What reasons lead young people to choose Medicine as their future profession? Most of them are seduced by what they are reported by television series or the mass media: technology, spectacular surgical procedures, new discoveries, saving lives, social prestige, etc. Others, with an excellent academic record, must answer for a singular and incomprehensible pressure from their environment.
A recent analysis carried out by Dr. Rafael Ramos, a family doctor and professor at the University of Girona, synthesizes the main reasons into three: helping people, developing scientifically, and achieving prestige. Here are three legitimate and commendable motivations that feed back throughout six years of university degree where our future professionals are trained to classify, explore, diagnose, intervene and treat hundreds of diseases. And yes, in feminine, because readers should know that medicine is already feminine: in the province of Barcelona, ??of the 19,389 registered members under 50 years of age, 65% are women (COMB data, 2022).
However, this seductive scenario for aspiring to graduate in Medicine, and focused on diseases, collides with the needs of people who go to a saturated health system to solve their problems.
Any applicant to access medical studies must understand that the profession consists of caring for a person and not caring for their illness, under a relationship of trust and a global and comprehensive approach; in maintaining an empathic and effective attitude with patients, assessing their fears, expectations and their context. It consists of knowing how to use communication; in knowing the determinants that influence individual and collective (community) health; and finally, in being very prepared to know how to listen, never judge; knowing when not to intervene or treat, or even label or diagnose. The great specialists who are dedicated to that, and much more, are the specialists in Family and Community Medicine. And in light of these competencies, it is undoubtedly the most complex specialty of all, and the one that appears the least in the media.
Family and Community Medicine is an academic discipline, a specialty and a health profession with its own healthcare, teaching and research body, its object being the knowledge of the person understood as a whole. It has countless strengths and evidence of its impact on individual and population health, in reducing mortality from any cause, in its pluripotentiality in various healthcare settings (the pandemic has shown it) or in a pragmatic verification: trained family doctors in Spain they are highly demanded by other neighboring countries. In these, they are offered attractive professional conditions in various fields (primary care, urgencies and emergencies, palliative care, among others).
In Spain, the most necessary specialty is in crisis: insufficient financing of primary care, excessive bureaucracy and care overload. Added to this is a retirement rate that exceeds the replacement rate, a declining proportion of family doctors compared to other specialties (when it should amount to 40-50%), and an excessively limited presence of family doctors in the faculties of Medicine.
These faculties must be spaces of influence and conditioning where family and community medicine can exercise an educational function while it exercises a central function of the health system. This entails reaching greater competency quotas as teachers of future specialists.
Achieving this requires its incorporation as an area of ??knowledge, the creation of specific units, the consolidation of the teaching staff and the university Primary Care Centers, the creation of its own compulsory subject, transversal participation (clinical training, ethics, communication, research , community, prevention, digital health, health promotion, home, end of life, etc.), the increase in weight in clinical practices, or the coordination of objective and structured clinical evaluations. The transformation is necessary. Family and community medicine has a horizon, and has its own deep roots rooted in science, in the context and in attitude.
