Hire medical specialists without certification: Is it illegal?

Demonstration for the recognition of foreign medical qualifications.

The toilet shortage is one of the most pressing health problems and one of the has a more difficult solution for the years it takes to train professionals, especially the doctors. In the short term, one of the remedies for this setback is Homologation process, which is generating more and more interest in the sector. However, this procedure has its own weaknessessuch as the difficulties in getting the go-ahead or the length of time to get it, which causes the hospitals hire foreign doctors with the approved Medicine degree but without certified specialty to exercise as such, a false legality that extends in the National Health System.

The same doctors affected by this formula are the ones who dare to denounce the “legal limbo” in which they find themselves and are exposed to losing their job to put the public administration on the ropes. Some hospitals also recognize that is “usual” that State health centers opt for the incorporation of these professionals while processing the homologation”, an exception that continues to be an “illegality”according to the General Council of Official Colleges of Physicians (Cgcom).

First-person testimonies, hospital addresses and the documents to which he has had access Medical Writing confirm the hiring of approved non-community doctors but without certifying that, although they are hired as a general practitioner with an assistant positionperform specialist duties and they are asked in expert quality evaluating equipment used in your Service. There are even cases of non-community doctors who work as heads of service for years and that are still pending certification by the Ministry of Health.

How is the contract trap?

In contractual terms, non-EU doctors must assume that in their contracts the term ‘specialist’ does not appear‘, they are hired as “general practitioner, but the practice is specialist”. The duration of the contract is subject to the temporary coverage of a workplace structural doctor attached to the corresponding Service of the hospital during the process of the definitive provision of the position through a public job offer.

These interims are justified by the “impossibility of coverage” of the required specialist, since “the calls have been deserted” that have been made to fill vacancies with medical specialists. The director of the hospital approves the agreement and the contracted person certifies “sufficient objective ability to comply with the delegated professional healthcare functions”.

Although they practice as a specialist and voluntarily commit to work in the Service, they are hired as a general practitioner

The doctor in this situation also accredits the specialty performed and the entity that certifies him as such as a guarantee of his capacity for the delegated functions. His hiring “is subject to the condition decision to obtain ministerial approval of his title of specialist in a reasonable term”, according to the clauses of the contract, which is renewed year after year. The same will be terminated if dismissed the requested homologation, when the position can be filled with a doctor who meets all the requirements or when the contract ends.

In other documents annexed to the contract, the non-community doctors without the certified specialty state commit “voluntarily” to provide their services as attending physician in the Service in which they are specialists. For their part, management alleges that they base themselves on “improving the health of the reference population”, on “optimal use of resources” and on “searching for the best assistance service… and the joint participation of its professionals“. Even these same professionals, on occasion, are consulted to evaluate technological equipment that will be used in the specialty in which they practice.

How do non-EU doctors feel?

The non-community doctors in this situation contacted by this newspaper assure that “non-community doctors have been hired at all levels for a long time”. This practice is not a matter of one or two autonomous communities, but breeds throughout Spain and especially in unpopulated areas, where it is more difficult to attract specialists via MIR. There are even hospital managers who already “nor do they ask for specialist certification because they know that they are not going to find a professional with that requirement”. hospitals with more than 15 and 40 cases.

Those affected feel in a state of “pseudolegality” and ask the Ministry of Health to “open another path via no MIR” that allows the specialty to be certified, as has already been done with Royal Decree-Law 30/2021, of December 23, which enables the autonomous communities the possibility of reinforcing themselves with professionals with a specialist degree obtained in non-member States of the European Union . Finally, this group emphasizes that “there is a large universe of trained specialists who are not certified but who are practicing as such because they know how to do it as well as or better than any professional with a specialty via MIR” and states that “If the non-community doctors leave the hospital, they have to close it”.

The president of the Association of Non-Community Medical Specialists (Asomex), Pablo Mejia Aguirre, also confirms that hospitals hire doctors as specialists without being certified. “Hospitals, both public and private, hire us to fill vacancies. There are those who have a contract as a general practitioner, but work as a specialist and others who have contracts as a specialist,” says Mejía.

What do the addresses hold?

Hospital directors that recognize this practice justify themselves by avoiding the fact that they have “performed all actions to fill the vacancies of specialist”, usually specialties with a significant shortage of professionals throughout the State. “During the waiting process (for validation of the specialty), and in the well-known scenario of the lack of professionals, it is common for health centers throughout the Condition opt for the incorporation of professionals not trained in Spain while processing the homologation”.

“If the non-community doctors leave the hospital, they have to close it”

However, they emphasize that “all professionals who work in a Service have the experience to perform they are in charge of and are integrated into a scheme of work and supervision of competencies and functions that focuses on and guarantees the safety of patients”.

This event is also visible in the health centers of Ibiza, where doctors without approved specialization number in the dozens. According to the latest data offered by the Col·legi de Metges de Baleares, 34 of the 42 Emergency and Pediatric beds are covered by these professionals.

Why is it not legal?

From the General Council of Official Colleges of Physicians, its treasurer, Enrique Gilbertstates that it is an “illegal” practice and a “negligence” by the employer. “A person who has the specialty in process of homologation you don’t have the right degreeIt’s in process,” he adds.

However, and unlike what is exposed by the testimonies, Guilabert maintains that this situation “there are few or no cases in hospitalswhile in Primary Care we know that it is being done”, which he considers a “fraud”.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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