Internal medicine calls for an urgent generational change

Castilla-La Mancha will have 17 new positions in internal medicine by 2023, which are insufficient to guarantee a generational change and increased pressure of care in the highly-demanded specialty, due to the consequences of COVID and the increase in patients with multiple diseases.

• Mir square for the year 2023
• Spain: 413 places in internal medicine.
• Castilla-La Mancha: 17.
• Simple: four.
• real city: 1.
• Alcazar San Juan: two.
• Puertolano: 1.
• pelvis: two.
• Guadalajara: two.
• Toledo: 3.
• Queen Talavera: two.

MIR recall is insufficient for internal medicine

In this context, the Spanish Society of Internal Medicine (SEMI) considers the call for MIR 2023 internal medicine vacancies, published in The Official Gazette published on September 2ndit will not be sufficient to respond to the need for specialists in the specialty or to solve the problem of not replacing generations of internists accused by the SNS.

In this call, 413 places to train internal medicine specialists are provided throughout the country, 17 of them for Castilla-La Mancha.

Despite the fact that this offer of places is larger than in the previous call (401 in 2022), this number of new doctors to be trained in this specialty will not be enough, according to SEMI. According to one of the latest available studies on physician shortages jointly prepared by the CESM and the World Trade Organization, in 2030, about 70,000 physicians will retire from SNS, a number higher than the MIR jobs called annually, without taking into account another type of leave such as leaving abroad. Or a dedication to practice in the private sector.

problems in the near future

In the case of internal medicine, the challenge of changing generations 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 who will have our specialty in the near future.”

“Training new health professionals should be a priority at all levels in order to solve the challenge of generational change for professionals, particularly internists in the national health system,” adds Dr. Diez Manglano.

In addition to the challenge of changing generations, today’s society is increasingly long-lived, increasing the frequency of visits to hospitals by elderly people who generally suffer from various chronic and comorbidities. In this sense, it is worth highlighting the multidisciplinary and holistic view of the patient that defines the work of the internist and is key in the management of chronic, complex and/or multi-disease patients.

multidisciplinary specialization

Currently, internists are active 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 combined care units for patients with surgery, psychiatry and oncology coordinated by internists, who also participate in PROA programs in 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. Diez Manglano.

A key role in the fight against COVID

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

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