Juan de la Haba and Fátima Santolaya.

Many specialists consider that the post-Covid era is going to need more professionals, either because of the ravages of the pandemic itself or because of the needs of Medicine itself, increasingly specialized and with more empowered patients. That is why they estimate that the MIR places designated by Health are going to be ‘short’.

The Spanish Society of Medical Oncology is analyzing the services of the specialty. With the census of oncologists that there is, and the MIR places that come out every year, they hope to draw conclusions and see how functions should be redistributed in Oncology services.

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They also seek to clarify whether it is necessary to have more oncologists or not in the future. Juan de la Haba, member of the Board of Directors of the SEOM, points out that, a priori, the 155 MIR places that the specialty will have in the next call may fall short. The conclusions obtained by the scientific society will give a much more certain answer to this.

“The Oncology we did 10 years ago has nothing to do with what we do now and probably has nothing to do with what we do 10 years ago. interpretation will be much more molecular. This will lead to a growing demand not only for the number of patients, but also for the characteristics in which they come for consultation, both from the technical point of view and the need for information, “says the also member of the Board of Directors of the society.

The complexity of patient care, future retirements, the technological and scientific development of the specialty (with Precision Medicine), the empowerment of the patient or the chronification of cancer, which implies more years of survival of the patients and, therefore, more demand for care, are some of the reasons why it seems that the number of places, very similar to that of other years, is not enough.

Cancer cases return to Primary

The European Cancer Organization estimated last June that during the pandemic, in Europe, nearly 100 million cancer screening tests have been stopped. They also highlighted that Covid-19 caused one out of every two patients with this disease in Europe to not receive adequate treatment.

Regarding the underdiagnosis in Spain, De la Haba explains that the impact of Covid-19 has been very variable depending on one autonomous community to another. “Not all have been punished equally But even in the last 18 months, the waves have occurred differently depending on the healthcare systems. Some have been more saturated than others depending on the time, “he explains.

Late diagnoses and delays in chemotherapy and radiotherapy treatments are having a great impact on Primary Care. Fatima Santolaya, a member of the Oncology Working Group of the Spanish Society of General and Family Physicians (SEMG), assures that this is increasing the demand in the consultation.

“If the patient is delayed in hospital treatmentHe comes and goes back to the health center. If they do not see it in specialized, we will see it. They are patients who need much more follow-up and support, because if you are not careful there may be metastasis. Among those who have overcome the disease there is a much higher risk of neoplasia. You have to do reviews with them every year, and in some, such as breast cancer, you need them to be in person “, explains the Family doctor.

Primary specialists are missing

Santolaya recalls that some cancer screening programs, such as breast or cervical cancer, were delayed. And “not delaying the test or diagnosis” is essential in this disease, as it is about “saving lives.” Both these tumors and other pathologies (including Long Covid) cause the Primary to be overwhelmed and little by little they know the 2,336 MIR places assigned to them.

It would take many more professionals in Primary. Since before the beginning of the summer, in all the centers we are less than half of the specialists. There are no substitutes. It professionals are physically and psychologically exhausted and they need a vacation. And those who have retired have not been able to meet, “explains the professional, who adds maternity leave.

Psychiatrists for the ‘other pandemic’

For its part, Psychiatry has 296 places, six more than in the previous call. They will be specialists who fight against the ‘other pandemic’: that of Mental Health. Covid-19 has caused disorders and diseases such as depression, anxiety or eating disorders to skyrocket in the country.

In 2020, the president of the Spanish Society of Psychiatry, Celso Arango, He assured that they were “missing a record with the number of specialists in the country and with the professionals who are going to retire.” Only in this way, he indicated, will they be able to know exactly how many specialists they need to face the increasingly intense demand. Manuel Martin Carrasco, vice president of the SEP, explains that this issue has not yet been resolved. It is expected, as in other specialties, that in the next 5-10 years a large number of psychiatrists will retire.

The psychiatrist recalls that in the promotions between the 80s and 90s, a large number of professionals graduated, which later decreased. He also points out that until now these specialists were “more versatile”, but with the approval of the specialty of Child and Adolescent Psychiatry it is probable that “the number of professionals required will be greater.”

In addition, it is very possible that the prevalence of mental health problems will continue to increase due to Covid-19. “Pandemics leave an effect that lasts longer than the pandemic itself,” explains the vice president of the SEP. To which is added that today there is already a deficit of professionals in Spain. For everything, “the 296 places are insufficient“.

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