Health

Medicine | Medical trapped in the homologation – El Salto

It’s Monday, September 19. At 2:00 p.m., the time to apply for the call for MIR 2023 places ends. This exam gives access to practices that are mandatory for newly licensed doctors to practice in Spain. But they are not available to everyone. This is stated with indignation by Jersey Ferrera and Paola Oblitas. Both have signed up, but they know they will be rejected. There is an hour left until the deadline, but they are resigned. The homologations of his general medicine degrees, one obtained in the Dominican Republic and another in Bolivia, are paralyzed in one of the lockers of the Ministry of Universities. Those of them and of thousands of non-community professionals. In 2021 alone, the Ombudsman for Children received more than 500 complaints in this regard. Complaints that, according to this institution, have quadrupled in recent times. Some files remain stranded for more than five years.

“We registered without the homologation with the hope that it would arrive before the term ended today. But we will not be admitted, we have run out of time”, says Ferrera to El Salto, a few minutes after the virtual window closes and in the fight to open the big windows for her and her colleagues, who have obtained the title in countries outside the European Union and who cannot train or exercise while waiting for a role. Together they have formed the medical front for a fair homologation, in which there are already thousands of members. On August 16, they demonstrated in front of the Ministry of Universities to make their situation visible.

Non-Community Medical 2

Ferrera arrived in Spain in the midst of a pandemic, in the summer of 2020, when his knowledge was even more necessary. He began the homologation process in August. Today it has been waiting for 25 months, while Royal Decree 967/2014 sets a maximum of nine months to resolve. “I arrived here in the midst of a pandemic and they did not give me the opportunity to work. Meanwhile, I have been studying at an academy for two years to prepare for the MIR”, explains who assures that his student visa has not allowed him to work and he lives on the money that his parents send him from Santo Domingo. And he does the math: “The academy charges 3,570 euros a year for my course. The second year they only charged me 300 euros. And now repeating it will cost me 3,570 euros again, ”she expresses with anguish.

“I laugh so as not to cry about the situation”, says Paola Oblitas, “I want to be with my patients, that’s why I’m a doctor and I’ve been sitting between books for three years”

Beside him, Oblitas gets excited. “I am 30 years old and I live with what my mother and sister send me from Bolivia,” she says. “This is absolutely illogical, I laugh so as not to cry about the situation. I want to be with my patients, I am a doctor for that and I have been sitting between books for three years”. Her case is even more bizarre if possible. It is already 35 months that she has been waiting for her homologation. “They changed the start date of my file to 2021, but I started my procedures in 2019. I filed a claim with the Ministry, I have been fighting for eleven months to change that date. At the end of May I got it and in June they sent me a request. Not even what they were asking for was understood,” says Oblitas. What came to him was the request for a letter of veracity, a document that they are demanding from most doctors in approval procedures. A new paper that is delaying the processes even more. And the “tripping” does not end there. “Some colleagues from Bolivia have been asked to seal and deliver their original title, but that cannot be done, that is what the Hague apostille is for,” she complains.

the long process

José María Casas is a spokesperson for the Migrant Interprofessional Front, a platform that emerged in 2021 to connect the struggles of different professionals. He is a psychologist, another of the professions that, together with dentistry or engineering, are part of the fight for an end to delays in approvals. He explains that to start the procedures, the first thing to do is bring the documentation from the country of origin with the Hague apostille, a simplified method of legalizing documents in order to verify their authenticity, to which different countries are attached, among they Spain. “In reality, a country should not check the seals and signatures of another country because the apostille already guarantees that everything has been fulfilled.” Casas explains that this method guarantees that all the documentation has been reviewed by the country’s administrations through a chain of signatures that begins with the dean of the University, goes to the rector, then to the Ministry of Education and finally to the Ministry of Foreign Affairs. “Some officials object, but the ministry of the country of origin has already reviewed everything,” he complains.

“Today it is taking two years to convert the record into a file and give you the file number so that you can view its status on the web,” José María Casas complains.

Later, the documentation is delivered to the Ministry of Universities through any State registry. “They verify that you have the original in your hands, they scan it and return it to you. There you get your registration number,” explains Casas. The law says that no more than six months can pass between registration and resolution and adds a three-month extension for the National Agency for Quality Assessment and Accreditation (ANECA) to issue an opinion. “Today it is taking two years to convert the record into a file and give you the file number so that you can view its status on the web. They are taking two years to start processing everything, ”he complains.

Casas also belongs to the Association of Argentine Health Professionals (APSAE). Between April and June 2021, they carried out a study to show that these situations are not “personal anecdotes”. They conducted 329 surveys among Argentine professionals in approval procedures. The majority —60%— were doctors. Only 38% could view their file on the web.

Sanitary necessary

In addition to homologation, these doctors face another problem when it comes to accessing internships at the MIR: the existence of quotas. Thus, in the 2023 call, 8,550 places are offered, and only 513 are for non-EU citizens, that is, 4%. But reality sometimes breaks corsets: during 2022, and given the existence of vacancies with the great need for doctors that currently exists, the Ministry of Health decided to increase the quota to 10%. Medical unions cry out against this measure. They speak of a “patch” since these people, they allege, will be trained and must return to their countries of origin in the absence of work permits.

“In my case I have the nationality, I could exercise at any time but I cannot do it because I have not been approved. Spain needs doctors, who put their officials to work”

“They don’t support us because we are migrants,” criticizes Jersey Ferrera, who denies that the objective of her and her colleagues is to return to their countries. While they are training, they look for ways to regularize themselves and, in addition, the recently reformed Immigration Regulation, in its article 42, provides for the possibility that people who have a stay authorization for studies may be authorized to carry out work activities.

Ferrera warns: among those who aspire to homologate their titles there are also Spanish men and women, who have been trained in Latin American countries, by not getting the cut-off mark to do the degree in their country of origin. In addition, there are people of Latin American origin who have obtained Spanish nationality. This is the case of Clara, who came to Spain from the Dominican Republic in 2008. “I came with the aim of finishing my degree here through a scholarship. The crisis caught me and I didn’t make it, I had to go back and forth. In 2019 I graduated from the Autonomous University of Santo Domingo and in August 2020 I began to homologate my degree in Spain”, she explains. In this time, she calculates that she has spent 4,000 euros in an academy. This year she had an online scholarship but, as she has not been approved, for the following year she will have to pay another 4,000 euros. She claims to have sent thousands of emails to the Ministry. She always responds with a kind response. Meanwhile, she works on what she can.

“In my case I have the nationality, I could exercise at any time but I cannot do it because I have not been approved. Spain needs doctors, who put their officials to work. I have my family here, my goal is to stay here. I only ask to work in what I have trained, ”she complains.

For José María Casas, at the bottom of this is institutional racism. “There is a deeply rooted issue within the Ministry that Spanish titles are the best in the world”

institutional racism

For José María Casas, at the bottom of this situation are prejudices: institutional racism. “There is a deeply rooted issue within the Ministry that Spanish titles are the best in the world. There is a chauvinism in disciplines where one plus one equals two. They are sciences, they are not debatable questions. Make a bypass is to make a bypass. If I tell you that your title is not worth it, I am telling you that you are not worth it, ”she denounces. Casas explains that, in addition to MIR applicants, in Spain there are already trained and specialized professionals, stranded because their medical specialties are not recognized.

Non-community doctors 3

Health personnel inside the area for COVID patients in the temporary hospital of Ifema during the pandemic.

Alvaro Minguito

Therefore, it is time to find allies. Senators such as Josep María Reniu, from ERC, have taken their cause to the upper house. Reniu explains to El Salto that, with this “exasperating” slowness, Spain is creating large pockets of precariousness, forcing people “with experience and training” to accept garbage contracts in other sectors. “We have a situation of deficiencies in certain sectors. We have a group of trained citizens, who have the capabilities and who have to prove that they have the potential to meet those needs. Why doesn’t the process speed up?”, he asks himself.

In this regard, Reniu explains that the director of ANECA, Mercedes Siles Molina, and the Secretary of State for Universities, José Manuel Pingarrón, appeared in the Senate. And they put commitments on the table. “We have been told that a new royal decree on foreign degrees is being worked on,” he says. On the other hand, the new Draft of the Organic Law of the University System, which has already begun its journey in Congress, incorporates articles for the “attraction of talent”. Thus, article 28.2 undertakes to speed up and simplify the homologation procedures. Reniu is optimistic. “I think it will be possible to decongest the plug. Resources and procedures will be reconsidered. During the next year we will have substantial improvements, ”she assures.

Meanwhile, Jersey Ferrera and Paola Oblitas gather the money to sign up for another year at the academy. It is time to trust that the one who enters will be the last course in no man’s land. “We have left our lives in our countries to come after a dream, which is not planned overnight, to get to this point… and I can’t do anything…”, Oblitas leaves in suspense while trusting that the fight collectively bear fruit.

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