Having a Faculty of Medicine is an advantage that no university neglects, as it is the most coveted career by students – it guarantees a brilliant student body – and an obvious pole of attraction for research funds. In this context, while the Government intends to invest 50 million euros in creating 1,000 new places for the Medicine degree ―9,000 doctors will be lacking in five years, according to the calculations of the Ministry of Health―, the communities, which have the skills, they do not stop approving the creation of new degrees. The central government can only act in the approval of the study plan.
The Ministry of Health explains that the injection of 50 million is only for public campuses and that it is thus intended that there will be no shortage of professionals 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 stated on October 4, during the announcement of the increase in places.
In this race to open degrees, the private university has become very strong. In 15 years, according to data from the Conference of Deans of Medicine, it has gone from having 28 faculties (26 public and two private) to 46 faculties (35 public and 11 private) and next year, if nothing goes wrong, it will be inaugurated the first year in a public one (Alicante) and three private ones (Loyola in Seville, Camilo José Cela in Madrid and Fernando Pessoa in the Canary Islands). This growth has meant that the number of students has increased by 75% in 15 years: from 4,343 to 7,591.
Training a doctor in a public classroom costs on average, in a low estimate, about 90,000 euros in total – the private ones raise that amount to 126,000 euros -, an amount so high that it is only surpassed by Veterinary. However, investing in the degree pays off for prestige and because the number of applications to enter the campus skyrockets. Only a third of 20,000 aspiring high school graduates manage to enter the degree. A wealthy minority goes to Eastern Europe to study for a degree in English. The furor is such that, at the Alfonso X El Sabio University in Madrid, if one pays (the price does not appear when information is requested) and passes a one-year “access to Medicine program”, a place is guaranteed in the first place. course (20,100 euros). In 22 public campuses, however, they requested in 2021 an entry grade above 13 out of 14.
There was a time when the increase in faculties coincided with that of new hospitals. The same year that Madrid inaugurated six hospitals (2008), the regional government of the PP signed agreements to create four new medical schools. A study commissioned by the Executive of Isabel Díaz Ayuso shows that in the region there is an oversupply of 12,000 places to access degrees in private universities, but this mess of deficit degrees is compensated because there are many families willing to pay thousands of euros a year for a health career. In the capital, 5,000 university students studied medicine in four public universities last year and 3,700 in four private ones, but the gap will decrease in months.
Lack of places for students
While the rectors of the public Madrid go through an ordeal for their students to do internships in hospital due to lack of places, in the private sphere they are experiencing turbulence. HM Hospitales had an agreement with the San Pablo CEU University for internships in its clinics ―those who were already in the race will continue in their clinics―, but it has allied itself with the Camilo José Cela University, until now very focused on the social sciences, to build a health sciences faculty on two campuses in the outskirts with an investment of 40 million euros. HM does not want concerts, but “to lead a project”. They will start with 80 seats, but the intention is for them to be 200.
“It is not a matter of competing with the public, but of receiving students who want a more personalized training”, predicted Dr. Juan Abarca, president of HM, at the presentation of the project. “We take more care of the student, the public ones have another model, I’m not going to say… Parents send their children to the public one because it is much cheaper than us, but our students are as or more brilliant,” concluded the new dean, Jose Barbarán.
Do we have to increase the places to satisfy families? “There is demand from students, but in a regulated profession, such as medicine, the number should be subject to specialized health training. [el MIR] for all. If there are more and more vacancies, we are going to go back to when I finished my degree in 1987, when there were 21,000 unemployed doctors”, argues Pablo Lara, president of the deans. The doctor despairs that no government has created a registry of health professionals, to know how many there are, what specialty, where they are missing…
In Catalonia, Medicine is offered in all provinces, but the weight of the two private universities in Barcelona is much less than that of the six public ones: 1,057 students compared to 5,600 in 2021. In the Valencian Community the difference is much smaller: 3,200 students in the public one compared to 1,500 in the private one. Perhaps this explains why the regional government, in the hands of the left, allergic to the previous wave of privatization with the PP, has approved that the University of Alicante offer medicine, despite the fact that neighboring Miguel Hernández de Elche, also public, already has the Title. The latter warned last week that it will try to stop the degree in court.
“We estimate that there is a deficit of 4,000 Medicine teachers,” says Lara. In 2021, it was estimated that 43% of medical teachers would retire in the next five years, a percentage that increased to 55% in the case of those who also work in health centers. The deans calculate that if the positions of the existing faculties are increased to 15% – as the Government will allow – 5,000 teachers will be lacking. The dean fears that this will affect the training. “We are the second country in the world with the largest number of faculties by population density,” he says. He aggravates the situation that very few active physicians are accredited to enter the body of civil servants as full professors.
Gabriel Aguilera, dean of Health Sciences in Almería, has not yet faced this problem. The degree has started this September with 60 students in the facilities they already had for Nursing and Physiotherapy. The doctors who were already professors in the other grades, only have had to hire four more Anatomy part-timers, teach classes – in the first year it is almost all theory. “We have had to do little work. A dissection room, an osteoteca, there will be corpses, we have made a small investment in anatomy and physiology material… Yes, it is true that, as the courses pass, we are going to need more teachers and resources”.
Aguilera is not afraid of opening all six courses, “because in this adventure we have always been in collaboration. There are two university hospitals, doctors who have done the thesis to be accredited as professors…”. Although she acknowledges: “Yes, there will be a problem 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 medicine. After its implementation this year in Jaén and Almería, Huelva insists. They have space because the engineering school has moved, so in an act last May its rector, María Antonia Peña, made a request to the Board: “We just need the economic push that allows us to take that step forward” .
In Castilla y León, historically Medicine is taught in Valladolid and Salamanca and there is anger every year because its classrooms are filled with students from other regions. But the duel is now fought in the Cortes. The Socialists, in opposition, have supported that Burgos implant the degree; They argue that it has the capacity to welcome him and there is a lack of doctors, but León is also running.
In Galicia more of the same. There are three public universities and only one, the historic one, Santiago, offers medicine. After years of back and forth, in 2015 they agreed that it would continue to be taught 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 Medicine students than other autonomous communities.”
In the autonomies with only one public university -known as the G-9- the movement is constant. For three years, Deusto, private, has competed 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 take– saw in 2019 how the Public University of Navarra opened its own; the Government of Aragon, from the left, supports that the San Jorge University, private, offers the degree in Zaragoza, which is already taught by the public one. La Rioja is the only region that does not have Medicine in its catalog of titles.
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