70,000 doctors to retire in the next decade in ageing Spain

Spain’s medical institutions have warned the country faces a healthcare bottleneck in terms of the number of medical graduates replacing those who retire.

70,000 doctors to retire in the next decade in ageing Spain
Spain's current national average of active doctors per 100,000 inhabitants is 476. Photo: AFP

Just two weeks after national stats body INE announced that Spain saw more deaths than births in 2017, new findings lay bare the future challenges of providing healthcare to the country’s constantly ageing population. 

A demographic study by the Medical Schooling Association and the General Council of Medical Associations points to a bottleneck of graduates who are unable to sit the MIR, the official entry exam to specialize and work for Spain’s National Health System.

Ironically, the number of medical faculties across Spain has risen from 28 in 2010 to 46 currently, putting it second just behind South Korea in terms of the number of medical schools per capita.

Up to 7,000 medical students graduate each year in Spain, but according to the Medical Schooling Association, a large of number of them “never specializes”.

In 2018 only 6,513 candidates got a Resident Medical Intern (MIR) place out of 14,448 graduates who sat the exam.

Those who fail have to choose whether to wait another year to sit the exam again or look for work in the private sector, Spain’s Medical Schooling Association adds.

This spells trouble for the researchers behind this study, as their findings also underline an alarming stat: 70,000 doctors in Spain will retire in the next ten years. The average age of a doctor in Spain is currently 49.2 years.

“Our health system will be greatly affected unless we make changes regarding HR and recruitment in the face of our ageing population,” Dr. Carmen Sebastianes, vice president of Cádiz ‘s College of Physicians, is quoted as saying in the study.

“In 2031, 25.6 percent of Spain’s population will be over the age of 65,” she stated, adding that the public sector is going to need a lot more medics in the fields of primary care, anesthesia, geriatrics, digestive system, cardiology, pulmonology and neurology.

Serafín Romero, president of the General Council of Medical Associations, stressed that this drop in doctors will be “moderate and transitory” in the Spanish regions that already have a vast pool of medical professionals.
“There is no shortage of doctors in Spain, they’re just badly distributed,” Romero explained.

Up to 58 percent of doctors are found in four regions: Cataluña with 16.4 percent, Madrid with 15.9 percent, Andalusia with 15.3 percent and Comunidad Valenciana with 10.5.

On the other side of the spectrum are La Rioja and Cantabria, with 0.7 and 1.6 percent of the total doctor pool, regions that are more likely to bear the brunt of the drop in public doctors in the coming years.

SEE ALSO: Spain takes tentative first step to legalise euthanasia 


How Spain could stamp out smoking

A fifth of Spain's population smokes on a daily basis. With such high numbers, here's how the country's pulmonologists propose to get smokers to quit.

Spain plans to get people to quit smoking
How Spain plans to get people to stop smoking. Photo: Khalil MAZRAAWI / AFP

For many outsiders, Spain is a nation of smokers. 

The stats from Spain’s Ministry of Health show that 23.3 percent of men smoke every day in Spain, compared with 16.4 percent of women.

For both males and females, the highest number of smokers are aged between 25 and 34, meaning that it’s the younger population who are smoking slightly more than the older generations. 

Spain’s pulmonologists are now pushing for the country’s tobacco laws to be tightened, claiming that reform is needed after the last legislation was approved a decade ago.

READ ALSO: Spain warns against smoking and vaping in public to avoid Covid infections

Why is smoking such a problem in Spain and what is being done about it?

The latest stats from the Spanish Ministry of Health show that lung cancer, often caused by smoking, is the third most frequently diagnosed cancer in Spain, with 29,549 cases diagnosed so far in 2021.

Given these high figures Spain’s Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has proposed five measures to help get people to stop smoking.

SEPAR points out that every time anti-smoking legislation is reformed and things for smokers made more difficult, the prevalence of smoking decreases.  

Smoking on terraces was banned in some regions during the pandemic. Photo: CRISTINA QUICLER / AFP
  • Price of tobacco to rise in 2022

The first point on their list is to raise the price of tobacco, which must cover all forms, from cigarettes to cigars, through to rolling tobacco, and electronic cigarettes.  

This first measure may soon become a reality as the Spanish government has already predicted that the price of tobacco will rise in 2022, after several years of stagnation.  

It is expected that tobacco will be responsible for almost a third of all special taxes received in 2022, equating to €21.8 billion.

According to the World Health Organization (WHO), “cheap tobacco” in Spain guarantees “a percentage of smokers above 30 percent”.

In Spain, the price of a pack of tobacco is around €5, which is much cheaper than in other countries. In Australia for example, a pack of tobacco costs around €22, and in the United Kingdom and France, each pack of tobacco costs around €12.4 and €10.5, respectively.

According to Dr. Carlos A. Jiménez Ruiz, pulmonologist and president of the society, the current anti-smoking law has “some deficiencies” that need to be addressed in order to develop legislation that is more effective and efficient, especially with regard to the prevention of tobacco consumption in young people, but also in helping smokers to stop smoking and in protecting the health of non-smokers. 

READ ALSO – Maps: Which beaches in Spain have banned smoking?

Besides increasing the cost of tobacco SEPAR proposes four other measures to get Spain to quit smoking. These include:

  • Banning the consumption of tobacco in public spaces, even outdoors
    During the pandemic, several regions approved a regulation to prohibit smoking on terraces. SEPAR proposes that smoking be prohibited not only in spaces such as terraces but also in sports stadiums, beaches, parks and bullrings, and that fines should be imposed for those who do not comply.

  • Establish generic packaging
    SEPAR also wants Spain to introduce generic packaging, which means no logos and images of the tobacco companies. This measure has also proven to lower the sales of tobacco in countries where it has been implemented, such as Australia and New Zealand. According to the latest statistics from the Australian National Drug Strategy Household Survey around 11.6 percent of adults in Australia smoke daily. 

  • The regulation of other smoking devices
    Despite the fact that all products that burn tobacco such as cigarettes are already regulated, SEPAR believes that it is also necessary to regulate the sale, consumption and advertising of electronic cigarettes. This is because e-cigarettes have become particularly popular among young people. 

  • Promote help for those seeking to quit smoking
    The last proposal is the creation and development of special units in public health departments to help people to stop smoking and to put more funds towards these programmes. 

How does Spain compare with other European countries when it comes to smoking?

According to the Organisation for Economic Cooperation and Development (OECD), while Spain does have a high number of smokers there are still several European countries that have more. The European countries with the highest number of smokers are Greece, Bulgaria and Hungary.

The latest European survey from 2020 shows that 42 percent of Greeks claim to be smokers, which is only slightly above Spain. 

On the other side, the European countries with the lowest number of smokers are mainly Nordic countries, such as Sweden, Finland, Iceland and Norway.