Top MIR 2022 Sofía Haselgruber Chooses Dermatology in Spain
Sofía Haselgruber scores 182/200 on Spain's 2022 medical exam, choosing dermatology for work-life balance amid debates on shifts and private practice.
English · Original discussion in Spanish · Published
Top MIR 2022 Sofía Haselgruber Chooses Dermatology: 'No Magic Formula'
On January 29, 2022, Sofía Mercedes Haselgruber de Francisco, a medicine graduate from the Universidade de Santiago, achieved 182 correct answers and 18 errors out of 200 questions. Her overall score was 93.6354 and final grade 103.2911, the highest among over 13,000 admitted doctors in Spain, thanks to an academic rating of 9.34. Her chosen specialty is now known: dermatology.
The daughter of an Austrian father and Galician mother, raised in Galicia since age three, the new top MIR candidate shares no secret method. “There is no magic formula to do much better,” she says. What she does highlight is the other front, the psychological one: enduring day by day. “I, who got number one, had many bad days, many days thinking this wasn't going forward,” she confesses.
The result is also supported by a streak: the Compostela faculty already placed a graduate at number 1 in 2019 and two graduates in second and ninth places in 2021.
Why dermatology and not neurosurgery?
The choice does not surprise those who know the incentive map. Haselgruber ruled out from the start a “purely surgical” discipline and sought something “more clinical, with more consultation and patient interaction.” She considered digestive, neurology, and nephrology, consulted with veteran doctors, and stayed with dermatology due to “better prospects and better quality of life”. Translated: not to end up burned out.
The debate is served. It is argued that dermatology equals an advanced civil servant schedule, with no nights or holidays; it is replied that this describes life after residency, not during. In full training, the on-call duty is the same for everyone, and the MIR involves nights and weekends rotating through services and emergencies. Those who confuse the afternoon consulting dermatologist with the second-year resident at dawn sustain much of the misunderstanding.
The calculation that changes depending on who does it
After residency, the tone of the analysis changes. Those looking at high incomes talk about marginal rates of 45-49% in income tax and specialties where life is not free: neurosurgery involves very long interventions, ICU post-op, and complications. High expense and little gain in private healthcare, where from that discipline hardly any meningiomas and, above all, spine surgeries are performed.
The most common comparison faces the hospital coat against the private clinic. On one side, on-calls, polytraumas, and midnight deliveries. On the other, creams and lasers, without generics competing against cosmetic business and with a client willing to pay out of pocket what they do not expect to wait six months for in the public waiting list.
Private dermatology: 1,400 euros for three pages
Here appear testimonies with figures. Seeking a dermatologist to prepare a forensic report on laser burns resulted in a single willing response: 1,400 euros provision of funds to draft three pages. In some clinics, the agenda is closed six months out and not expanded, it is said, due to lack of hands.
The margin does not live solely from consultation. Laser hair removal, cosmetics, and treatments that do not require operating theaters or ICUs and are charged directly to the patient configure a specialty with practically unlimited private practice. In contrast, ophthalmology is also pointed out as a safe bet: more waiting lists, more cataracts, more operating theaters.
How much is earned in public: from the top contribution limit to the Norwegian mirror
On the other side is the public system. A retired nurse with the top contribution base —more than 48,000 euros annually— received around 50,000 euros in her last active year; nurses between 30 and 45 years old declare above 40,000, according to the examples managed. At the same time, the opposite case is recalled: more than twenty years in public healthcare never approaching 4,000 euros monthly.
The external reference does not help close the debate. An inexperienced nurse in Norway earns about 6,000 euros per month, up to 8,000 in hospitals, and an unskilled worker's salary is around 2,500, with a miccionan living standard three times higher than Spain's. The comparison stops there: currency change, cost of living, and model.
What still does not add up
No one disputes that dermatology is a good economic move. What no one puts in black and white is exactly how much a Spanish dermatologist earns between public consultation, on-calls, and private practice: from concrete ranges, we move to loose examples and from there to silence. The top MIR candidate's decision was made, in any case, before that calculation is resolved.
On January 29, 2022, Sofía Mercedes Haselgruber de Francisco, a medicine graduate from the Universidade de Santiago, achieved 182 correct answers and 18 errors out of 200 questions. Her overall score was 93.6354 and final grade 103.2911, the highest among over 13,000 admitted doctors in Spain, thanks to an academic rating of 9.34. Her chosen specialty is now known: dermatology.
The daughter of an Austrian father and Galician mother, raised in Galicia since age three, the new top MIR candidate shares no secret method. “There is no magic formula to do much better,” she says. What she does highlight is the other front, the psychological one: enduring day by day. “I, who got number one, had many bad days, many days thinking this wasn't going forward,” she confesses.
The result is also supported by a streak: the Compostela faculty already placed a graduate at number 1 in 2019 and two graduates in second and ninth places in 2021.
Why dermatology and not neurosurgery?
The choice does not surprise those who know the incentive map. Haselgruber ruled out from the start a “purely surgical” discipline and sought something “more clinical, with more consultation and patient interaction.” She considered digestive, neurology, and nephrology, consulted with veteran doctors, and stayed with dermatology due to “better prospects and better quality of life”. Translated: not to end up burned out.
The debate is served. It is argued that dermatology equals an advanced civil servant schedule, with no nights or holidays; it is replied that this describes life after residency, not during. In full training, the on-call duty is the same for everyone, and the MIR involves nights and weekends rotating through services and emergencies. Those who confuse the afternoon consulting dermatologist with the second-year resident at dawn sustain much of the misunderstanding.
The calculation that changes depending on who does it
After residency, the tone of the analysis changes. Those looking at high incomes talk about marginal rates of 45-49% in income tax and specialties where life is not free: neurosurgery involves very long interventions, ICU post-op, and complications. High expense and little gain in private healthcare, where from that discipline hardly any meningiomas and, above all, spine surgeries are performed.
The most common comparison faces the hospital coat against the private clinic. On one side, on-calls, polytraumas, and midnight deliveries. On the other, creams and lasers, without generics competing against cosmetic business and with a client willing to pay out of pocket what they do not expect to wait six months for in the public waiting list.
Private dermatology: 1,400 euros for three pages
Here appear testimonies with figures. Seeking a dermatologist to prepare a forensic report on laser burns resulted in a single willing response: 1,400 euros provision of funds to draft three pages. In some clinics, the agenda is closed six months out and not expanded, it is said, due to lack of hands.
The margin does not live solely from consultation. Laser hair removal, cosmetics, and treatments that do not require operating theaters or ICUs and are charged directly to the patient configure a specialty with practically unlimited private practice. In contrast, ophthalmology is also pointed out as a safe bet: more waiting lists, more cataracts, more operating theaters.
How much is earned in public: from the top contribution limit to the Norwegian mirror
On the other side is the public system. A retired nurse with the top contribution base —more than 48,000 euros annually— received around 50,000 euros in her last active year; nurses between 30 and 45 years old declare above 40,000, according to the examples managed. At the same time, the opposite case is recalled: more than twenty years in public healthcare never approaching 4,000 euros monthly.
The external reference does not help close the debate. An inexperienced nurse in Norway earns about 6,000 euros per month, up to 8,000 in hospitals, and an unskilled worker's salary is around 2,500, with a miccionan living standard three times higher than Spain's. The comparison stops there: currency change, cost of living, and model.
What still does not add up
No one disputes that dermatology is a good economic move. What no one puts in black and white is exactly how much a Spanish dermatologist earns between public consultation, on-calls, and private practice: from concrete ranges, we move to loose examples and from there to silence. The top MIR candidate's decision was made, in any case, before that calculation is resolved.
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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 (262 replies).
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