After twelve days of election and allocation of resident doctor positions, the forecasts have been met, with a historical record of vacancies (473), most of them in family and community medicine (459) and the rest in preventive medicine (12) and public health (2). The Ministry of Health has called this Friday an “extraordinary call” for applicants who have resigned and by which the quota of non-EU graduates who can obtain a residence is expanded by 351 places (from 526 to 877).

Not unexpectedly, the number of graduates who have given up specialized training basically because they refuse to practice family medicine is no longer a hard blow for primary care. There are 257 more vacancies than last year. The largest offer in history, with 2,492 family mir positions, has resulted in almost a quarter being overdrawn and with some teaching units completely deserted.

Catalonia is the community with the most unfilled positions (98, all in family medicine and all outside Barcelona), ahead of Castilla y León (84), Andalusia (66), Galicia (63) and Extremadura (61). On the contrary, Madrid is the only autonomy that has managed to complete the offer. Marc Soler, general director of Professionals of the Department of Health, attributes this circumstance to the fact that Madrid lacks territory far from the capital while other regions have a large rural component.

The situation deserves reflection, according to Soler. The Generalitat has made great efforts to promote family medicine and residency in this specialty both at the urban and rural levels, but it is difficult to notice the effects of the increase in salaries for residents and the plan for positions that are difficult to fill. linked to primary care. “We have to evaluate the effectiveness of the actions carried out and reflect on those that can be carried out in the future, in collaboration with all actors, scientific societies, medical colleges and teaching leaders,” explains Soler. In his opinion, the dynamics of Catalonia are similar to those of the rest of the communities and the solution is to continue giving prestige to primary care and incentives, not only remunerative, but also in terms of professional career or training offer.

Professionals demand, for their part, greater exposure and understanding of rural and family medicine during university training. The fact that this specialty does not appear as a subject in the faculties is an obstacle to the interest of residents. Although it is the cornerstone of the system, it is often an underappreciated specialty, and the working conditions, with high patient quotas, do not contribute to its attractiveness. On Wednesday, after 10 days of procedure, only 52% of the family residences had been awarded.

Unlike the previous two years, in this edition there have not only been vacancies in this specialty. The twelfth and last day of awarding specialized training places for doctors began this Friday with 7,842 positions awarded and 926 vacated, most of them in family and community medicine (841) and the rest in geriatrics (2), occupational medicine ( 33), preventive medicine (43) and microbiology (7). Finally, preventive (12) and public health (2) have also had gaps.

The fact that this time the ministry established the play-off mechanism in advance already foreshadowed the scenario. And it doesn’t end here. 9% of family mir abandon training and between 50% and 905, depending on the autonomies, leave the specialty when they finish their residency. “We can fill the glass with professional positions, but it has many holes to cover,” Mónica García warned in February. “This has to do with taking many measures at the same time that make the specialty attractive. “You see 60 patients a day, it is a crusher of vocations,” concluded the health minister. The crisis does not exist for dermatology and plastic and reconstructive surgery, again the first branches to run out.