Pontevedra Medical Head Prefers Trainees Over Foreign Doctors

Medical association supports hiring residents without full specialization

Is a doctor in training better than one trained abroad and unverified? Isidro Lago, president of the Official College of Physicians of Pontevedra, was sworn in for a new term on Saturday. The next day, he endorsed the Consellería de Sanidade’s plan to hire fourth-year family medicine residents this summer to cover absences in health centers. “A supervised fourth-year resident can handle many issues, and ask about those they cannot,” he said. He added: “What is the alternative? Hiring non-EU doctors whose training we don’t know? As a patient, I prefer being treated by an R4 rather than a non-EU doctor.”

The statement landed like a stone in a sector that has spent years debating how to fill staffing gaps without touching the bottleneck of entry into the profession.

Why family doctors are missing this summer

The standard mechanism is well known: every year, family doctors finish their specialty in May, and the Sergas (Galician Health Service) hires them to cover absences and vacancies. In Spain, working in a health center requires the specialty of family and community medicine, which entails studying Medicine, passing the MIR (national residency exam), and completing four years as a resident.

This year, the calendar broke. In 2020, due to the pandemic, the end of the academic year was delayed until September, meaning fourth-year residents could not finish on time. The Sergas has promised these R4s an extra €2,000 per month and assured they will work under supervision.

Lago argues that this supervision is sufficient: the trainee doctor attends only to the patient and, if in doubt, asks the head of service. For context, he recalled that previously, family medicine training lasted three years, not four.

What the law requires of doctors trained outside the EU

Citizens from outside Europe must have their Medical degree recognized by the Ministry of Health, as well as their specialty. Many choose to re-specialize in Spain because the procedures are complex and slow. In other words: the pathway exists, it is legal, but it is cumbersome.

Here lies the crux of the matter. The alternative Lago dismisses is not an undocumented doctor, but one whose recognition file may take months or years, and regarding whose level of training the system itself does not issue a quick judgment. The comparison he made—a supervised R4 versus a non-EU doctor “whose training we don’t know”—mixes two distinct problems: the broken schedule of one cohort and the administrative slowness of credential validation.

The other front: 8,000 doctors without positions

Lago did not stop there. He criticized the specialist training access system: “In Spain, there are eight thousand doctors who cannot work,” he said, referring to those who fail to secure a position after taking the MIR. His proposal is that autonomous communities determine their specialist needs and distribute them accordingly, leaving no doctors out. He also called for raising the retirement age to 72 years and “re-grouping doctors” toward areas with higher population density in summer.

There is an evident tension in that package: it demands extending the working life of those already employed, hires those who have not yet finished, and leaves out those who passed the exam without getting a spot. Three responses to the same deficit, without a single criterion to order them.

What is debated in public: validations and double standards

Social reaction to Lago’s argument quickly shifted to the terrain of credential validation. One current holds that the system recognizes foreign degrees with more lax criteria than it applies among Spanish universities, where changing faculties can cost tens of credits. Another points to the opposite bottleneck: medical school spots are restricted, and extremely high grades are required for entry, while seeking abroad what is not formed domestically.

In between, personal testimonies of healthcare attention circulate, both in public and private sectors, which cannot be taken as evidence of anything: they are isolated cases, unverified and undiagnosed. What is a fact is the complaint about the level of rigor in validations, which Lago himself fueled by doubting the training of non-EU doctors without providing a single data point on how many practice, with what qualifications, or under what controls.

What remains to be resolved

The plan to hire supervised R4s this summer remains in place. The underlying question—whether a resident without a specialty can assume consultations with supervision and at what price—does not yet have a public technical answer. Nor does the validation bottleneck or the fate of those 8,000 doctors without positions.

Lago, who has just renewed his mandate, has put his finger on a real wound with an argument that reads as a judgment on the origin of professionals. He has highlighted the problem. The solution, for now, remains owed.