Internal Medicine calls for an urgent generational change

Castilla-La Mancha will have 17 new Internal Medicine MIR positions by 2023, insufficient to guarantee generational change and the increase in care pressure in a specialty that is increasingly in demand, both due to the consequences of COVID and the increase in multi-pathological patients .

  • MIR square for 2023
  • Spain: 413 places in Internal Medicine.
  • Castilla la Mancha: 17.
  • Albacete: 4.
  • Real city: 1.
  • Alcazar of San Juan: 2.
  • Puertollano: 1.
  • Cuenca: 2.
  • Guadalajara: 2.
  • Toledo: 3.
  • Talavera of the Queen: 2.

An insufficient MIR call for Internal Medicine

In this context, the Spanish Society of Internal Medicine (SEMI) considers that the call for MIR 2023 vacancies for Internal Medicine, published in the Official State Gazette of last September 2would not be enough to respond to the need for professionals in the specialty or to solve the lack of generational replacement of internists accused by the SNS.

In this call, 413 places are offered for the training of specialists in Internal Medicine throughout the country, 17 of them for Castilla-La Mancha.

Despite the fact that this offer of places is greater than in the previous call (401 in 2022), this number of new doctors to be trained in the specialty would be insufficient, according to SEMI. According to one of the latest studies available on the shortage of physicians prepared jointly by the CESM and the WTO, in 2030 around 70,000 doctors will have retired from the SNS, a number higher than the MIR positions that are called annually, without taking into account other type of leave such as departures abroad or dedication to exercise in the private sector.

Problems in the immediate future

In the case of Internal Medicine, the challenge of generational change is not alien to the specialty. According to Dr Jesús Díez Manglano, president of the Spanish Society of Internal Medicine, “at this rate, we will not be able to meet the needs of professionals that our specialty will have in the immediate future.”

“The training of new health professionals must be a priority at all levels in order to solve the challenge posed by the generational change of specialists and, particularly, of internists in the National Health System”, adds Dr. Díez Manglano.

In addition to the challenge of generational change, today’s society is increasingly long-lived, increasing the frequency of visits to hospitals by elderly people who generally have different chronic pathologies and comorbidities. In this sense, it is worth highlighting the multidisciplinary and comprehensive vision of the patient that defines the work of the internist, key in the management of chronic, complex and/or multi-pathological patients.

A multidisciplinary specialty

Currently, internists carry out their activity in new care areas such as Home Hospitalization, Care Continuity Units and Day Hospitals. As well as in Short Stay Units, Palliative Care Units, Emergency services, and Infectious Diseases Units.

In addition, more and more hospitals have Shared Care Units for surgical, psychiatric and oncological patients coordinated by internists, who also participate in the PROA programs of multiple hospitals. “With the number of internists currently being trained, it will be difficult to continue with these services in the near future,” warns Dr. Díez Manglano.

Key role once morest COVID

On the other hand, it is worth emphasizing the important role that internists have played during the pandemic. During this time, they have coordinated and led multidisciplinary COVID-19 teams, caring for 8 out of 10 non-critical hospitalized patients in Spanish hospitals, hand in hand with other specialties and levels of care.

“Public administrations and scientific societies must work together to find the tools that provide solutions to the challenges that arise in the SNS. For this, it is key to have the opinion of specialists to achieve, together, build an increasingly better SNS for both professionals and patients”, concludes the president of the SEMI.

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