Medical school is an advantage that no university overlooks, as it is the most desirable career path for students – guaranteed by a brilliant student body – and an obvious attraction for research funding. In this context, while the Government intends to invest 50 million euros in opening 1,000 new places for a medical diploma – in five years there will be a shortage of 9,000 doctors, according to the calculations of the Ministry of Health – communities that have the skills do not stop approving the creation of new degrees. The central government can act only in approving the study plan.
The Ministry of Health explains that the injection of 50 million is only for public campuses and that in this way it is foreseen that there will not be a shortage of specialists planned for 2027. “Because [hay que decidir] if we produce or import [médicos]and this Government wants to continue betting on the MIR model of excellence [Médico Interno Residente]”, Minister Carolina Darias said on October 4 when announcing the increase in the number of seats.
In this race to open degrees, the private university has become very strong. In 15 years, according to the data of the Association of Deans of Medicine, from 28 faculties (26 public and two private), it reached 46 faculties (35 public and 11 private), and next year, if something goes wrong, it will be inaugurated in the first year in one public (Alicante) and three private (Loyola in Seville, Camilo José Cela in Madrid and Fernando Pessoa in the Canary Islands). This growth means that the number of students increased by 75 percent in 15 years: from 4,343 to 7,591.
The education of a doctor in a public classroom costs on average, according to a low estimate, a total of around 90,000 euros – private individuals raise that amount to 126,000 euros – which is such a high amount that it is surpassed only by Veterinary Medicine. However, investing in a degree pays off because of the prestige and because the number of applications for admission to the campus is skyrocketing. Only a third of the 20,000 prospective high school graduates manage to enroll. A wealthy minority goes to Eastern Europe to study English. The storm is so great that at the Alfonso X El Sabio University in Madrid, if one pays (the price does not appear when information is requested) and passes the one-year “access to medicine program”, a place is guaranteed at the first place.course (20,100 euros). At 22 public campuses, however, in 2021 they requested an enrollment score above 13 out of 14.
There was a time when the increase in the number of colleges coincided with the increase in new hospitals. In the same year that Madrid inaugurated six hospitals (2008), the PP regional government signed agreements to establish four new medical schools. A study commissioned by Executive Director Isabel Díaz Ayuso shows that there is a surplus of 12,000 places in the region to access diplomas in private universities, but this mess of deficient degrees is compensated because there are many families willing to pay thousands of euros a year for a health career. In the capital last year, 5,000 students studied medicine at four public universities and 3,700 at four private ones, but the difference will narrow in a few months.
Lack of places for students
And while the rectors of public Madrid go through the ordeal of having their students do internships in the hospital due to a lack of places, they are experiencing turbulence in the private sphere. HM Hospitales had a contract with the University of San Pablo CEU for internships in its clinics ―those who were already in the race will continue in their clinics― but it partnered with the University of Camilo José Cela, until now very focused on social sciences, to build a health faculty of science on two campuses in the periphery with an investment of 40 million euros. HM does not want concerts, but to “lead a project”. It will start with 80 places, and the intention is to have 200.
“It’s not a matter of competing with the public, but of receiving students who want more personalized training,” predicted Dr. Juan Abarca, president of HM, at the presentation of the project. “We take more care of the student, the state schools have a different model, I won’t say… Parents send their children to the state school because it is much cheaper than ours, but our students are equally or more brilliant. ,” concluded the new dean Jose Barbarán.
Do we need to increase the number of seats to accommodate families? “There is a demand for students, but in a regulated profession, such as medicine, their numbers should be subject to specialized health training. [el MIR] for everything. If there are more vacancies, we will return to the time when I graduated in 1987, when there were 21,000 unemployed doctors”, claims Pablo Lara, president of the dean. The doctor despairs that no government has made a register of health workers, so that it is known how many there are, what specialties, where they are lacking…
In Catalonia, medicine is offered in all provinces, but the weight of the two private universities in Barcelona is much lower than the weight of the six public ones: 1,057 students compared to 5,600 in 2021. In the Community of Valencia, the difference is much smaller: 3,200 students in the public compared to 1,500 in private. Perhaps this explains why the regional government, in the hands of the left, allergic to the previous wave of privatization with the PP, approved the University of Alicante to offer medicine, despite the fact that neighboring Miguel Hernández de Elche, also public, already has the title. The latter warned last week that he would try to stop the diploma through the courts.
“We estimate that there is a shortage of 4,000 medical professors,” says Lara. In 2021, it was estimated that 43% of medical teachers will retire in the next five years, and the percentage has increased to 55% in the case of those who also work in health centers. The deans calculate that if the number of jobs at the existing faculties increases to 15 percent – as much as the Government will allow – there will be a shortage of 5,000 teachers. The dean is afraid that this will affect the training. “We are the second country in the world with the largest number of colleges in terms of population density,” he says. The situation is complicated by the fact that a very small number of active doctors are accredited to work for civil servants as full professors.
Gabriel Aguilera, dean of health sciences in Almería, has not yet faced this problem. The study started this September with 60 students in the rooms they already had for nurses and physiotherapy. Doctors who were already professors in other classes, just had to hire four more part-time anatomy assistants, teach classes – the first year is almost all theory. “We had to work a little. The dissection room, the osteotheque, there will be corpses, we have invested a little in anatomy and physiology material… Yes, it is true that as the courses go on, we will need more teachers and resources”.
Aguilera is not afraid of opening all six courses, “because we have always collaborated in this adventure. There are two university hospitals, doctors who did graduate work to be accredited as professors…”. Although he admits, “Yes, there will be problems when we have to hire full-time professionals; the university is not economically competitive with the Public Health System”.
Differences between communities
In 2010, the Junta de Andalucía, then socialist, promised that all provinces would have medicines. After implementation this year in Jaén and Almeria, Huelva insists. They have space because the engineering school has moved, so last May its rector, María Antonia Peña, made a request to the Board of Directors: “We just need an economic stimulus that will allow us to take that step forward.”
In Castilla y León, medicine has historically been taught in Valladolid and Salamanca and every year there is anger because the classrooms are full of students from other regions. But the duel is now being fought in Cortes. Socialists, in the opposition, supported Burgos to incorporate the diploma; They claim that they have the capacity to meet him and that there is a shortage of doctors, but León also runs.
More of the same in Galicia. There are three public universities, and only one, the historic one, Santiago, offers medicine. After a number of years, in 2015 they agreed that they would continue to study only in Santiago, but that the sixth and final year could be taken in other Galician university hospitals. But Mayor Abel Caballero (PSOE) is campaigning for Vigo to launch its own career: “It is not understood that Galicia has a quarter of medical students than other autonomous communities.”
In the autonomies with only one public university – known as the G-9 – movement is constant. For three years, Deusto, a private individual, has been competing with the University of the Basque Country in medicine; The University of Navarra – whose prestige rests on this degree, which young people from other parts of Spain and the world come to study – saw in 2019 that the Public University of Navarra opened its own; The government of Aragon, from the left, supports that the University of San Jorge, privately, offers a degree in Zaragoza, which it already teaches publicly. La Rioja is the only region that does not have medicine in its catalog of titles.
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