A foreign doctor: “We are treated like third-rate health care workers. We only import in crises like the covid crisis”.

A 80% of non-EU physicians in Catalonia, both in the public and private systems, have not taken the MIR exam (medical intern resident), according to the Col.legi Oficial de Metges de Barcelona (COMB). This does not necessarily indicate that they lack a medical specialty: although some do not have it, there are many others who do. But the problem is that this title is not always homologable with the Spanish system. Thus, these physicians, most of whom are Latin American and who are not recognized as having any specialized degree, are considered, they denounce, “third-rate doctors”. Throughout the Institut Català de la Salut (ICS) there are. between 9% and 11% of physicians without MIR medical specialty, without distinguishing between foreigners and those born in Catalonia, according to figures from the agency itself.

Many foreign doctors, exhausted after years of what they consider to be a “mistreatment” in their working conditions by the Administration, they decide to leave Catalonia and Spain. This is the case of Maigualida Rodriguez, 51-year-old Venezuelan who arrived in Barcelona in 2018 accompanied by her two children. “I was four years doing substitutes, guards and with contracts for a maximum of six months in the Institut Català de la Salut (ICS)”, denunciation.

The dream of “a better life”.

Maigualida came out of Venezuela in 2013 “due to the economic precariousness and the violation of human rights”. He was residing in Brazil, where he obtained the specialty as a family physician. In 2018 he moved to Spain, with a specialist degree and “believing”, at last, that he would have “a better life, job stability”. But that has not been the case.

“When I try to homologate my medical specialty, they tell me that it is better to do the MIR because the other process can take a long time. up to six years.” she says. However, between settling in the city and obtaining her residence permit, Maigualida decides not to do so for the time being. “From then on, I start the periplus of looking for work, of trying to make a professional name for myself on a continent where I don’t know anyone,” she says.

The homologation of the degree of Medicine corresponds to the Ministry of Education and that of specialties, to that of Health, point out sources from the Conselleria de Salut. Given that for professionals not trained in Spain, the validation of the specialty is a more complex bureaucratic process than that of the degree, it is common for the different autonomous health systems to opt for the incorporation of these health professionals while they process the homologation. Catalonia and other autonomous regions have asked the Health Department to call a extraordinary MIR exam for these people and to make a working group to alleviate the lack of professionals, Salut sources point out.

Destination: “Where there is work.”

Maigualida thus began filling in at the ICS and in the private system. “I traveled wherever there was work. I would go to Ripollet, do up to 24-hour shifts, accepted one-day contracts and so on,” he says. After two years (2018 and 2019) “jumping around”, in March 2020 the covid pandemic broke out. It was the moment when the lack of resources in the healthcare system was uncovered after years of cutbacks and when the Conselleria de Salut began to call for retired doctors and trainees to work because they lacked hands.

The ICS also called Maigualida: they needed doctors for the Atenció Continuada Domiciliària (ACD). She accepted and began to sign single-day contracts, something that continued throughout 2020, once the first wave had passed. “In November 2020 I got my first one-month contract.” recounts the physician.

“I would travel wherever there was work. I would go to Ripollet, do shifts of up to 24 hours, accept one-day contracts and so on.”

She believes that behind all this “disrespect.” is the fact that she does not have the MIR and is considered by the system as a “third-rate physician”. She assures that she is not the only one in this situation, but that there are “many, many South American doctors who complain about the same thing she does”: about “precarious contracts”, of the lack of “stability”, that not having the MIR is a “nightmare”. Without the MIR, for example, they will never be able to apply to a interim position. “If they really count on you, it’s because there’s a crisis like covid,” Maigualida denounces.

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Six-month contracts

Finally, in 2021, after some three-month contract, the ACD, which depends on the ICS, makes him a six-month contract. “Although they cannot make me an interim because I do not have the MIR, they promise to give me a job continuity every six months and they even think, because they told me so, about making me a one-year contract.” With two six-month contracts Maigualida was there for the whole of 2021, but when 2022 arrived, he was not given a one-year contract like the rest of his colleagues, but a six-month contract.

“You don’t feel like staying. You come, you make an effort, you put your health on the line and there’s no way they treat you with respect.”

She believes that this comparative grievance was a kind of punishment, as it happened one night after she had a disagreement with a driver with whom she was working and who opened a incidence. His relationship with ICS began to get even worse from there. He became infected with covid-19, developed persistent covid… The last contract Maigualida was offered was last June, for three months, ie, Worse even than the ones he had already been offered. She turned it down and, as of the 30th of last month, no longer has a link with the ICS.

She now works for some hospital doing on call (“whatever comes out,” he says) and in the Sistema d’Emergències Mèdiques (SEM). Even so, his income has decreased a lot and he assures that he does not know in what conditions he will live, as he sometimes He has to send money to his brothers and father in Venezuela. And what is Maigualida’s next step? “To leave here, not Catalonia, but Spain. You don’t feel like staying. You come, you make an effort, you risk your health and there’s no way they treat you with respect,” he concludes.

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