Seven out of every ten resident doctors in Catalonia consider leaving this community as soon as they finish their training and up to 40% do not see themselves working in the public health system within ten years. 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 aforementioned union, considers the low adherence expressed by doctors in training to be worrying, which is basically attributed to the working conditions: 68% describe their workload as overwhelming or very overwhelming and up to a 81% say they exceed the 48 hours of work per week stipulated by European standards.
In Catalonia, some 4,000 mir are being trained in 18 primary care teaching units and 48 hospital teaching units. MC has surveyed 767 of them, between the months of February and March of this year, in order to find out their opinion about their working conditions and their future prospects within the public health system once 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 for professionals who are trained in the public system to remain in the public system, lately there is a lot of demand and ease of access for doctors in the private environment of Catalonia”, stated Mayer.
One of the biggest deficits detected in the survey is that 77% of residents claim to have problems reconciling family life. “We cannot rest properly between work days and we are more focused on work than training. We Mir are not cheap labor nor do we have to accept labor exploitation,” denounces resident Marc Albiol. And he concludes: “The overload of the attending doctors is not less than ours.”
The accumulation of guards and the feeling of not being able to cover all commitments cause stress and discomfort in residents, according to Mercè Gil, a fourth-year mir in family and community medicine. In this sense, 37% of residents have considered leaving training for mental health reasons, the survey indicates.
Up to 85% declare themselves in favor of eliminating 24-hour guards. 77% consider a change in format to 12-hour shifts positive even if it means having to go to the hospital more days. Guards are identified as one of the most important exhaustion factors for the Mir.
In view of the opinion of the residents, Metges de Catalunya raises the need for the future government of the Generalitat to draft and apply a mir statute to improve adherence to the public system of doctors in training. “It is about regulating and unifying working conditions and setting attractive and favorable minimums so that they want to stay in the system,” says Mayer.
Surgical and medical-surgical specialties are those that accumulate the most complaints from residents due to non-compliance with rest days. “Regarding family medicine, the main core of discomfort does not come so much from the residency period but afterwards,” already in the work environment, Gil points out.
Not everything is negative data in the MC survey. Residents’ working conditions improved significantly with the agreements derived from the 2020 strike. Now 62% declare that they do not perform more than four monthly shifts, and those who exceed this figure do so mostly voluntarily.
On the other hand, complaints about the adjunct/resident ratios have decreased and the possibilities to attend courses and conferences have increased.
In fact, 87% would choose the same specialty they are studying again and 68% would do so again in the same teaching unit. The survey obtained responses from 767 resident doctors (201 in the first year, 173 in the second, 207 in the third, 162 in the fourth and 24 in the fifth). The majority (589) are being trained in Barcelona. The rest, in Tarragona (78), Girona (71) and Lleida (29).
The 2024 call resulted in a record of 22 vacant positions in Catalonia, all in family medicine, to which resignations must be added (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 or foreign system. “Although it is not a fact that appears in the survey, the feeling is that when you finish your residency, more and more hospitals, clinics and other private centers call residents. If conditions continue to worsen, the private system will have an increasingly easier time capturing them,” Mayer warns.
