Is it necessary to rescue the old election system?

Pilar Sánchez, director of institutional relations at CTO.

The Ministry of Health extends the offer again MIR vacancies with the call for a total of 8,503 places for resident doctors. An increase that Pilar Sanchezdirector of institutional relations of CTO, receives with optimism taking into account the volume of doctors that will retire in the coming years, although without losing sight of the number of vacancies that were left without an owner in the last award.

As an expert in all matters surrounding the MIR modelSánchez values ​​in Medical Writing the main novelties introduced by the ministerial body, such as the reduction of the cut-off mark or the possibility of holding an extraordinary award. Likewise, the directive examines in depth the situation that the system of resident doctors in Spainas well as the ‘consequences’ of the exclusively telematic selection process.

How do you assess the increase in MIR vacancies?

I think it is always positive to have an increase in places. From 2011 to 2015 they began to worryingly cut the number of places in each call, but, finally, since 2016 it has been progressively increasing. I want to think that they are taking into account the large number of doctors who are going to retire in the very short term, so that all current MIRs can fill those positions.

Is the offer enough?

I wouldn’t know if the offer is enough because there are two situations. On the one hand, each year more students start the first year of medicine (about 8,000). On the other hand, there are too many seats (we remember that last year there were more than 200 seats left over), which is an interesting paradox. I think that the Ministry should consider going back to the traditional system of choosing positions, in real time, to avoid so many places left over.

What do you think about the cut-off mark reduction?

It is clear that it is a very good measure to avoid overcrowding. Until now, a grade equal to or greater than 35 percent of the average of the best scores was required, and now it has been reduced to 25 percent. This will clearly allow an increase in the number of applicants with the right to a place.

Is it a necessary measure? How will it affect the results of the call?

In the previous call, there were 1,895 opponents eliminated by not exceeding the cut-off mark, which prevented them from obtaining a place. This volume of those affected will be reduced with the reduction of the percentage of this cut-off mark.

I do not see it as a bad measure, on the contrary, if these people had been able to choose, there would not have been places left over and they would not have left hundreds of hospital services completely uncovered. I do not think that it negatively affects the results of the call in any way.

“One of the reasons why you may not like a certain specialty is the job insecurity that doctors currently suffer”

Do you consider its complete elimination necessary?

I would like to believe that there are many brilliant minds mulling over this measure. I can only say that the MIR is an exam that places you in a law of order, from 1 to 8,503, to be able to choose a specialty, but the grade obtained does not define how good a doctor you can become later.

But, on the other hand, it would not be good to eliminate it completely either, because we would remove the incentive to study and achieve a sufficient and integrated mastery of Medicine, at least from its theoretical point of view, by students. We consider this to be a positive aspect of the MIR exam and should not be missed.

As for holding a second MIR round, in the event that the entire offer is not covered, how do you assess this extraordinary award? Will it solve the problem of empty seats?

I think it is positive that there is an extraordinary MIR adjudication in case all the places are not filled in a first round, but we remember that last year there were 218 first places left over, and 93 after the second call.

There are other things to take into account, first of all the system for choosing a place, better said “allocation” of a place, which is not live or in real time, and this has greatly distorted a transparent act, which was already well done and It allowed to correct at the moment when changing options, specialties. If you have the number 5200, you have to make a giant priority list so you don’t miss out on any of the slots you previously wanted. It is a totally unnecessary uncertainty.

On the other hand, it is really lawful not to want to choose a place in a specialty that you do not like, and that leads you to make the brave and difficult decision to repeat the MIR exam. And one of the reasons why a certain specialty cannot be liked is the job insecurity that doctors currently suffer from, it is terrible, and something that should be solved in the short term.

“I don’t think that the MIR is going through a deep crisis, but things that have more to do with the current Spanish health model should continue to be improved”

Another of the great novelties for this call is the approval of the way to increase the quota of non-community nationals in the MIR to 10 percent. How do you assess this possibility?

An increase from 4 to 6 percent of places for non-EU citizens has already been approved.
I believe that it is also something positive because it is another measure by which vacancies will be avoided, although the ideal is that, after their training period, they could stay and continue contributing knowledge and value to the Spanish national health system.

Regarding the content of the exam, what changes do you consider necessary in the current MIR model? Need a reformulation?

The ministry has introduced these changes in previous calls and we believe that now a good general and transversal approach has been achieved, with all the medical specialties represented in it. The eternal dream of carrying out an OSCE-type test of practical assumptions does not yet seem feasible, but it would be the natural evolution of the exam.

Is the MIR model experiencing the deepest crisis in its history?

Regarding the exam model itself, I think it is fair, very hard and you have to be very well prepared, but it is objective. There is no second phase where you have to pass an interview in a hospital like in many other countries. The applicant, with his MIR note, chooses specialty, teaching unit and city.

I do not think at all that it is experiencing a deep crisis, but things must continue to be improved, which do not have so much to do with the MIR but with the current Spanish health model. They should stop to organize in a more rigorous and profound way aspects that we mentioned earlier. We have more and more talent draining abroad, given the working and salary conditions that exist in Spain, and this is dangerous, if we remember the 70,000 doctors who are going to retire soon.

On the other hand, the number of vacancies is increased each year, but there cannot be accredited teaching vacancies without the autonomous communities removing them. A clearer study of the needs that exist should be made and thus identify what measures must be taken in the long term for the benefit of our health professionals.

And, finally, it cannot be, for example, that the number of graduates per faculty grows at a higher percentage than the increase in the number of places offered per year.

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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