Nuria Monsó Madrid

Madrid

Updated Monday, January 22, 2024-18:47

  • Health More than 30,000 people are examined this Saturday in Spain to qualify for a MIR place and other health specialties

  • Health Record number of MIR family doctor positions despite lack of interest in the specialty

The MIR exam frequently contains a question that draws the attention of those who are not candidates and generates debate in the healthcare world.

One of the

questions of the 2024 MIR exam

has ignited the spirits of Family doctors

by exposing the case of a professional who accumulates delays in the consultation, claims that he has no free time or social life, it is said that he is not able to discern what is urgent and a priority than what is not... and the approach is that he has

a personality disorder

.

The controversy has reached the point where

the Secretary General of Health himself, Javier Padilla, has called the question "regrettable."

The controversial question

The text of the question (number 84 of version 0 of the exam) and the options presented are as follows:

"50-year-old doctor who frequently accumulates delays of 2 hours in the consultation, creating some conflict, although he is the one with the smallest number of patients. He starts his workday before the time to plan and advance his work, but he is always the last to leave. He explains: "I can't stand leaving something half done, I am a very perfectionist, I have many things to do besides visits (bureaucracy, paperwork) and I don't have time for anything else.

I don't know how my colleagues who have families, hobbies... I don't even have time to go to the gym.

On weekends I stay at home, resting.

I do not have a social life."

The examination reveals a concern for details, order and rules, an inability to discern what is urgent and a priority from what is not, an inflexible behavior and an inability to delegate.

Which of the following would be the diagnostic orientation?

1. Schizoid personality disorder.


2. Narcissistic personality disorder.


3. Obsessive-compulsive personality disorder.


4. Personality disorder not otherwise specified."

Unfortunate, a lack of respect, stigmatizing, a mockery

... the qualifiers on the social network X (formerly Twitter) have been various and negative.

And some professionals propose an alternative diagnosis:

what happens to that doctor is that he is

burned

.

DOCTORS' REACTIONS

The Semergen company has been the first to react with a statement in which they have indicated that "this situation is very unfortunate and it is intolerable to hold the doctor responsible for the great burden he suffers both at the bureaucratic level and in the consultation. Currently, primary care suffers a deep crisis and at Semergen we have been denouncing for years the lack of investment, the lower provision of human resources, the job insecurity and the excessive bureaucracy that family doctors endure. Questions like this, in the MIR exam itself,

discourage new generations from want to dedicate themselves to Family Medicine and what they achieve is to generate great discomfort in the profession

."

SEMG regrets that the doctor in the question "

is attributed a mental health problem related to personality in all the response options, not considering the work context

in which it occurs, with a reality that is difficult to defend."

In the current situation "it seems more like a practical joke than a question worthy of being included in a MIR exam."

Society has demanded that the Ministry of Health apologize to the professionals.

"Not only are the working conditions currently not ideal for future doctors compared to other specialties, but also now the MIR exam itself contributes to remembering this, without contemplating or weighing the reality that the doctors suffer among the response options. primary care professionals: the strong

burnout

syndrome

that many family doctors suffer from due to the precarious situation that has been established for years

.

Doctors of Catalonia (MC) has called on Health to publicly apologize for including a "deeply disrespectful and cynical" question.

The union considers that the presentation of this alleged clinical case "blames and pathologizes" medical professionals, simulating that their emotional discomfort is due to a personal problem and is not related to the "deficiencies and precariousness of the system."

"Professional exhaustion syndrome or burnout affects almost 50% of the medical community, especially in the field of primary care. This high incidence is directly related to the functioning and organization of the teams and

its main cause is the care overload of the facultative staff

."

The union considers it "incomprehensible" that the question has passed "all the filters and reviews prior" to the approval of the questionnaire.

Therefore, it requests a rectification from the ministerial officials.

JAVIER PADILLA: "IT IS REGRETTABLE AND A LACK OF RESPECT"

El propio Javier Padilla, secretario de Estado de Sanidad, que para más inri es médico de Familia, ha valorado la pregunta en cuestión: "Es lamentable y una falta de respeto a todos los profesionales de Atención Primaria que siempre son "los últimos en salir", con unas consultas infinitas y un compromiso más infinito aún con sus pacientes". "Lo último que necesita la situación de la atención primaria es una caricatura en forma de pregunta que obvie que lo que se dibuja como "caso clínico" es la realidad forzada cotidiana de miles de profesionales tan comprometidos como maltratados", ha concluido.

Esta pregunta es lamentable y una falta de respeto a todos los profesionales de Atención Primaria que siempre son "los últimos en salir", con unas consultas infinitas y un compromiso más infinito aún con sus pacientes.

Dicho esto, también ha exculpado al Ministerio de Sanidad de la redacción e inclusión de la pregunta. "Las preguntas las elabora un Comité de Expertos, con profesionales de diversa trayectoria y procedencia en cada categoría de examen, y en el que no participa ninguna persona del Ministerio de Sanidad".

Fuentes del ministerio aclaran a este medio que el comité está formado por "un grupo de expertos para cada titulación con experiencia en educación y formación especializada. Estos expertos que, a lo largo de más de seis meses, recopilan respuestas de colaboradores, califican la dificultad de las preguntas propuestas, reelaboran y seleccionan las preguntas de la prueba. Los grupos de expertos están compuestos por 5 ó 6 personas. Cada uno de ellos, a su vez, están apoyados por 10-15 colaboradores (5 preguntas máximo por colaborador). Comenzamos a trabajar en el mes de abril-mayo en la prueba del año siguiente", precisas.

Ese comité "selecciona las preguntas con unas indicaciones sobre las proporciones en relación al grado de dificultad y materias" y una vez se entregan, van directamente a la empresa adjudicataria de la impresión.