The coordinator of Family and Community Medicine of the Degree in Medicine of the University of the Balearic Islands, Ignacio Ramírez.
This course has graduated first promotion of the Medicine Degree of the University of the Balearic Islands (UIB), which in its university plan gives a weight to the subject of Family and Community Medicine superior to other universities. This was highlighted by the Minister of Health and Consum of the Balearic Government, Patricia Gomezin an interview with Medical Writing. Gómez explained that they must “reformulate the training curricula of universities” and that one of the things with which she felt most satisfied is that the graduates “stated that the place where they have most enjoyed their practices is in Primary Care and some of them have come up with the idea of specializing in Family Medicine and in the Balearic Islands“.
The coordinator of Family and Community Medicine of the Degree in Medicine at the UIB is Ignatius Ramirez, which reveals why this subject has 12 credits in the Balearic Islands, while there are other Spanish universities that do not dedicate one to it. His feeling is that “Withdrawing credits from other subjects creates a conflict of interest and teaching”. Ramírez considers that Family and Community Medicine should be a subject that existed in all universities and was compulsoryin line with the places of the specialty that are offered in the MIR and its importance in the health system.
What differentiates the University of the Balearic Islands in Family and Community Medicine compared to other universities?
In the first place, that half of the universities in Spain do not have the subject of Family and Community Medicine. And, among those that have it, the weight given to the subject. In the Balearic Islands it is a subject with six credits in intramedicine and a six-week rotation in the sixth year of Medicine, which we consider important and should exist in all universities.
It must be taken into account that if approximately 25 percent of MIR positions are in Family Medicine and our public health system is based above all on this specialty, it is important that future doctors know about it because if not what happens they don’t know what to opt for. When I was studying they told me that what is not known cannot be diagnosed. Doctors cannot choose that specialty that they do not know. Family and Community Medicine should be a subject that is in all Spanish universities, as is the case in European universities, and with sufficient weight to be known by students.
Is it easier to implement this subject in a newly created Degree than in others with more years?
Evidently. The university plans are already established and each career has a series of credits. To be able to offer a Family and Community Medicine subject at other universities, it is necessary to withdraw credits from other subjects, and it is very difficult for a professor of one subject to want to transfer credits to another. It is an important and necessary job, but it involves a conflict, let’s say, of interests and teaching, because every teacher believes that his subject is the most important.
Over time there have been changes in the course and, therefore, I think it would be essential to incorporate this subject in all faculties. Nor should it be considered as an optional subject as has been done in other universities due to its weight. Perhaps a specialty, and I prefer not to give names so that no one feels offended, in which there are 50 or 60 vacancies a year for MIR training, it can be an optional subject. But in a specialty in which some 2,500 or 2,600 MIR vacancies leave each year, it is a subject that must necessarily be in the Degree.
“If Family Medicine were taught in more faculties, the MIR places would not remain empty”
What has been the experience of the students?
The experience has been very satisfactory both in fifth grade, which is where the theoretical classes are given, and in sixth grade, which is in rotation, where they have done the practices. Most of the students have been very satisfied because they have been allowed to do many things, they have seen the specialty from within. They have been able to do ultrasounds, sutures and blood draws, in addition to other functions that are performed in other specialties that have motivated them a lot.
What they like the most and what most students prefer Medicine is dealing with people, dealing with patients and being able to do things that are useful. These tasks and having undergone consultations, always with a doctor and supervised by him, have given them very high satisfaction. Some students have even left the Faculty saying that they want to do the specialty of Family Medicine, something that did not happen before. This year there have been 217 places left unfilled for Family Medicine, precisely when we have a tremendous shortage of doctors. Many have been left without choosing because the students do not know what this specialty is.
Will it serve to alleviate the deficit of Family doctors?
If Family Medicine were taught in more faculties, there would be many more graduates who would take the specialty, and the MIR places would not remain empty. In any case, we have a significant deficit of physicians and, in the coming years, the deficit is going to be much higher. It would be necessary to get as many more places as the needs of the National Health System, as many places as there are graduates, and the MIR could establish the order of election of places.
I have been a resident tutor in the specialty of Family and Community Medicine for 27 years. In summer we have foreign students from Switzerland, Germany, Italy, Holland, that is, doctors who are doing their specialty there and who come to spend a month or two with us. Two years ago, a doctor who was doing the specialty in the Netherlands said that she was surprised by the little recognition that Family Medicine had in Spain when in her country it was one of the most recognized, while here, however, many people even despise this specialty . This happens because the specialty is known. It is not that it is more important than others, but neither is it less than what it is considered now.
Is 12 credits enough or should there be more?
In the fifth year of Medicine, there are six credits, and in the sixth year of Medicine, there are six weeks of internship rotation. They spend six weeks rotating through the health center, the emergency system and 061. There is also the subject of Communication and Health, which is given by a Family doctor and a psychiatrist, which is three credits, and the Bioethics part, which It is common to all specialties. Ideally, the subject of Family and Community Medicine would have twelve credits in all universities.
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