strike. Now 62% say they do no more than four shifts each month, and if they exceed that number it is mostly voluntary. In fact, 87% would choose the same specialty they are studying again and 68% would do it again in the same teaching unit.
The survey received responses from 767 medical residents (201 first-year, 173 second-year, 207 third-year, 162 fourth-year and 24 fifth-year). The majority (589) are trained in Barcelona. The rest, in Tarragona (78), Girona (71) and Lleida (29).
The 2024 call ended with a record 22 vacancies in Catalonia, all in family medicine, to which resignations must be added (there were 48 in 2023).
According to MC, the dissatisfaction of the mir can aggravate the deficit of doctors in the public system, with migrations to the private sector or abroad. “Although it is not a data that is in the survey, the feeling is that when you finish residency more and more hospitals, clinics and other private centers call residents. If conditions continue to worsen, the private system will find it increasingly easy to capture them”, advises Mayer.