Yesterday, eighth day of seat allocation look. The procedure to grant 8,768 specialized training positions to doctors began on the 5th and will end on Thursday. According to the forecasts and the model of the previous editions, dermatology and plastic surgery were sold out on the first day. After 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 at the moment has only managed to fill 26% of the offer. It is one of the branches with the most deficits, also the one with the most opportunities (2,492). The bad reputation of this specialty persists among recent graduates, mainly due to the working conditions, say the professionals.
Conditions that have not held back 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 of which, consequently, she knows very good strengths and weaknesses. After six years at the Complutense University, on May 7 – like the rest of the graduating class – he will begin his residency, in his case at the San Carlos Clinical Hospital, in Madrid. Roberto Pinto Lorente, who obtained order number 1,082, could also have chosen any specialty (except dermatology and plastic surgery, sold out in numbers 648 and 827). And he opted for family medicine, the first of the 371 places to be allocated in Catalonia, the community with the most vacancies after Andalusia (434).
Hero or unconscious? The trajectory of this new R1 (first-year resident), born in Salamanca and settled in Barcelona for years, is very particular. A biotechnologist by training, he worked in the CSIC/UAB proteomics laboratory and studied medicine at the same time. He finished the 2021-2022 academic year, passed the examination and took a gynecology position, but he understood that he had made a mistake and decided to let it be. “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 the family because in this specialty you don’t focus only on organs, you see the person as a whole, it’s medicine in its essence: the doctor, the stethoscope, the clinical assessment… “.
He had his eye exam again on January 20 and still got a better number than last year. So, on May 6, at the age of 39, Pinto will join the multiprofessional teaching unit for family and community care Barcelona Ciutat (UDM) and will visit different health centers to choose and start a four-year residency. It won’t be in Vall d’Hebron, because he studied there and wants to see other work environments. He sees it as a reward for his vocation and the effort he has devoted to studies outside of working hours – “if you don’t like it this race, it’s almost impossible to pull it off”, although he admits he had doubts.
Doubts that end up making hundreds, thousands of aspirants give up: “In the end, family medicine is very abused. Resources are needed. But without good primary care, the public health system collapses. I think it is necessary to seriously strengthen the primary school, and we are part of this strengthening”.
“I opted for family because it is very complete and I can do good for society. The primary school needs motivated doctors and for the specialty to be highlighted”, he proclaims. However, 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 allocation 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 are not just prescribing ibuprofen. In one morning you have 30 patients and you’re seeing an ear as soon as you’re doing a bandage. It’s a very dynamic specialty and you have to know a lot about medicine.” Those around him, he says, ask him how, having been able to take anything else, he has opted for primary school. The stigma
According to David Arribas, deputy secretary general of Metges de Catalunya and family doctor, the rejection does not correspond to remuneration. The new agreement of the Catalan Institute of Health foresees a homogenization of the salary tables between all specialties. According to Arribas, “the initial priority of all specialists is to work in the public, but let’s assume that this love for the public lasts 15 years. Because our public system is so abusive, people want to have options that have high private potential, and for family medicine going private is more difficult than for cardiology, plastic surgery or dermatology.”
Students learn about the suffering of family medicine professionals. That is why, according to Arribas, it is not attractive to them: “From minute zero you enter a very high quota of work and the Administration has no appreciation for the work you are doing”.
Roberto Pinto hopes to be able to dedicate himself to work thinking about his patients and not about his working conditions: “Get to know people, that people talk about me as their doctor”. “I would encourage those who are still undecided to bet on primary school, despite the fact that what is important is to be a good doctor no matter what they choose”.
