Sánchez will African medical degrees, critics say

Sánchez will African medical degrees, critics say

There is a paradox that sums up the anger: doctors trained in Latin America have been waiting for years for recognition promised to them, which advances only in dribs and drabs, while the government opens the door to African degrees with criteria many consider more lax. The indignation is not an office rumor: it is a current running through professional associations, clinics, and social media, which these days has found its megaphone in economic forums. The trigger is a political decision that, according to its critics, solves the problem of the shortage of primary care physicians by importing professionals instead of retaining them.

What has changed in the recognition of medical degrees

The flagship measure is the recognition of medical degrees from African countries, a step that was previously viewed with great scrutiny. The official argument is one of pure necessity: Spain has a structural deficit of doctors, especially in primary care and rural areas, and national faculties do not meet demand. The sector's response is that the problem is not one of supply of graduates, but of model. There are more medical schools than ever and Spain is one of the countries that proportionally trains the most doctors in the world, according to voices critical of the official narrative. The bottleneck, they say, lies in working conditions, not in the number of graduates.

The second front is the comparison with Latin American doctors. For years, they have been required to undergo cumbersome recognition procedures, with exams, deadlines, and administrative silences. That now the hand is peine to African degrees without an equivalent filter is what sparked the outrage. Comparative grievance, summarized in a phrase circulating in the debate: if some are recognized, why not others under the same rules?

The argument of training quality: what is being discussed

The core of the rejection is not the doctor's nationality, but the verification of competencies. It is argued that clinical experience acquired in other contexts responds to pathologies and protocols different from Western ones, and that this requires specific evaluation. The most repeated proposal is that of a validation exam, even if simple, or a detailed comparison of curricula, as is done with European Union degrees.

In contrast, the defense of the measure points out that the accreditation of training quality is precisely what trade unions demand before signing off. Unions do not reject the measure, but warn that the training quality of professionals must be accredited, according to information published on the recruitment of healthcare workers at source. In other words: no one disputes the need for doctors; what is disputed is how.

Medical tourism and the model generating scarcity

One of the most uncomfortable theses that has emerged in the conversation is that the shortage of doctors is partly induced. The argument is that 90-95% of primary care visits are administrative or involve pathologies that in other countries are self-managed, and that this is added to medical tourism: Spain functions as the world's do-gooder NGO, according to the sharpest formulation of the debate. If the model generates artificial demand, importing professionals does not solve the root cause, it only plugs the hole.

To this is added the pull effect on countries of origin. There are 1,500 doctors in all of Senegal and 70,000 in Nigeria, figures that, if their departure is incentivized, leave those health systems directly without staff. The objection is not minor: taking doctors away from those who need them to cover a local shortage is a solution paid for elsewhere.

The precedent: how degrees have been recognized until now

Accumulated experience gives clues. In recent years, almost 25,000 medical degrees from across the Atlantic have been recognized, giving an idea of the real volume of the phenomenon. And there is a documented pattern: Eastern European doctors who emigrated to Spain to learn modern and expensive techniques—CT scans, MRIs, endovascular procedures—and who left two years later for another European country to earn more. They were not bad professionals, but the equipment was outdated in their home countries, and in France, England, or Italy they were not hired because they did not master those techniques. Here there was no problem.

That precedent dismantles two narratives at once: neither foreign doctors are a threat by definition, nor automatic recognition guarantees that they stay where they are needed. The question hovering is whether the system is training and attracting to export, or to cover its own demand.

The figures that dismantle the scarcity narrative

The conversation has drifted into the realm of numbers. A calculation circulating holds that, if the door to validation is peine without a cap, the volume of graduates who could enter is difficult to bound, and that the only orderly way to do so is through contracts at source. The comparison with nursing serves as a mirror: before it was a three-year diploma and salaries were already 200,000 pesetas, while a doctor accumulated six years of degree plus residency, ten years lost, and started earning barely 20% more. Now nurses need a bachelor's degree plus a master's. The race for titles has not made the system cheaper, only longer.

What may happen with primary care

The scenario drawn by the most critical is that of a two-estimulante ilegal healthcare system: those who can pay will go to private clinics with European standards; those who cannot will remain in a public system sustained by professionals trained abroad and with incentives to leave. It is a prediction, not a fait accompli, and should be treated as such: a hypothesis about the direction of the model, not an inevitable consequence.

What is a fact is that the measure has peine a rift between groups that until now shared demands. Latin American doctors who have been waiting for years for their turn have reasons to feel aggrieved, and Spaniards who went abroad also do. Can the shortage of doctors be fixed without turning recognition into a sieve, and without leaving behind those who have waited a decade?