Two out of every three doctors who decided not to enter specialized training in 2025 did so because they were unable to enter the specialty they wanted, according to research released today by the Central Administration of the Unified Health System (ACSS).
The data from this survey, aimed at doctors who completed general medical internship training and chose not to enter specialized training last year, also indicate that the fact of not being able to stay in the desired health unit is another of the factors that weighs most in the decision.
On the other hand, economic factors, such as remuneration or costs associated with commuting, assume less relative importance.
Applied to 507 doctors, the survey was answered by half (254). Of these, more than 80% expressed their intention to repeat the National Access Test to improve their classification and try to obtain placement in the desired specialty, thus postponing the start of specialized training.
The distribution of desired specialties indicates greater attractiveness for hospital areas, particularly surgery, to the detriment of General and Family Medicine and Public Health.
In the study, the ACSS admits that, in the medium term, this lower attractiveness for General and Family Medicine and Public Health “could worsen difficulties already recognized in the recruitment and retention of professionals in these strategic areas for the functioning of the National Health Service”.
Among the specialties most cited by the young doctors who responded were Pediatrics, Orthopedics, General Surgery, Anesthesiology and Gynecology/Obstetrics.
The data show a significant proportion of non-response (20.8%) and indecision (6.4%) regarding the chosen specialty, suggesting that a relevant proportion of respondents keep the future path under reassessment.
The decision not to enter specialist training does not seem to result from a devaluation of specialization as a training stage, since almost all participants recognized the importance of acquiring technical-scientific skills within the scope of specialized training.
In a statement, the ACSS refers to the meeting it had with the Order of Doctors last February to create synergies for a more in-depth study of the topic, resulting in the commitment to set up a joint working group to identify possible structural constraints in the model of access to specialized training and propose measures that reinforce the predictability and efficiency of the training system.
This group must also include members of the National Medical Internship Council.
In the study, the ACSS highlights that discontinuities in access to specialization compromise the predictability of the training process, delay generational replacement and can worsen inequalities in the distribution of specialists, with a direct impact on the assistance response capacity of public systems.
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