Access to specialties in Mexico is limited since out of every 10 doctors who try to specialize in the public health system, only four are accepted, according to data from the federal Ministry of Health (SSA).
According to historical data from the SSA, in 2001, 8,645 doctors applied for the specialty exam, of which only 1,996 were selected, the equivalent of 23 percent.
By 2008, seven years later, the number of doctors who took the exam to specialize grew to 21,386 (147%), that is, 12,741 more doctors than in 2001; however, the number of people who passed the exam was 6,242 (29%).
Seven years later, by 2015, the number of doctors seeking to specialize in one of the more than 50 areas ranging from oncology to plastic surgery had grown to 33,697, equivalent to 57.5% more than in 2008.
Of the more than 33,000 doctors who sought to specialize, only 22.4% (7,564) were selected to continue their training.
While for 2020, the last year with SSA data on the matter, a total of 44,333 doctors were registered to take the exam that would allow them to specialize, of which only 17,576 (39.6%) were accepted.
If the figures for 2001 are compared with 2020, the number of doctors who sought to specialize increased by 412 percent.
Selection process
Once a doctor completes the medical degree process in any country, he or she can opt for a specialization as part of continuing his or her training.
To do this, in Mexico it is necessary to present a National Examination for Applicants to Medical Residencies (ENARM) whose objective is to select the general practitioners who have the best performance in the exam so that they can study a specialty.
The exam, which costs 3,000 pesos, “explores contextualized cognitive skills in clinical cases focused on Public Health, Emergencies and Family Medicine and the 4 core specialties: Internal Medicine, Pediatrics, Gynecology-Obstetrics and General Surgery.
The exam, indicated in the 2021 call, “includes questions structured in reagents with clinical case format, containing one to three questions for each clinical case; a single correct answer option in the best answer modality and three distractors”.
The ENARM was established in Mexico in 1977 after an agreement reached between the federal Ministry of Health, the IMSS, the Institute of Security and Social Services for State Workers and the Faculty of Medicine of the National Autonomous University of Mexico.
A few years later, in 1983, the Interinstitutional Commission for the Training of Human Resources for Health was created, which is currently in charge of organizing the examination of specializations in Mexico.
The number of medical specialists in Social Security decreases by 22%
The number of medical specialists hired at the Mexican Social Security Institute (IMSS) has been on the decline between 2016 and this 2022, according to data from the same institution.
According to the response to a request for information, with folio 0064100799216, given by Social Security to an individual, until April 2016, the Institute had 53,805 medical specialists on its payroll who provided care to beneficiaries in the country.
While for February of this 2022, as indicated by Social Security in response to the request for information with folio 330018022004661, the number of medical specialists attached to the institution was 41,813.
In other words, between 2016 and 2022, the IMSS decreased the number of medical specialists by 11,992 places, which is equivalent to a drop of 22.2 percent.
However, where the IMSS workforce has been expanded is in the number of general practitioners since, for 2016, there were records of 2,934 as recorded in the information request 0064103131516, while last February there were 8,962 physicians. generals.
The foregoing is equivalent to a 205% increase in the number of jobs in said range, according to Social Security data.
Covid emergency
Derived from the emergency caused by the Covid-19 pandemic in the country, the IMSS made contracts between 2020 and 2021, as reported in the response to the request for information with termination 04661.
As detailed by Social Security, in 2020 it hired 6,841 doctors, of which most were general doctors (4,574).
While for 2021, the IMSS added 5,227 doctors to its ranks, including non-family (1,876), family (689) and general (2,662).
In total, between both years, 12,068 doctors were hired by the IMSS to reinforce care for Covid-19.
However, the same Institute refers in the same request that it is not possible to determine that all those hired by the emergency kept a place in the institute.
“It is not possible to determine that all the personnel continue to be active, since the dynamics for the coverage of places for Covid care, as well as the operation of the rest of the services in other Medical Units, is carried out in accordance with the needs of the Mexican Institute. of Social Security and the increase in infections of the entitled population, the latter, has not been the same since the pandemic began in 2020, it is important to remember that the health emergency remains in force.