«They left me alone in an ambulance during an interhospital transfer. “I had anxiety thinking about what would happen if something happened to the patient and there was no assistant I could ask what to do.” It is the story of Andrés (fictitious name, because he does not want to expose himself publicly because when he tried to report the situation at the hospital where he worked he already received threats), a Family and Community Medicine resident who criticizes the poor supervision that doctors in training receive many times. times in health centers during shifts. This situation had been a recurrent comment among the MIR for a long time, but now, for the first time, a report puts figures. It was the MIR Spain Association (AME) that, through 5,268 surveys carried out with internal doctors residing in 207 hospitals throughout Spain, has confirmed that 71.4% of MIRs believe that they are not well supervised in their emergency wards. According to the responses included in the document, the perception of the majority of doctors in training is that their presence in the guards responds more to making up for the lack of human resources in healthcare than to training them. Due to this fact, Andrés came to change centers. «At my previous hospital, they were more interested in using cheap labor than in my training. They didn’t give us practical workshops or any kind, I did techniques without any supervision… I have found situations in which I arrived and the assistants went to have coffee and I was left alone diagnosing and treating the patients, but no one told me. guardianship,” he explains. It is normal, acknowledges Alejandra García López, president of the MIR Spain Association, that as the resident progresses in their training they have more and more skills and autonomy, but not that from the first moment they must only face situations in which the health of the resident patient depends solely on your judgment and decisions. «We are not saying that there should not be rest time on duty, we understand that we are acquiring skills and that the work can be distributed, but it is important to have the deputy available to be able to ask, that he is not missing, because these situations leave us in a situation of lack of protection,” he denounces. Related News standard Yes The vacancies and resignations of the MIR leave 400 places vacant in Familia Elena CalvoCeuta and Melilla top the list of regions with less supervision, as the residents of the autonomous cities that have responded to the survey assure this. Cantabria and Extremadura also stand out on the decline. On the opposite side, La Rioja, Galicia or the Valencian Community. There are many cases, says the president of AME, in which this situation negatively affects the mental health of young doctors. «The insecurity you feel is very great and on a psychological level it affects anxiety before the shift or not being able to sleep the night before because you do not feel capable of facing everything that may come. There are cases of even not being able to get out of the car at the hospital door thinking about what could happen,” he says. García López insists that this concern that residents have is especially due to a patient arriving with a health problem and not having the capacity to react. «A person’s life is in your hands. We are not saying that we do not have to have autonomy, but we all have a learning curve and someone who is starting out cannot be left alone. “If a lady arrives who has fallen and it turns out that she has a hemorrhage and since you are alone you don’t see her and you send her home and she dies, that’s what you live with,” he says. “Verbal abuse” The report also includes other situations that residents say they experience in the centers where they work. The first are the so-called “black lists” or “situation lists” by which the MIR are forced to cover last-minute casualties even if they are not on duty, which makes them contactable at all times. But he also speaks of “verbal abuse” towards the MIRs by their superiors. «In practically all cases, residents are afraid to report retaliation, but these are situations that should not be tolerated and that should be pursued by the teaching units. Situations that occur especially in surgical specialties and that are camouflaged by threats or punishments of not going to the operating room,” the text continues. Through the “black lists” the MIR are forced to cover last-minute casualties even if they are not on duty, which makes them contactable at all times. The document also denounces that on many occasions those who supervise the MIR are doctors without a specialty, which which negatively affects both the quality of care and the training of the resident. This is the case of María del Mar, also a resident of Family and Community Medicine. “The emergency service, both primary and hospital care, is made up practically entirely of doctors without MIR,” he criticizes. He explains that in recent years, in his health area (which he does not reveal) this fact has caused several serious cases of negligence. There is even talk of some deaths due to late diagnoses or diagnoses made by doctors without adequate training. This young woman claims that she has found herself several times in the situation of being alone caring for a patient and not having anyone to turn to to ask her questions. «In the end, since you have no other choice, you overcome it and adopt the role of leader, which would not correspond to us, but we do it. And we rely a lot on the nursing team who always help when we are left alone,” he says.
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