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Amid the lack of professionals that is not being reversed in the health system, the number of applicants who will take the single exam next Tuesday to enter residencies in medicine, nursing and biochemistry in hospitals and private centers in the country increased compared to last year, although the proportion of Argentine graduates interested in going through this training stage remains below 70% for the second consecutive year. 31.1% are foreigners, attracted especially by medicine.
On this date, exactly one year ago, THE NATION The report revealed that not only was one in three newly graduated doctors, nurses or biochemists who applied for the national evaluation foreign, but that this greater interest from professionals of other nationalities was inversely proportional to that of their Argentine colleagues. This happened in a structural crisis of the health system that relies on residents from midday onwards for various reasons, including admissions. This has not changed in these 12 months. If not, just go to the health centres.
Last year, 7,312 applicants were eligible to apply. This year, among more than 11,000 registered, 8,282 met the requirements to do so: a 68.9% are Argentine and 31.3% are from other countries (Ecuador, Bolivia, Colombia, Brazil, Peru and Venezuela, the most present).
In both cases, the number of interested parties increased compared to 2023, according to data from the official online list compared by this media. How much? 13.5% of Argentines (from 5,028 last year to 5,705 this year), compared to 12.9% of foreigners (from 2,284 to 2,577), according to the analysis of the records of the Human Talent and Knowledge Department of the Ministry of Health of the Nation What did THE NATION.
When asked, from that portfolio they indicated that The majority of professionals from other countries approved the degree to complete residency in Argentina as a rented postgraduate degree, especially in surgery, orthopedics and traumatology, diagnostic imaging, nursing and dermatology. Last year, the San Francisco University of Chuquisacafrom Bolivia, was the third institution with the most graduates taking the national exam, after the National University of Buenos Aires (UBA) and the National University of Rosario (A R).
Among Argentines, the medical specialties with the highest number of applicants this year are anesthesiology, general surgery, internal medicine, obstetrics and gynecology, cardiology, pediatrics combined with neonatology and intensive care, orthopedics and traumatology, psychiatry and diagnostic imaging, among others.
There are 7,007 applicants – almost 1,000 more than last year – in the More than 70 medical areas are being offered for which almost 4,700 places are to be filled starting next September; 65.5% are Argentine and it is here that the proportion of local graduates who opt for residency grew less than that of foreigners compared to last year (12.2 versus 22.3%).
For Miguel Indart de Arzapresident of the Argentine Society of Pediatrics (SAP), “history repeats itself” In one of the five specialties that you consider to be prioritized, there are about 600 vacancies and around 420 applicants, a number that drew attention. “It hides the number of foreign applicants,” he explained. “There is a significant percentage (in the first year of residency at the Gutiérrez Hospital it was 30% last year and, at the Elizalde Hospital, 20%) who are doctors trained at other universities, who come to our residencies and are likely to return to their countries.” There is going to be a serious public health problem: the number of pediatricians, which is critical now, is going to be dramatic in the coming years.”
Pediatrics, as the doctor defined it, is a specialty with high emotional demand, containment, and care for situations that exceed symptoms, including family and social situations, especially in the on-call. “People are increasingly coming to emergency services with problems that have been exacerbated by the pandemic, such as mental health problems. The wards are often occupied by patients who would have to be admitted to pediatric clinic wards and they are there, with double work for the pediatricians on duty,” Indart continued.
In the country, there are 188 centers that offer pediatric residency among public hospitals, university hospitals and the private sector. “When we talk about the number of pediatricians, as we talk about foreigners and nationals, there are also pediatric specialties. To access, you have to be a pediatrician, but when that pediatrician trains, he will not practice as such but as a specialist. That’s why, There is no real dimension of the number of pediatricians there are. –added the head of the SAP–. The pediatric residency is not being chosen for professional practice and this will have consequences. It is the specialty that is responsible for caring for the health of children and adolescents up to the age of 18. AND professionals are doing it with multiple jobs and exhausted.”
In biochemistry, as well as in pharmacy, there is a scenario that is followed with concern. There are 151 registered to cover 165 open positions in all their specialties; Unlike medicine, 98% is Argentine. “There are about 50 places offered for residency in hospital pharmacy, but only 15 registered. In biochemistry, that relationship is lower. This is something that has been going on for years. With the salary of residents, there are few who apply,” he said. Pablo Evelsondean of the Faculty of Pharmacy and Biochemistry from the UBA.
In dialogue with THE NATIONconsidered that this is due to two reasons. “Before, the place to do the residency was chosen in order of merit and those with the best reputation for professional training were chosen. Now, with the salary that residents receive, the choice is more based on proximity or convenience. Selection patterns for graduates have changed –Evelson continued–. In recent years, there have been more vacancies than applicants in the competition.. In addition, there is the logic that biochemical and pharmaceutical residents have a lower income in some institutions than medical residents and this, together with the on-call shifts and the effort that this requires, makes the offer unattractive. As long as there is no recomposition of the residents’ stipend, this trend will not improve.”
In the nursing field, a human resource in high demand in the health system, a hundred more professionals took this exam than last year. There are 1,125 applicants in total, with only 394 positions offered, three fewer than last year, when 722 nursing graduates took the exam. 85.8% are Argentine, with 20 more foreign applicants than for the previous exam.
“Residency is the most important health issue for the next 10 years. “We all agree with that and we are working on the training paths: the faculty, the residency and the optimal resources for patient care,” he responded. Leonardo BussoSecretary of Health Quality of the national health portfolio, THE NATION“We are working with the faculties to see how to modify the curriculum in order to train doctors more closely linked to the priority specialties (pediatrics, clinical medicine, surgery and obstetrics) – he added -. Last year, 50% of the positions in these cases were vacant. We will see what happens this year when the exam is taken.”
After the first adjudication, the remaining vacancies will be reassigned, as every year, and, as indicated by the official, The priority will be to cover the positions of the basic specialties. Going forward, they plan to work with the provinces and universities to give priority to these places and the knowledge they require. “We seek to incorporate public health in all years of the medical training course,” added Busso. With the Pan American Health Organization (PAHO), as anticipated, are moving forward with an observatory to find out what is happening with the job placement of graduates, for which there is no data.
About what If there is information, it is where the future residents were trained.. The majority, according to the registrations, obtained their bachelor’s degree at the UBA, the National University of La Plata, the UNR, the National University of Tucumán, the National University of the Northeast, the National University of the Litoral, the National University of Cuyo and the Barceló Foundation, as specified by the National Directorate of Human Talent based on the documentation required for registration for the Single Exam.
Among foreigners with a degree obtained in the country, in addition to the UBA, the UNR and the Barceló Foundation, the Inter-American Open University appears. 6% of those who applied are Brazilian.
For Marcelo Garcia Dieguez, Associate Professor of the Clinical Areas and Epidemiological Analysis of Health Determinants of the Department of Health Sciences National University of the Souththere is a key debate that must be faced in the country: reviewing the scope of the autonomy of the university degree to practice and making residency mandatory for that autonomy.
“There are different legal ways to do it: one would be that the degree has a mild qualification, not a complete one as it is currently. Agreeing with universities that, in health careers, professional qualification requires postgraduate training,” said García Diéguez, former director of Human Talent of the Ministry of Health of the Nation. “It is a balance between autonomy and responsibility: can a recently graduated doctor do anything? No, because he does not have the experience, even with supervision – he explained in dialogue with this media –. How can a graduate have sufficient skill to attend a birth, for example, if as a student he could not do it in practice or under direct observation? There is a dilemma that is resolved only with supervised practice until he learns to do it. And this is a debate that must be held.”
Another point to resolve, he considered, is the intelligent distribution of charges with the percentage of professionals in the specialties demanded by the health system. “It is the easiest way so that, at least, we can have the number of specialists we need in the areas that are necessary,” he said. Once the number of residency positions available is equal to the number of graduates, which has been the case in the country for a few years, then the decision can be made to grant the enrollment the attenuated qualification for professional practice, having to complete the home. This could resolve this conflict, in which the Ministries of Health and Education must intervene and involve the universities so that, through academic management, the residences enter the quality accreditation process. Argentina is one of the few countries in which postgraduate medical training is managed by hospitals and the Ministries of Health.”García Diéguez concluded.
Through the Single Exam, each year, a large part of the places in the country are filled for residencies in medicine, biochemistry and nursing offered by provinces, the Nation, universities and private centers that adhere. National, Buenos Aires and Buenos Aires hospitals, in addition to community care centers, participate in this examination through the Unified Competition Among the three jurisdictions, the majority of applicants for next Tuesday’s evaluation are participating through this competition.
Other disciplines, as well as post-basic residencies (in a specialty after the basic residency), have their own evaluations, depending on the competition chosen.
Last year, 89% of the 7,312 registrants authorized to sit actually showed up on the day of the exam.
