Internal diseases call for an urgent change of generations

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

  • MIR square for 2023
  • Spain: 413 places in internal medicine.
  • Castilla la Mancha: 17.
  • Albacete: Four.
  • Real City: 1.
  • Alcazar of San Juan: two.
  • Puertolano: 1.
  • pool: two.
  • Guadalajara: two.
  • Toledo: 3.
  • Queen’s Talavera: two.

Insufficient MIR call for internal medicine

In this context, the Spanish Society of Internal Medicine (SEMI) considers that the call for vacancies for the MIR 2023 for Internal Medicine, published in the Official State Gazette on September 2, would not be sufficient to meet the need for professionals in the specialty or to address the lack of generational change in interns that SNS blames.

In this call, 413 internal medicine specialist training places are offered throughout the country, 17 of them for Castilla-La Mancha.

Despite the fact that this supply of places is greater than 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 doctor shortage, jointly prepared by CESM and the WTO, in 2030 about 70,000 doctors will retire from the SNS, a number higher than the MIR positions that are called up annually without taking given another type of leave, such as going abroad or devoting himself to private sector practice.

Problems in the near future

In the case of internal medicine, the challenge of generational change is no stranger to the specialty. According to Dr. Jesus Diez 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 near future.”

“The training of new health professionals must be a priority at all levels to solve the challenge posed by the generational change of specialists and in particular 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 hospital visits by elderly people who usually have various chronic pathologies and co-morbidities. In this sense, it is worth emphasizing the multidisciplinary and comprehensive vision of the patient that defines the work of the internist, key in the management of chronic, complex and/or multipathological patients.

Multidisciplinary major

Internists are currently practicing in new areas of care such as home hospitalization, continuity of care units and day hospitals, as well as in short-stay units, palliative care units, emergency services and infectious disease units.

In addition, more and more hospitals have shared care units for surgical, psychiatric, and oncology patients coordinated by internists who also participate in multihospital PROA programs. “With the number of internists currently in training, it will be difficult to continue these benefits in the near future,” warns Dr. Díez Manglano.

Key role against COVID

On the other hand, it is worth emphasizing the important role that internists played during the pandemic. During this time, they coordinated and led multidisciplinary teams for COVID-19, 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 SNS. That is why it is crucial to have the opinion of specialists to achieve, together, the construction of an ever better SNS for both professionals and patients”, concludes the SEMI president.

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