MIR 2026: Doctors Avoid Emergency Medicine for Private Practice
MIR 2026: Doctors shun emergency services due to poor pay and violence, choosing dermatology instead. See the salary gap and career trends.
English · Original discussion in Spanish · Published
MIR 2026: Doctors Flee Emergency Medicine for Private Practice
In the 2026 MIR residency placement choices, specialties like Emergency and Critical Care Medicine remain largely unfilled in several provinces, while Dermatology and Plastic Surgery dominate the top spots. Selection data confirm that new doctors avoid emergency departments, where working conditions are poorest: night shifts, assaults, and salaries barely exceeding 1,400 euros monthly including all on-calls.
The Math Doesn't Add Up: MIR vs. McDonald's
A recurring point in the analysis is the salary comparison: a resident doctor with shifts earns only 326 euros more than a McDonald's waiter. Precariousness intensifies when housing costs in major cities absorb almost the entire salary. "If you earn 1,400 with shifts, you can't pay 1,200 for an apartment," several testimonies summarize. Thus, the MIR call numbers show that the best candidates opt for specialties without on-calls and private practice opportunities: dermatology, plastic surgery, ophthalmology.
The Violence Factor and the 'Hollowed-Out Spain'
Emergency medicine has become a hotspot for conflicts. Testimonies describe "stabbings by Algerians" and "voodoo rituals" as part of daily life. Security is notably absent. Additionally, provincial posts in areas like Palencia, Zamora, Ávila, or Cuenca have gone unfilled in the first days of selection. Moving to a rural area implies, for many, being "isolated" and "poorly connected." The feminization of the profession (over 70% of successful candidates are women) also plays a role: young doctors prioritize an urban environment and conditions that allow for work-life balance.
The Private Sector Business: From Public to Aesthetics
The strategy is clear: train in public healthcare during residency, then set up a private practice. In dermatology and aesthetics, income is significantly higher. For example, a specialist earns 10 euros per MAPFRE patient for the first consultation, but 100% private clinics charge much higher fees. Doctors who remain in the public system do so by stringing together temporary contracts, with mandatory shifts and no career prospects. "I spent 10 years on 3-month contracts, then 6-month, then one-year contracts," complains a specialist.
What to Do About Emergency Medicine?
The unanswered question is how to attract talent to a specialty that is the pillar of the system. Some propose mandatory "tolls," but shifts are already required for all MIRs, even those in dermatology. Others point out that the problem is structural: as long as conditions do not improve and security is not guaranteed, doctors will continue to flee. The result is that emergency medicine and family medicine will be left in the hands of foreign professionals or those with no other options.
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In the 2026 MIR residency placement choices, specialties like Emergency and Critical Care Medicine remain largely unfilled in several provinces, while Dermatology and Plastic Surgery dominate the top spots. Selection data confirm that new doctors avoid emergency departments, where working conditions are poorest: night shifts, assaults, and salaries barely exceeding 1,400 euros monthly including all on-calls.
The Math Doesn't Add Up: MIR vs. McDonald's
A recurring point in the analysis is the salary comparison: a resident doctor with shifts earns only 326 euros more than a McDonald's waiter. Precariousness intensifies when housing costs in major cities absorb almost the entire salary. "If you earn 1,400 with shifts, you can't pay 1,200 for an apartment," several testimonies summarize. Thus, the MIR call numbers show that the best candidates opt for specialties without on-calls and private practice opportunities: dermatology, plastic surgery, ophthalmology.
The Violence Factor and the 'Hollowed-Out Spain'
Emergency medicine has become a hotspot for conflicts. Testimonies describe "stabbings by Algerians" and "voodoo rituals" as part of daily life. Security is notably absent. Additionally, provincial posts in areas like Palencia, Zamora, Ávila, or Cuenca have gone unfilled in the first days of selection. Moving to a rural area implies, for many, being "isolated" and "poorly connected." The feminization of the profession (over 70% of successful candidates are women) also plays a role: young doctors prioritize an urban environment and conditions that allow for work-life balance.
The Private Sector Business: From Public to Aesthetics
The strategy is clear: train in public healthcare during residency, then set up a private practice. In dermatology and aesthetics, income is significantly higher. For example, a specialist earns 10 euros per MAPFRE patient for the first consultation, but 100% private clinics charge much higher fees. Doctors who remain in the public system do so by stringing together temporary contracts, with mandatory shifts and no career prospects. "I spent 10 years on 3-month contracts, then 6-month, then one-year contracts," complains a specialist.
What to Do About Emergency Medicine?
The unanswered question is how to attract talent to a specialty that is the pillar of the system. Some propose mandatory "tolls," but shifts are already required for all MIRs, even those in dermatology. Others point out that the problem is structural: as long as conditions do not improve and security is not guaranteed, doctors will continue to flee. The result is that emergency medicine and family medicine will be left in the hands of foreign professionals or those with no other options.
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Summary of a discussion on Burbuja.info - Foro de economía, actualidad y política., translated from Spanish and reviewed before publication. Read the full discussion (256 replies).
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