Buscar en
Radiología (English Edition)
Toda la web
Inicio Radiología (English Edition) Choice of the specialty of diagnostic radiology by results of the competitive ex...
Journal Information
Vol. 59. Issue 3.
Pages 232-246 (May - June 2017)
Visits
66
Vol. 59. Issue 3.
Pages 232-246 (May - June 2017)
Original Report
Full text access
Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015
Análisis de la elección de la especialidad de radiodiagnóstico en el examen MIR desde el año 2006 hasta 2015
Visits
...
E. Murias Quintanaa,
Corresponding author
emuriass@hotmail.com

Corresponding author.
, F. Sánchez Lasherasb, A. Fernández-Somoanoc, J.M. Romeo Ladrerod, S.M. Costilla Garcíaa, M. Cadenas Rodrígueze, J.B. Baladrón Romerof
a Servicio de Radiología, Hospital Universitario Central de Asturias, Facultad de Medicina, Departamento de Medicina, Universidad de Oviedo, Asturias, Spain
b Departamento de Construcción e Ingeniería de Fabricación, Universidad de Oviedo, Asturias, Spain
c IUOPA-Área de Medicina Preventiva y Salud Pública, Departamento de Medicina, Universidad de Oviedo, Asturias, Spain
d Editor del blog, MIRentrelazados, Zaragoza, Spain
e Servicio de Radiología, Hospital Universitario Central de Asturias, Asturias, Spain
f Director del Curso Intensivo MIR Asturias, Oviedo, Asturias, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (9)
Table 1. General data for the specialty of diagnostic radiology when choosing specialty from 2006 through 2015.
Table 2. Comparison among different specialties from 2006 through 2015.
Table 3. Analysis of numbers of order needed to be able to choose the specialty of diagnostic radiology from 2006 through 2015.
Table 4. Analysis of the amount of net questions, and correct questions minus one third of the amount of questions failed with which the specialty of diagnostic radiology was chosen from 2006 through 2015.
Table 5. Analysis of candidates who chose the specialty of diagnostic radiology based on sex and nationality (Spanish or foreign physicians).
Table 6. Classification of medical specialties arranged according the percentage of candidates who chose them in the 10 years of study. Diagnostic radiology ranks #33 with an average 58.26 per cent of women among the candidates.
Table 7. Absolute and relative values of the positions adjudicated to the different medical specialties on grouds of public demand arranged from the lowest to the highest percentage of foreign physicians among the candidates (from the public announcement made in 2006 until the public announcement made in 2015).
Table 8. Data based on the choosing process and arranged by autonomous community and hospital in the present study.
Table 9. Hospitals with an position pick mean <2500 regardless of the amount of positions offered.
Show moreShow less
Abstract
Objective

To analyze the profile of residency candidates choosing the specialty of diagnostic radiology in function of variables related to the positions available in different years.

Materials and methods

We compiled the data published on the Spanish Ministry of Health's website during the acts celebrated to allow residency candidates to choose positions based on the results of the competitive examinations held from 2006 to 2015, comparing the specialty of diagnostic radiology with the other specialties available in terms of positions available, net questions, sex, nationality, and order of choice of the position.

Results

The specialty of diagnostic radiology occupied the 16th position in the ranking of specialties according to the median number of order in the choice for each of the positions offered in the years studied. The first diagnostic radiology residency position was usually assigned after 75 candidates had chosen other specialties, and the last position was usually assigned after 3700–4100 candidates had chosen their positions. During the period studied, of those who chose diagnostic radiology 58% were women and 76% were Spanish nationality. Candidates preferred hospitals in the Autonomous Community of Madrid, and the hospital chosen with the lowest median position (highest score on the competitive examination) was the Hospital Clínic de Barcelona.

Conclusions

Diagnostic radiology is chosen by candidates with good positioning in the ranking according to official examination results, is less likely than other specialties to be chosen by women, and is chosen mostly by Spanish physicians. Candidates prefer large hospitals in provincial capitals.

Keywords:
Medical training
Residents
Medical specialties
Diagnostic radiology
Resumen
Objetivo

Analizar el perfil del opositor que ha escogido la especialidad de radiodiagnóstico, analizando variables relacionadas con las plazas convocadas a lo largo de la historia.

Material y métodos

Se recogen los datos publicados por el Ministerio de Sanidad español en su página web durante los actos de elección de plaza en el examen MIR desde el año 2006 hasta 2015, comparando la especialidad de radiodiagnóstico con el resto de las ofertadas en términos de plaza, preguntas netas, sexo, nacionalidad y lugar de elección de la plaza.

Resultados

La especialidad de radiodiagnóstico ocupa la posición número 16 en el ranking de especialidades ordenadas según la mediana de número de orden con la que se escogió cada una de sus plazas desde el año 2006 hasta 2015. La primera plaza se suele escoger por debajo del número de orden 75 y la elección de la especialidad se suele terminar entre los números de orden 3.700 y 4.100. Durante el periodo estudiado, un 58% de los electores de radiodiagnóstico fueron mujeres y un 76%, españoles. Los opositores prefieren los hospitales de la comunidad de Madrid, y el hospital elegido con la mediana más baja (mejor número de orden) es el Hospital Clínic de Barcelona.

Conclusiones

Radiodiagnóstico se escoge en el MIR con buenos números de orden, con menor tendencia a ser elegida por mujeres que otras especialidades y escogida en su mayoría por médicos españoles. Se prefieren hospitales grandes en capitales de provincia.

Palabras clave:
Formación médica
Médico interno residente
Especialidades médicas
Radiodiagnóstico
Full Text
Introduction

In Spain, in order to be able to practice medicine, the college degree of Bachelor in Medicine and Surgery, Bachelor in Medical Science or degree in Medicine is needed. Since 1984 and as the only available way to be able to have access to specialized medical training it is mandatory to pass a nationwide access exam that the Ministry of Health, Social Services, and Equality announces every year. This exam is known as the MIR (Medical Residency Exam).1

Since 2009, the exam consists of 225 multiple choice test-like questions together with 10 reserve questions. Theoretically, the maximum number of net questions one candidate can take is 225, yet noone has ever been able to take more than 200 net questions. Net questions are those questions answered correctly in the exam minus one third of the amount of questions failed.1–3 The grade obtained in the exam (90 per cent of the final grade), added to the assessment of the scale or academic record (10 per cent of the final grade) is used to classify all candidates from first to last based on their respective scores. A higher total score equals a lower position in the classification, so candidate #1 will be the candidate with the highest final grade of all who will have earned the right to be the first one to choose his/her medical specialty among the different medical specialties available in the existing accredited academic institutions across the country.

Diagnostic radiology is one of these medical specialties since the MIR exam became a reality for choosing medical specialties back in the 1980s. The official denomination of this specialty – diagnostic radiology dates back to 1984 and is defined as that medical specialty based on imaging diagnoses aimed at achieving diagnostic impressions from macroscopic images of the inside of the body obtained using minimally or absolutely non invasive procedures that may include the use of different kinds of ionizing radiations and other types of power sources. Also, radiologists are responsible for what is known as the “method as the basis for the technique”’ that includes two different moments: choosing the most appropriate procedure (radiological technique) and acknowledging, analysing and interpreting the radiological signs.1,2

The main goal of this paper is to study what the profile of these candidates who choose the specialty of diagnostic radiology is by analysing the variables associated with the positions made available by the government from the very beginning, and the variables associated with the position within the MIR classification list that, in general, allowed the candidates to choose this specialty, based on sex, origin, hospital, and geographical region. The secondary goal of this paper is to compare the tendencies in the candidates’ profile with other published papers in other settings of similar profile,4–13 and make a correlation between them and surveys from the Spanish Ministry on specialists in medical training.14,15

Materials and methods

One retrospective descriptive analysis was designed of the numbers of order, exam grade, age, sex, nationality of the candidaes and destination hospitals with the specialty of diagnostic radiology in the access test to the MIR medical residency exam announced publicly every year by the Spanish Ministries of Health and Education, from 2006 until present.

The denomination of the exam follows the nomenclature by the Spanish Ministry of Health including the year the exam was publicly announced - usually one year before taking the exam (the MIR medical residency exam 2015 took place in January, 2016). Data have been collected from the specialty choosing events published by the Ministry of Health in its official website after every annual public announcement.1 The “quota for foreign physicians” is the amount of total positions that can be assigned to non-EU physicians who are not sons or spouses of EU citizens, or who do not have a permit license, or are not EU residents.

Since some of the institutions that used to offer this specialty have changed along the study period–the names with which they appear within the specialty choosing lists published by the ministry, there have been times that certain institutions that were offered with a different denomination have been grouped under one single name, and this is the way they are shown both in the tables and the document herein.

The value of net questions needed to be able to choose diagnostic radiology, the average, maximum and minimum values, mean value, and percentiles 25 and 75 of the candidates’ order of choosing have been assessed by comparing the specialty of diagnostic radiology with the remaining specialties. This is an analysis of all positions segemented by institution and autonomous community. Both the demographical data and origin of the candidates have been collected too. The estimation of percentiles has been graded by weighted percentages and influenced by data distribution.

Results

The average of positions offered from 2006 though 2015, both inclusive, was 217.1; the year with the largest public offer was 2009 with 229 positions and the year with the smallest public offer was 2014 with 207 positions. The percentage of positions with respect to the total was 3.36 per cent and ranged between 3.25 per cent and 3.46 per cent depending on the year (Table 1, Fig. 1). In Spain, the specialty of diagnostic radiology ranks #8 in the list of medical specialities with the largest number of positions offered, with a total of 2171 in the 10 years studied (Table 2). The specialties that have ran out of positions during the specialty choosing events during the last 10 years have been plastic surgery, that was chosen with the lowest average number of order for choosing, 332, followed by dermatology, cardiology, and neurosurgery. Diagnostic radiology ranks #16 (of a total of 47 specialties, including the specialties offered by professional schools) with an average number of order for choosing of 1.965. This standing is maintained when the specialties are arranged according to percentiles 25, 50, or 75 of the numbers of order necessary to choose them (Table 2), or when the analysis is conducted only with the last MIR exam from 2015.

Table 1.

General data for the specialty of diagnostic radiology when choosing specialty from 2006 through 2015.

Public announcement  Number of students who took the MIR exam  Obtained number of order  Total positions offered  Positions for diagnostic radiology  Positions percentage for diagnostic radiology 
MIR 2006  8.148  8.148  6.048  209  3.46 
MIR 2007  8.897  8.898  6.517  217  3.33 
MIR 2008  9.471  9.428  6.797  221  3.25 
MIR 2009  11.438  11.407  6.944  229  3.30 
MIR 2010  11.623  11.554  6.874  228  3.32 
MIR 2011  11.906  11.868  6.704  225  3.36 
MIR 2012  11.771  9.182  6.388  218  3.41 
MIR 2013  10.241  7.360  6.145  208  3.38 
MIR 2014  10.801  8.554  6.079  207  3.41 
MIR 2015  11.227  9.288  6.097  209  3.43 
Total  105.523  95.687  64.593  2.171  3.36 
Figure 1.

Total of positions offered: progression of the public offer of diagnostic radiology positions in the MIR exam with respect to the total of positions offered. Notice data truncation in the axis of ordinates between 195 and 235 in diagnostic radiology positions (left) and between 5600 and 7200 in the total of positions offered (right) in order to see the correlation between the variation of all the positions offered and the total of positions offered in diagnostic radiology only.

(0.09MB).
Table 2.

Comparison among different specialties from 2006 through 2015.

Especialidad  Min.  p25  Average  p75  Max.  Median  Number of positions 
Plastic and reconstructive surgery  114  255  499  1174  332  330 
Dermatology  176  348  562  1596  401  740 
Cardiology  210  484  951  2638  636  1488 
Neurosurgery  468  1095  1815  3283  1174  389 
Neurology  517  1138  2041  4120  1331  1168 
Pediatric surgery  29  504  1143  1882  3076  1247  204 
Cardiovascular surgery  690  1325  2120  3727  1424  240 
Oral and maxillofacial surgery  815  1370  2062  3296  1463  292 
Endocrinology and nutrition  683  1390  2166  3923  1499  694 
Pediatrics  10  770  1398  2114  3818  1468  3941 
Ophthalmology  11  855  1447  2123  3601  1517  1598 
Digestive system  12  851  1573  2288  3920  1603  1360 
Obstetrics and gynecology  13  1027  1748  2602  3797  1800  2496 
Orthopedic and trauma surgery  14  1078  1888  2661  3825  1871  2140 
Urology  15  1040  1912  2693  3823  1866  898 
Diagnostic radiology  16  6  1164  1965  2781  4227  1975  2171 
General/Digestive system surgery  17  1252  2053  2831  3823  2013  1805 
Angiology and vascular surgery  18  42  1235  2089  2914  3879  2036  351 
Otorhinolaryngology  19  27  1339  2150  2872  3901  2099  775 
Medical oncology  20  1208  2236  3347  5006  2270  1012 
Anesthesiology  21  1505  2375  3071  4226  2260  3185 
Thoracic surgery  22  32  2329  2796  3171  3837  2602  180 
Rheumatology  23  12  2025  2949  3662  4913  2771  490 
Internal Medicine  24  1632  3106  4124  5903  2870  3088 
Psychiatry  25  2110  3292  4184  9035  3091  2296 
Hematology and hemotherapy  26  2260  3432  4101  5822  3106  1149 
Pneumology  27  58  2894  3586  4017  8149  3379  1046 
Nephrology  28  16  2747  3639  4170  5330  3360  895 
Intensive Medicine  29  2756  3677  4104  5441  3317  1535 
Radiation oncology  30  308  3660  4152  4607  5826  4059  494 
Physical medicine and rehabilitation  31  53  3767  4420  4967  7161  4292  917 
Allergology  32  1102  4043  4680  5196  7217  4593  505 
Pathological anatomy  33  18  3741  4798  5664  8357  4543  864 
Nuclear medicine  34  1676  4370  5100  5541  7097  4953  378 
Geriatrics  35  117  4453  5241  5724  8111  5038  567 
Immunology  36  1335  4418  5281  6096  8962  5238  108 
Neurophysiology  37  39  4369  5319  5963  7754  5045  398 
Microbiology and parasitology  38  50  5225  6041  6740  10343  5882  337 
Preventive medicine and public health  39  30  4658  6089  7177  11315  5761  729 
Clinical pharmacology  40  727  5266  6155  6915  9114  6041  186 
Clinical laboratory  41  24  5091  6190  7116  10457  6067  242 
Family and community medicine  42  40  5030  6196  7451  11604  6286  17342 
Legal and forensic medicine  43  25  5242  6277  7379  9612  6216  206 
Biochemistry  44  1139  5798  6720  7701  11533  6802  117 
Labor medicine  45  1149  5886  6845  7789  11472  6875  880 
Medical hydrology  46  3482  6570  7522  8337  10972  7543  76 
Physical education and sports medicine  47  582  6724  7865  9242  11862  7985  683 

The number of positions, the minimum and maximum numbers of positions, percentiles 25, 50, and 75, and average numbers are shown in this table. Specialties have been arranged based on the orden number average required to choose among such specialties from 2006 through 2015.

Between the years 2006 and 2015, the lowest number of order with which the specialty of diagnostic radiology was chosen was 6 in the year 2010, and the highest number of order was 4227 in the year 2012. The year with the lowest average number of order (1772) for choosing the specialty of diagnostic radiology was 2006, and the year with the highest average number of order (2130) was 2012. (Table 3).

Table 3.

Analysis of numbers of order needed to be able to choose the specialty of diagnostic radiology from 2006 through 2015.

  First  p75  p50  p25  Last  Average  SD  Range 
MIR 2006  21  1106  1799  2405  3447  1772  871  3426 
MIR 2007  73  1016  1781  2456  3851  1794  942  3778 
MIR 2008  52  1261  1936  2712  4018  1998  988  3966 
MIR 2009  164  1066  2131  2949  3964  2036  1039  3800 
MIR 2010  1262  1963  2892  3715  2002  981  3709 
MIR 2011  73  1114  1949  2760  3970  1954  1010  3897 
MIR 2012  42  1280  2162  2994  4227  2130  1037  4185 
MIR 2013  1058  1925  2742  4066  1943  1033  4058 
MIR 2014  28  1296  2048  2950  3802  2088  1012  3774 
MIR 2015  25  1234  1988  2831  3943  2036  1044  3918 
Total  492  11693  19682  27691  39003  19753  9957  38511 

SD: standard deviation.

With respect to net questions, right questions answered minus one third of the questions failed, and using as a reference a 10 year statistics average, the specialty of diagnostic radiology may be chosen starting at 179.3 nets questions all the way through 105.7 net questions. The year 2014 was the year when this specialty was chosen with the highest score of net questions, 187.67 and the year 2008 when the last position in this specialty was chosen with the lowest score of net questions, 85.67 (Table 4).

Table 4.

Analysis of the amount of net questions, and correct questions minus one third of the amount of questions failed with which the specialty of diagnostic radiology was chosen from 2006 through 2015.

  First  p75  p50  p25  Last  Average  SD  Range 
MIR 2006  18000  14200  13000  12133  9233  13205  1568  8767 
MIR 2007  17533  14233  13267  12133  9233  13278  1545  8300 
MIR 2008  17467  14467  13133  12267  8567  13266  1625  8900 
MIR 2009  16933  14000  12567  11533  8967  12708  1609  7966 
MIR 2010  18133  13517  12567  11692  10400  12743  1393  7733 
MIR 2011  17567  15067  13933  13000  11467  14090  1324  6100 
MIR 2012  18167  15167  14184  13333  11700  14305  1274  6467 
MIR 2013  18667  14867  13750  12700  10867  13875  1456  7800 
MIR 2014  18767  15150  14400  13617  12600  14469  1150  6167 
MIR 2015  18100  15333  14667  13867  12700  14685  1093  5400 
Total  179334  146001  135468  126275  105734  136624  14037  736 

When it comes to analysing the positions chosen in diagnostic radiology according to sex and origin of the candidates, during the last ten (10) years, 58.22 per cent of the candidates have been women and 76.42 per cent of the candidates have been Spanish physicians. The year with the largest amount of women was 2012 with 65 per cent, and the year with the largest amount of Spanish physicians was 2006 with 92 per cent. The year 2009 was the year with the lowest percentage of women (52 per cent) and 2011 was the year with the lowest amount of Spanish physicians (65 per cent) (Table 5). The specialty of diagnostic radiology ranks #33 in the ranking of specialties arranged by highest percentage of women, and ranks #21 in the ranking of specialties arranged by highest percentage of foreign physicians (Tables 6 and 7).

Table 5.

Analysis of candidates who chose the specialty of diagnostic radiology based on sex and nationality (Spanish or foreign physicians).

  Women  Men  Spaniards  Foreigners  Total 
MIR 2006  121 (58 per cent)  88  193 (92 per cent)  16  209 
MIR 2007  134 (62 per cent)  83  180 (83 per cent)  37  217 
MIR 2008  131 (59 per cent)  90  175 (79 per cent)  46  221 
MIR 2009  118 (52 per cent)  111  161 (70 per cent)  68  229 
MIR 2010  136 (60 per cent)  92  162 (71 per cent)  66  228 
MIR 2011  139 (62 per cent)  86  147 (65 per cent)  78  225 
MIR 2012  142 (65 per cent)  76  151 (69 per cent)  67  218 
MIR 2013  113 (54 per cent)  95  161 (77 per cent)  47  208 
MIR 2014  111 (54 per cent)  96  154 (74 per cent)  53  207 
MIR 2015  119 (57 per cent)  90  175 (84 per cent)  34  209 
Total  1264 (58 per cent)  907  1659 (76 per cent)  512  2171 
Table 6.

Classification of medical specialties arranged according the percentage of candidates who chose them in the 10 years of study. Diagnostic radiology ranks #33 with an average 58.26 per cent of women among the candidates.

  Specialties  Years of training  Women  Women/total percentage  Men  Men/total percentage  Total 
Obstetrics and gynecology  2174  85.62 per cent  365  14.38 per cent  2539 
Pediatrics and specific areas  3387  85.42 per cent  578  14.58 per cent  3965 
Allergology  397  77.09 per cent  118  22.91 per cent  515 
Endocrinology and nutrition  536  76.14 per cent  168  23.86 per cent  704 
Hematology and hemotherapy  850  73.21 per cent  311  26.79 per cent  1161 
Rheumatology  356  72.36 per cent  136  27.64 per cent  492 
Pediatric surgery  147  71.71 per cent  58  28.29 per cent  205 
Family and community medicine  12033  69.14 per cent  5372  30.86 per cent  17405 
Psychiatry  1595  68.96 per cent  718  31.04 per cent  2313 
10  Physical medicine and rehabilitation  630  68.40 per cent  291  31.60 per cent  921 
11  Pneumology  711  67.33 per cent  345  32.67 per cent  1056 
12  Medical-surgical dermatology and venereology  507  66.89 per cent  251  33.11 per cent  758 
13  Medical oncology  697  66.70 per cent  348  33.30 per cent  1045 
14  Radiation oncology  336  65.88 per cent  174  34.12 per cent  510 
15  Digestive system  904  65.70 per cent  472  34.30 per cent  1376 
16  Microbiology and parasitology  224  65.31 per cent  119  34.69 per cent  343 
17  Clinical neurophysiology  265  65.27 per cent  141  34.73 per cent  406 
18  Internal Medicine  2024  65.00 per cent  1090  35.00 per cent  3114 
19  Nephrology  585  64.71 per cent  319  35.29 per cent  904 
20  Geriatrics  368  64.67 per cent  201  35.33 per cent  569 
21  Clinical laboratory  164  64.31 per cent  91  35.69 per cent  255 
22  Pathologica anatomy  554  63.31 per cent  321  36.69 per cent  875 
23  Preventive medicine and public health  465  63.18 per cent  271  36.82 per cent  736 
24  Intensive Medicine  972  62.95 per cent  572  37.05 per cent  1544 
25  Neurology  745  62.82 per cent  441  37.18 per cent  1186 
26  Labor medicine  555  62.78 per cent  329  37.22 per cent  884 
27  Anesthesiology and resuscitation  1997  61.81 per cent  1234  38.19 per cent  3231 
28  Ophthalmology  1002  60.54 per cent  653  39.46 per cent  1655 
29  General/Digestive system surgery  1094  60.11 per cent  726  39.89 per cent  1820 
30  Immunology  65  59.63 per cent  44  40.37 per cent  109 
31  Otorhinolaryngology  467  59.26 per cent  321  40.74 per cent  788 
32  Clinical pharmacology  111  58.42 per cent  79  41.58 per cent  190 
33  Diagnostic radiology  4  1264  58.22 per cent  907  41.78 per cent  2171 
34  Clinical biochemistry  67  57.26 per cent  50  42.74 per cent  117 
35  Nuclear Medicine  218  55.33 per cent  176  44.67 per cent  394 
36  Angiology and vascular surgery  191  54.26 per cent  161  45.74 per cent  352 
37  Cardiology  764  50.66 per cent  744  49.34 per cent  1508 
38  Thoracic surgery  89  49.44 per cent  91  50.56 per cent  180 
39  Oral and maxillofacial surgery  142  47.81 per cent  155  52.19 per cent  297 
40  Urology  427  46.77 per cent  486  53.23 per cent  913 
41  Cardiovascular surgery  100  41.67 per cent  140  58.33 per cent  240 
42  Orthopedic and trauma surgery  874  40.20 per cent  1300  59.80 per cent  2174 
43  Neurosurgery  159  40.15 per cent  237  59.85 per cent  396 
44  Plastic and reconstructive surgery  127  37.24 per cent  214  62.76 per cent  341 
  Total    41339  65.98 per cent  21318  34.02 per cent  62657 
Table 7.

Absolute and relative values of the positions adjudicated to the different medical specialties on grouds of public demand arranged from the lowest to the highest percentage of foreign physicians among the candidates (from the public announcement made in 2006 until the public announcement made in 2015).

  Specialties  Years of training  Foreigners  Foreigners/total percentage  Spaniards  Spaniards/total percentage  Total 
Pediatrics and specific areas  218  5.50 per cent  3733  94.15 per cent  3965 
Obstetrics and gynecology  225  8.86 per cent  2298  90.51 per cent  2539 
Neurology  115  9.70 per cent  1061  89.46 per cent  1186 
Psychiatry  235  10.16 per cent  2065  89.28 per cent  2313 
Medical-surgical dermatology and venereology  88  11.61 per cent  668  88.13 per cent  758 
Oral and maxillofacial surgery  38  12.79 per cent  259  87.21 per cent  297 
Orthopedic and trauma surgery  274  12.60 per cent  1889  86.89 per cent  2174 
Internal Medicine  384  12.33 per cent  2698  86.64 per cent  3114 
Cardiology  202  13.40 per cent  1298  86.07 per cent  1508 
10  General/Digestive system surgery  282  15.49 per cent  1523  83.68 per cent  1820 
11  Medical oncology  175  16.75 per cent  865  82.78 per cent  1045 
12  Pediatrics surgery  33  16.10 per cent  169  82.44 per cent  205 
13  Anesthesiology and resuscitation  560  17.33 per cent  2648  81.96 per cent  3231 
14  Digestive system  247  17.95 per cent  1120  81.40 per cent  1376 
15  Plastic and reconstructive surgery  64  18.77 per cent  273  80.06 per cent  341 
16  Endocrinology and nutrition  139  19.74 per cent  562  79.83 per cent  704 
17  Intensive Medicine  299  19.37 per cent  1226  79.40 per cent  1544 
18  Urology  185  20.26 per cent  717  78.53 per cent  913 
19  Physical medicine and rehabilitation  196  21.28 per cent  714  77.52 per cent  921 
20  Angiology and vascular surgery  82  23.30 per cent  269  76.42 per cent  352 
21  Diagnostic radiology  496  22.85 per cent  1659  76.42 per cent  2171 
22  Hematology and hemotherapy  264  22.74 per cent  885  76.23 per cent  1161 
23  Neurosurgery  92  23.23 per cent  301  76.01 per cent  396 
24  Ophthalmology  380  22.96 per cent  1253  75.71 per cent  1655 
25  Preventive medicine and public health  164  22.28 per cent  555  75.41 per cent  736 
26  Rheumatology  132  26.83 per cent  354  71.95 per cent  492 
27  Family and community medicine  4574  26.28 per cent  12470  71.65 per cent  17405 
28  Clinical laboratory  64  25.10 per cent  180  70.59 per cent  255 
29  Pneumology  294  27.84 per cent  744  70.45 per cent  1056 
30  Radiation oncology  150  29.41 per cent  353  69.22 per cent  510 
31  Pathological anatomy  271  30.97 per cent  581  66.40 per cent  875 
32  Cardiovascular surgery  81  33.75 per cent  154  64.17 per cent  240 
33  Thoracic surgery  60  33.33 per cent  115  63.89 per cent  180 
34  Clinical neurophysiology  131  32.27 per cent  258  63.55 per cent  406 
35  Alergology  182  35.34 per cent  320  62.14 per cent  515 
36  Otorhinolaryngology  290  36.80 per cent  488  61.93 per cent  788 
37  Nuclear Medicine  149  37.82 per cent  236  59.90 per cent  394 
38  Nephrology  351  38.83 per cent  534  59.07 per cent  904 
39  Microbiology and parasitology  119  34.69 per cent  201  58.60 per cent  343 
40  Clinical biochemistry  42  35.90 per cent  66  56.41 per cent  117 
41  Labor Medicine  376  42.53 per cent  473  53.51 per cent  884 
42  Geriatrics  255  44.82 per cent  291  51.14 per cent  569 
43  Clinical pharmacology  88  46.32 per cent  89  46.84 per cent  190 
44  Immunology  55  50.46 per cent  45  41.28 per cent  109 
  Total  13101  20.91 per cent  48660  77.66 per cent  62657   

The autonomous community that has offered the largest amount of positions for the specialty of diagnostic radiology from 2006 through 2015 has been Madrid with 432 (20 per cent), followed by Andalucía with 330 (15 per cent), and Catalonia with 305 (14 per cent) (Table 8).

Table 8.

Data based on the choosing process and arranged by autonomous community and hospital in the present study.

Hospital  City  Minimum  p25  p50  p75  Maximum  Average  Positions 
Andalucía: 330 positions in 15 hospitals
H. Universitario Virgen del Rocío  Sevilla  42  709  992  1331  2234  999  38 
H. Universitario Virgen de la Victoria  Málaga  73  593  1081  1455  2543  1070  24 
H. Universitario Virgen de las Nieves  Granada  764  1095  1616  2487  1131  28 
H. Universitario Reina Sofía  Córdoba  1168  1752  2433  3387  1759  36 
Aragón: 69 positions in 3 hospitals
H. Universitario Miguel Servet  Zaragoza  174  1389  1805  2257  3226  1753  40 
H. Clínico Universitario Lozano Blesa  Zaragoza  1529  2009  2629  2857  3414  2510  20 
H. Obispo Polanco  Teruel  1610  3444  3811  3858  4123  3381 
Asturias: 62 positions in 2 hospitals
H. Universitario Central de Asturias  Oviedo  397  1471  1974  2562  3434  1965  42 
H. Universitario de Cabueñes  Gijón  944  2342  2816  3450  3896  2737  20 
Islas Baleares: 34 positions in 2 hospitals
H. Universitario Son Espases  Palma de Mallorca  280  1994  2654  2954  3704  2443  30 
H. Son Llàtzer  Palma de Mallorca  2844  2882  3117  3524  3734  3203 
Comunidad Valenciana: 218 positions in 10 hospitals
H. Universitari i Politècnic la Fe  Valencia  153  935  1315  1600  2264  1268  40 
H. Universitario Doctor Peset  Valencia  159  993  1484  1670  2748  1352  38 
H. General Universitario de Alicante  Alicante  139  1431  1977  2399  2920  1906  30 
H. de la Ribera  Alzira  357  1532  2131  2787  3262  2074  16 
Islas Canarias: 79 positions in 4 hospitals
H. Nuestra Señora de la Candelaria  Santa Cruz de Tenerife  488  617  996  2147  3465  1469  10 
H. Universitario de Canarias  La Laguna  570  1664  2589  3117  3509  2355  20 
C.H. Dr. Negrín  Las Palmas  732  2291  3066  3445  3861  2764  29 
H. Universitario Insular de Gran Canaria  Las Palmas  631  2450  3145  3285  3884  2757  20 
Cantabria: 30 positions in one hospital
H. Universitario Marqués de Valdecilla  Santander  73  812  1346  2413  2991  1485  30 
Castilla la Mancha: 69 positions in 5 hospitals
C.H. Universitario de Albacete  Albacete  634  1505  2430  2994  3726  2268  18 
C.H. de Toledo  Toledo  552  1843  2934  3175  3395  2575  23 
H. General Universitario de Guadalajara  Guadalajara  2725  2979  3090  3191  3326  3061  10 
H. General Universitario de Ciudad Real  Ciudad Real  851  2415  3115  3363  3406  2722  12 
Castilla y León: 135 positions in 8 hospitals
H. Universitario del Río Hortega  Valladolid  208  950  2096  3131  3618  2093  10 
H. Clínico Universitario de Valladolid  Valladolid  330  2183  2885  3186  3625  2600  20 
Complejo Asistencial de León  León  496  2391  2802  3364  3867  2674  20 
Complejo Asistencial Universitario de Salamanca  Salamanca  463  2323  3120  3462  3831  2830  40 
Cataluña: 305 positions in 16 hospitals
H. Clínic de Barcelona  Barcelona  28  166  330  622  1095  401  30 
H. Universitari Vall d’Hebron  Barcelona  334  870  1172  1413  2132  1165  49 
Corporació Sanitària Parc Taulí  Sabadell  340  673  1094  1666  2404  1220  31 
H. del Mar-Parc de Salut Mar  Barcelona  1202  1563  1708  1997  2668  1843  18 
Extremadura: 35 positions in 3 hospitals
C.H. Universitario de Badajoz  Badajoz  210  1104  1584  2936  3613  1885  19 
H. de Mérida  Mérida  1971  2005  3567  3783  3916  3090 
C.H. de Cáceres  Cáceres  825  2549  3744  3801  3966  3102 
Galicia: 144 positions in 13 hospitals
C.H. Universitario Coruña  La Coruña  252  779  952  1740  3071  1254  27 
C.H. Universitario de Santiago de Compostela  Santiago de Compostela  412  1409  2035  2471  3568  2028  26 
C.H. Universitario de Vigoa  Vigo  1821  2388  2640  3172  3750  2748  30 
H. Universitario Lucus Augustib  Lugo  2770  3026  3288  3732  3943  3346  10 
La Rioja: 10 positions in 2 hospitals
H. de San Pedroc  Logroño  1870  3404  3609  3690  3847  3338 
C.H. San Millánc  Logroño  2904  3232  3572  3757  3929  3494 
Madrid: 432 positions in 14 hospitals
H. General Universitario Gregorio Marañón  Madrid  21  241  462  664  972  457  40 
H. Universitario 12 de Octubre  Madrid  126  573  811  1010  1820  812  50 
H. Universitario la Paz  Madrid  253  648  922  1144  1740  913  40 
H. Universitario Clínico San Carlos  Madrid  98  768  1121  1354  1774  1053  50 
Murcia: 76 positions in 3 hospitals
H. Clínico Universitario Virgen de la Arrixaca  Murcia  416  1338  2094  2765  3239  2033  40 
H. General Universitario José M.ª Morales Meseguer  Murcia  1021  1840  2280  2677  3351  2265  27 
H. General Universitario Reina Sofía de Murciad  Murcia  2096  2614  2908  3154  3786  2878 
Navarra: 40 positions in 2 hospitals
Clínica Universidad de Navarra  Pamplona  52  506  2266  2610  3150  1694  20 
C.H. de Navarrae  Pamplona  200  979  2023  2775  3854  1894  20 
País Vasco: 96 positions in 6 hospitals
H. Universitario Cruces  Barakaldo  53  610  1091  1628  2293  1108  28 
H. Universitario Basurto  Bilbao  295  721  1093  1523  2227  1123  20 
H. Universitario Donostia  Donostia-San Sebastián  284  981  1871  2518  3367  1817  28 
H. de Galdakao  Galdakao  1277  1508  1943  2262  3599  2077  10 

Here follows data from a 10 year study of hospitals with the lowest mean of position choosing in every autonomous community with a maximum of 4 hospitals. C.H.U.: Complejo Hospitalario Universitario; H., hospital; #, total amount of positions offered in this period; p25, percentile 25; p75, percentile 75; the name of each training center as provided by the Ministry in its public offering with the following center group is the name that has been taken into consideration:

a

Vigo has experienced the merge of various hospitals with several changes in the denomination of public hospitals and the training offer for the candidates, so for better clarification purposes, the positions offer has beed divided based on whether such offer comes from the Hospital Policlínico de Vigo (POVISA) or the Complejo Hospitalario Universidad de Vigo – including the offer by the Xeral-Cíes and Meixoeiro hospitals.

b

In Lugo, the actual Hospital Universitario Lucus Augusti is referred to in the public announcements as C.H. Universitario Xeral–Calde de Lugo.

c

C.H. San Millán and H. de San Pedro should be considered as the same hospital due to name change; consequently the autonomous community of La Rioja has had one resident per year only.

d

The Hospital General de Murcia has changed its name into Hospital General Universitario Reina Sofía.

e

The actual Complejo Hospitalario de Navarra is the combination of two hospitals. On the one hand, Hospital de Navarra (Provincial) and on the other hand, Hospital Virgen del Camino.

The hospital chosen with the lowest number of order mean (best number) is Hospital Clínic de Barcelona, followed by three (3) hospitals from Madrid: Hospital Universitario Gregorio Marañón, Hospital Universitario 12 de Octubre, and Hospital Universitario La Paz (Table 9).

Table 9.

Hospitals with an position pick mean <2500 regardless of the amount of positions offered.

Number of order  Hospital ranking per p50 of number of order MIR 06–15  Autonomous community  City  Min.  p25  p50  p75  Max  Average  Positions 
H. Clínic de Barcelona  Cataluña  Barcelona  28  166  330  622  1095  401  30 
H. General Universitario Gregorio Marañón  Madrid  Madrid  21  241  462  664  972  457  40 
H. Universitario 12 de Octubre  Madrid  Madrid  126  573  811  1010  1820  812  50 
H. Universitario la Paz  Madrid  Madrid  253  648  922  1144  1740  913  40 
C.H. Universitario a Coruña  Galicia  La Coruña  252  779  952  1740  3071  1254  27 
H. Universitario Virgen del Rocío  Andalucía  Sevilla  42  709  992  1331  2234  999  38 
H. Nuestra señora de la Candelaria  Islas Canarias  Santa Cruz de Tenerife  488  617  996  2147  3465  1469  10 
H. Universitario Virgen de la Victoria  Andalucía  Málaga  73  593  1081  1455  2543  1070  24 
H. Universitario Cruces  País Vasco  Barakaldo  53  610  1091  1628  2293  1108  28 
10  H. Universitario Basurto  País Vasco  Bilbao  295  721  1093  1523  2227  1123  20 
11  Corporació Sanitària Parc Taulí  Cataluña  Sabadell  340  673  1094  1666  2404  1220  31 
12  H. Universitario Virgen de las Nieves  Andalucía  Granada  764  1095  1616  2487  1131  28 
13  H. Universitario Clínico San Carlos  Madrid  Madrid  98  768  1121  1354  1774  1053  50 
14  H. Universitario Vall d’Hebron  Cataluña  Barcelona  334  870  1172  1413  2132  1165  49 
15  H. Universitario Ramón y Cajal  Madrid  Madrid  343  827  1195  1610  2303  1239  40 
16  H. Universitari i Politècnic la Fe  Valencia  Valencia  153  935  1315  1600  2264  1268  40 
17  H. Universitario Marqués de Valdecilla  Cantabria  Santander  73  812  1346  2413  2991  1485  30 
18  H. Universitario Puerta de Hierro  Madrid  Madrid  185  706  1372  1651  2184  1218  30 
19  H. Universitario de la Princesa  Madrid  Madrid  464  1000  1475  1792  1937  1356  30 
20  Fundación Jiménez Díaz  Madrid  Madrid  532  722  1483  1839  2638  1412  20 
21  H. Universitario Doctor Peset  Valencia  Valencia  159  993  1484  1670  2748  1352  38 
22  C.H. Universitario de Badajoz  Extremadura  Badajoz  210  1104  1584  2936  3613  1885  19 
23  H. del Mar-Parc de Salut Mar  Cataluña  Barcelona  1202  1563  1708  1997  2668  1843  18 
24  H. Universitari de Bellvitge  Cataluña  Hospitalet de Llobregat  577  1057  1723  2164  2573  1594  36 
25  H. Universitari Germans Trias i Pujol  Cataluña  Badalona  683  1497  1751  2249  2744  1804  20 
26  H. Universitario Reina Sofía  Andalucía  Córdoba  1168  1752  2433  3387  1759  36 
27  H. Universitario Miguel Servet  Aragón  Zaragoza  174  1389  1805  2257  3226  1753  40 
28  H. de la Santa Creu i Sant Pau  Cataluña  Barcelona  123  1495  1846  2155  2601  1741  32 
29  H. Universitario Donostia  País Vasco  Donostia-San Sebastián  284  981  1871  2518  3367  1817  28 
30  H. de Galdakao  País Vasco  Galdakao  1277  1508  1943  2262  3599  2077  10 
31  H. Santiago Apóstol  País Vasco  Vitoria-Gasteiz  1966  1966  1966  1966  1966  1966 
32  H. Universitario Central de Asturias  Asturias  Oviedo  397  1471  1974  2562  3434  1965  42 
33  H. General Universitario de Alicante  Valencia  Alicante  139  1431  1977  2399  2920  1906  30 
34  H. Universitario de Getafe  Madrid  Getafe  852  1569  2016  2268  2766  1977  30 
35  C.H. de Navarra  Navarra  Pamplona  200  979  2023  2775  3854  1894  20 
36  C.H. Universitario de Santiago de Compostela  Galicia  Santiago de Compostela  412  1409  2035  2471  3568  2028  26 
37  H. Universitario Fundación Alcorcón  Madrid  Alcorcón  989  1808  2036  2298  2694  1993  20 
38  H. Regional Universitario de Málaga  Andalucía  Málaga  311  1534  2063  2640  3280  2028  44 
39  H. Clínico Universitario Virgen de la Arrixaca  Murcia  Murcia  416  1338  2094  2765  3239  2033  40 
40  H. Universitario del Río Hortega  Castilla León  Valladolid  208  950  2096  3131  3618  2093  10 
41  H. Universitario Araba  País Vasco  Vitoria-Gasteiz  1353  1699  2104  2887  3549  2252 
42  H. Universitario Ntra. Sra. de Valme  Andalucía  Sevilla  1114  1628  2111  2628  3046  2080  20 
43  H. de la Ribera  Valencia  Alzira  357  1532  2131  2787  3262  2074  16 
44  H. Clínico Universitario de Valencia  Valencia  Valencia  329  1771  2135  2493  2841  2065  28 
45  Clínica Universidad de Navarra  Navarra  Pamplona  52  506  2266  2610  3150  1694  20 
46  H. General Universitario José M.ª Morales Meseguer  Murcia  Murcia  1021  1840  2280  2677  3351  2265  27 
47  H. Universitario Virgen Macarena  Andalucía  Sevilla  1409  1808  2293  2562  3028  2254  30 
48  H. Universitario Puerta del Mar  Andalucía  Cádiz  780  1754  2299  2883  3228  2253  27 
49  H. General Universitario de Valencia  Valencia  Valencia  1852  2220  2374  2689  3203  2412  19 
50  H. Universitario Severo Ochoa  Madrid  Leganés  1914  2024  2375  2480  2828  2318  20 
51  H. Universitario San Cecilio  Andalucía  Granada  481  1828  2380  2776  3091  2195  20 
52  H. Universitari Sagrat Cor  Cataluña  Barcelona  1757  2019  2384  2666  2822  2355 
53  C.H. Universitario de Albacete  Castilla la Mancha  Albacete  634  1505  2430  2994  3726  2268  18 
54  H. Universitario de Fuenlabrada  Madrid  Fuenlabrada  2184  2386  2493  2687  3014  2540  17 
55  H. Costa del Sol  Andalucía  Málaga  1798  2092  2497  3005  3330  2539 

Here follows data from a 10 year study of hospitals with the lowest mean of position choosing in every autonomous community with a maximum of 4 hospitals. C.H.U., Complejo Hospitalario Universitario; H., hospital; #, total amount of positions offered in this period; p25, percentile 25; p75, percentile 75; the name of each training center as they appear in the public offer by the Ministry is the one that has been considered with the following center grouping:

a Vigo has experienced the merge of various hospitals with several changes in the denomination of public hospitals and the training offer for the candidates, so for better clarification purposes, the positions offer has beed divided based on whether such offer comes from the Hospital Policlínico de Vigo (POVISA) or the Complejo Hospitalario Universidad de Vigo - including the offer by the Xeral-Cíes and Meixoeiro hospitals.

b In Lugo, the actual Hospital Universitario Lucus Augusti is referred to in the public announcements as C.H. Universitario Xeral–Calde de Lugo.

c C.H. San Millán and H. de San Pedro should be considered as the same hospital due to name change; consequently the autonomous community of La Rioja has had one resident per year only.

d The Hospital General de Murcia has changed its name into Hospital General Universitario Reina Sofía.

e The actual Complejo Hospitalario de Navarra is the combination of two hospitals. On the one hand, Hospital de Navarra (provincial) and on the other hand, Hospital Virgen del Camino.

Discussion

The specialty of diagnostic radiology is one of the classic specialties that started offering traning positions for specialized physicians back in the 1980s. We have picked the last ten (10) years for our study for two reasons: because they are pretty homogeneous in the positions offer with respect to the total, and because there are no significant variations in its geographic distribution.

The amount of positions offered for all medical specialties varies on a yearly basis. For example, in the MIR exam 2015, 12,427 physicans were admitted to take the test for a total of 6097 positions and 11,227 physicians attended the exam. Out of all the physicians who attended the exam, 9288 obtained a number of order (potential candidates) in the lists of definitive results from the Ministry after the application of the cut-off mark (65.67 net questions), while 1939 physicians were disqualified because their score in the exam was not above the cut-off mark. In the MIR exam 2015, the last position of all the opernings offered was chosen with number of order 7759 (physicians unaffected by the ratio of foreign candidates), and with number of order 4547 (physicians affected by the ratio of foreign candidates). The ratio of foreign candidates ranges between 10 per cent in the year 2010, and 4 per cent from 2014 until present day.

The number of positions offered for diagnostic radiology ranges between 207 and 230, with a maximum amount of positions offered in the years 2008 and 2009 and then a drop until 207 in 2014. This oscillation in the number of positions for the specialty of diagnostic radiology is directly proportional to the total number of positions offered, because if we analyze the percentage of annual positions, the value is nearly stable at 3.36 per cent (Fig. 1). This stability is constant in most medical specialties, though there are cases like the specialty of clinical laboratory that offered some 35 positions in the year 2007 but that has been reduced to only 18 positions in 2015. Other medical specialties like digestive system, pneumology, and pediatrics have increase their percentage of annual positions; these variations occur based on estimation researches conducted by the Ministry on the need for specialists14–16.

In the classification of specialties arranged by number of order mean for all candidates, the specialty of diagnostic radiology ranks #16 among the 47 medical specialties offered, which is a stable position when all medical specialties are arranged by number of order mean of the candidates who chose them, or by percentiles 25, 50, or 75 for number of order.

The first candidate who is eligible to choose diagnostic radiology usually scores in over 170 net questions, except for the year 2009 when the maximum score dropped to 164 net questions; 25 per cent of all positions have already been covered by the time candidates score in 150 net questions, and the last position by the time they score in over 100 net questions. Comparing these data with the simulation for exams of 225 questions as shown in Fig. 2, we see that to be eligible for the very first position in diagnostic radiology, the candidates’ scores need to be among the top 75 exams, that 25 per cent of the positions have been covered by the time the numbers of order reach numbers 1016 and 1296 and that the last position is usually above the average and mean of candidates between the numbers of order 3715 and 4066. The surveys published by the Ministry confirm that 78 per cent of the candidates who choose diagnostic radiology say that such medical specialty was their very their first choice.14,15 Also these surveys confirm that diagnostic radiology is one of the most popular medical specialties, far from specialties such as family and community medicine, or internal medicine. The average age of the candidates is 28 years old–well above the average age of medical college graduates, suggestive that the average candidate is savvy on diagnostic radiology, that he or she has followed special training and that he/she has not finished such training until the completion of this specialty.14,15 As the surveys from the Ministry claim, the main issue here is trying to generalize these outcomes to the overall population of candidates, since only the candidates who answer these surveys are included.14

Figure 2.

Simultation of MIR exams as if they consisted of 225 questions (it only happens since 2009) and the cut-off mark was stable at 35 per cent. Compiled and edited from https://gangasmir.blogspot.com.es/. The MDME is the average grade of the top ten (10) exams, and the cut-off mark was 35 per cent of the MDME grade in the 2013–2015 period, and 30 per cent in 2012. From 2008 through 2012 the cut-off mark was the minimum positive grade only, while from 2001 through 2007 there was not cut-off mark.

(0.26MB).

Twenty four per cent of all diagnostic radiology positions are chosen by foreign physicians–which makes this specialty rank #21 in the overeall classification of 44 offered medical specialties (excluding the specialties offered by professional schools) arranged from lower to higher percentage of foreign physicians, which is suggestive that diagnostic radiology is an intermediate option for foreign candidates living in Spain. Always taking into account that the ratio of foreign physicians conditions access of such physicians to the medical specialties and that only those with low numbers of order have access to specialized training.

Every year the amount of women who choose diagnostic radiology exceeds the number of men who do so, and in the year 2012 it reached its peak with 65 per cent of all positions offered (Tables 3 and 5). Diagnostic radiology ranks #33 in the ranking of medical specialties arranged from lowest to highest presence of female physicians. This is indicative that the feminization of diagnostic radiology is lower than the feminization of most specialties. The largest presence of masculine candidates who choose diagnostic radiology has been reported in descriptive studies conducted in the United States, though countries like Switzerland report different results.8–10 The studies published by the Ministry reveal that there are 49 per cent of female specialists in diagnostic radiology today, there will be 48.4 per cent by 2020, and 47.2 per cent by 2025, meaning that we will witness a slight drop of women who choose this specialty.14,15 We have not found any sources that give a clear explanation for this finding which is particulary unsual given the benefits associated with this specialty that ease the family responsibility of women, which should rise the percentage of women who choose this specialty.9,10 Barriers in the advancement of women in the field of academic radiology have been proposed as one of the possible reasons, though without specific data,9 as well as the low satisfaction of female radiologists in their job17 and even that this type of technology is not appealing to female physicians anymore.10 Other studies talk about meeting this specialty for the first time in the colleges of medicine, and about the low exposure of candidates to female specialists in diagnostic radiology during training.10 In any case, in our study we have not found any justification or conclusive reason to explain this.

The first autonomous community in the number of positions offered in diagnostic radiology in 10 years of study is Madrid with 432 posititions distributed in 14 hospitals. Up to 130 of these positions are offered by (3) hospitals from the Comunidad de Madrid, that cover all positions with a number of order mean below 1000 (Hospital General Universitario Gregorio Marañón, Hospital Universitario 12 de Octubre, and Hospital Universitario la Paz).

Andalucía is the second autonomous community in the number of positions offered during the 2006–2015 period: 330 positions distributed in 15 hospitals. Two (2) hospitals from Andalucía reported a number of order mean below 1000: Hospital Universitario Virgen del Rocío de Sevilla, with 38 residents in 10 years, and Hospital Universitario Virgen de la Victoria de Málaga, with fewer residents per year, and a total of 24 residents in 10 years.

The hospital with the best number of order mean in this classification is Hospital Clínic de Barcelona with a number of order mean among candidates of 330. Catalonia is the third autonomous community in the number of positions offered (305) in the studied period.

The fourth autonomous community in the number of positions offered for residents is Comunidad Valenciana (218 positions), distributed in 10 hospitals. The hospital with the lowest number of order mean is Hospital Universitari i Politècnic la Fe with 1.315 and 40 residents trained in 10years.

This list of hospitals with a number of order mean below 1000 is completed with Hospital Universitario de la Coruña, with a percentile 50 of 952 and 27 residents trained during the 10 years of study, and Hospital Nuestra Señora de la Candelaria with a number of order mean of 996, though with a significantly lower number of residents trained – 10 residents in 10 years. The Basque Country has been offering 96 positions during these 10 years and two (2) of its hospitals complete the classification of the 10 hospitals with the lowest percentile 50 of number of order: Hospital Universitario de Cruces, with a number of order mean of 1081 and 28 residents trained in 10 years, and Hospital Universitario de Basurto with a number of order mean of 1093 and 20 residents trained in the 10 years of the study. The first hospital of one mono-provincial autonomous community is Hospital Universitario Marqués de Valdecilla, with a number of order mean of 1346 and 30 residents trained in 10 years.

Consequently, we can deduce that the candidates of the specialty of diagnostic radiology prefer to do their medical residency in large volume hospitals like those located in provincial capital cities. This statement is a constant in the process of choosing all medical specialties since all surveys pubished by the Ministry and conducted among training specialists claim that if candidates were free to choose, the first three hospitals they would choose from are (1) Hospital Universitario La Paz, (2) Hospital Clínic de Barcelona, and (3) Hospital 12 de Octubre.14,15

What physicians look for when they choose position and place of residence is personal and varies from one physician to the other. In Spain, specialized healthcare training is strictly characterized by the process of choosing position, and by the number of order obtained in the MIR exam, something that does not happen in other settings. According to the surveys conducted by the Ministry, up to 40 per cent of the residents said that they chose their medical specialty based on career opportunities, professional development, and future of such medical specialty, 17 per cent chose their medical specialty on grounds of social recognition, and 9 per cent for the prestige they were going to get from family and friends14,15; also other variables such as “because the hospital offering this specialty is highly advanced”4–7,12,13 were studied too. Probably, all the aforementioned motivations make candidates choose hospitals located in provincial capital cities that are closer to their main future goals, with more technological advancements, and career opportunities.

In these studies the influence of medical schools has not been analyzed, and yet they play a role in the candiates’ process of choosing probably because they choose hospitals they knew during their college training versus unknown hospitals of similar characteristics.

In any case, we cannot ignore the territorial reality of Spain or the personal characteristics of each candidate that make some hospitals fall outside this general rule. According to surveys from the Ministry, up to 23 per cent of the candidates choose their training center because it is close to their place of residence and because they want to be close to their families. These personal of family motivations are often quoted among the most important ones in studies that analyze how the process of choosing this or that center to complete the specialty unfolds, such as one survey conducted in Germany where respondants said that both family and leisure opportunities are more important than social status, scientific work, or mentoring. One Australian study that analyzed the reasons to choose diagnostic radiology says that what is perceived as the most important of all is how the specialty will shape family life, and how it is an organized job with a flexible schedule to which one can return easily after a period of absence.11,13

On the other hand, in the surveys published by the Ministry, training specialists say that money is not the main motivation to choose diagnostic radiology in any of surveys conducted through the years.14,15 But this cannot be ignored when making the decision of specializing in diagnostic radiology since the prospect of good career opportunities when completing the specialty is among the main motivations as reported by the specialists - up to 10 per cent of the respondents.14 Our specialty offers the appropriate career opportunities if we consider that the Ministry of Health thinks that by offering positions in the MIR training exam in diagnostic radiology there is already a balance between training and the withdrawal of specialists, unlike what happens in other specialties with training surplus like allergology or negative balance like pediatrics.15

The main difficulties we had while conducting this study are the lists including the positions to choose from published by the Ministry that happen to be available only for a short period of time in the official website of the Ministry of Health. We had to conduct annual registrations of these lists while the position choosing events of each year were taking place for further grouped data analysis.

Hospital classification by number of order mean of the candidates is biased due to the different number of positions offered every year in each center. The number of order mean of the candidates of one center used to elaborate the ranking is not as important if such estimate derives from a high number of positions offered by large volume centers compared to a low number of positions offered by small volume centers. In the latter case, the results from one or few candidates may dramatically modify the mean value (up or down).

Lastly, there is significant bias in the statistics of the different positions available due to hospital merge processes. The motivations of the candidates are not the same in old compared to new hospitals or hospital merges, even if both the setting and personnel stay the same. So, as far as possible, we tried to keep those institutions with a different denomination in the public announcement separately, except for certain occasions whose special characteristics are described herein.

In conclusion, candidates eligible for the medical specialty of diagnostic radiology need good numbers of order in the MIR exam, and the specialty is usually chosen by Spanish physicians, but not so much by women. Also, those eligible for the specialty of diagnostic radiology prefer large volume hospitals located in provincial capital cities.

Ethical responsibilitiesProtection of people and animals

The authors declare that no experiments with human beings or animals have been performed while conducting this investigation.

Data confidentiality

The authors confirm that in this article there are no data from patients.

Right to privacy and informed consent

The authors confirm that in this article there are no data from patients.

Authors’ contribution

  • 1.

    Manager of the integrity of the study: EMQ.

  • 2.

    Study idea: EMQ, JBR.

  • 3.

    Study design: EMQ, JBR.

  • 4.

    Data mining: EMQ, JBR, FSL, JMRL.

  • 5.

    Data analysis and interpretation: EMQ, FSL, AFS, JMRL, MCR.

  • 6.

    Statistical analysis: EMQ, FSL, JMRL.

  • 7.

    Reference: EMQ.

  • 8.

    Writing: EMQ, SCG, JBR, MCR, AFS, SCG.

  • 9.

    Critical review of the manuscript with intellectually relevant remarks: MCR, JBR, AFS, FSL, JMRL, MCR, SCG.

  • 10.

    Approval of final version: all authors.

Conflicts of interests

The authors declare no conflict of interests associated with this article whatsoever.

Acknowledgements

We wish to thank Ms. Conchi García, Head of the Spanish Medical Residency Examination (MIR Asturias).

References
[1]
Real Decreto 127/1984, de 11 de enero, por el que se regula la formación médica especializada y la obtención del título de médico especialista.
(1984), pp. 2524-2528
BOE núm. 26, de 31 de enero de 1984
[2]
Programas de Formación Sanitaria Especializada. Ministerio de Sanidad, Servicios Sociales e Igualdad. Available from: http://sis.msssi.es/fse/Default.aspx?MenuId=QE-00 [accessed 11.02.17].
[3]
J. Baladrón, J. Curbelo, F. Sánchez-Lasheras, J.M. Romeo-Ladrero, T. Villacampa, A. Fernández-Somoano.
El examen al examen MIR 2015. Aproximación a la validez estructural a través de la teoría clásica de los tests.
FEM, 19 (2016), pp. 217-226
[4]
K.L. Clinite, K.J. DeZee, S.J. Durning, J.R. Kogan, T. Blevins, C.L. Chou, et al.
Lifestyle factors and primary care specialty selection: comparing 2012–2013 graduating and matriculating medical students’ thoughts on specialty lifestyle.
Acad Med, 89 (2014), pp. 1483-1489
[5]
K.L. Clinite, S.T. Reddy, S.M. Kazantsev, J.R. Kogan, S.J. Durning, T. Blevins, et al.
Primary care, the ROAD less traveled: what first-year medical students want in a specialty.
Acad Med, 88 (2013), pp. 1522-1528
[6]
D. Baschera, T.E. O’Donnell, Y.J. Masilon, P. Isenegger, R. Zellweger.
Are medical students who want to become surgeons different? An International Cross-Sectional Study.
World J Surg, 39 (2015), pp. 2908-2918
[7]
O. Creed, J. Searle, M. Rogers.
Medical speciality prestige and lifestyle for medical students.
Soc Sci Med, 71 (2010), pp. 1084-1088
[8]
B. Buddeberg-Fischer, A. Hoffmann, S. Christen, D. Weishaupt, R.A. Kubik-Huch.
Specialising in radiology in Switzerland: still attractive for medical school graduates.
Eur J Radiol, 81 (2012), pp. 1644-1651
[9]
S.R. Baker, M. Barry, H. Chaudhry, B. Hubbi.
Women as radiologists: are there barriers to entry and advancement.
J Am Coll Radiol, 3 (2006), pp. 131-134
[10]
V.K. Potterton, S. Ruan, J.H. Sunshine, K. Applegate, Y. Cypel, H.P. Forman.
Why don’t female medical students choose diagnostic radiology? A review of the current literature.
J Am Coll Radiol, 1 (2004), pp. 583-590
[11]
J. Abendroth, M. Schnell Lichte Oemler, A. Klement.
Motives of former interns in general practice for speciality-choice – results of a cross-sectional study among graduates 2007–2012.
GMS Z Med Ausbild, 17 (2014), pp. 31
[12]
R.W. Arnold, M.J. Goske, D.I. Bulas, E.C. Benya, J. Ying, J.H. Sunshine.
Factors influencing subspecialty choice among radiology residents: a case study of pediatric radiology.
J Am Coll Radiol, 6 (2009), pp. 635-642
[13]
S.W. Ip, H.S. Ko, K.E. Applegate.
Factors influencing career choices in radiology trainees in Queensland, Australia.
J Med Imaging Radiat Oncol, 54 (2010), pp. 93-99
[14]
Grupo de Investigación EcoSalud de la Universidad de Las Palmas de Gran Canaria. Informe descriptivo de la encuesta a adjudicatarios MIR de la convocatoria 2013/14. Available from: https://www.msssi.gob.es/profesionales/formacion/necesidadEspecialistas/doc/ACT2015InforDesMIR_convocatoria_2013_14.pdf [accessed 11.02.17].
[15]
Equipo economía de la salud. Oferta y necesidades de médicos especialistas en España (2010–2025). Available from: https://www.msssi.gob.es/profesionales/formacion/necesidadEspecialistas/doc/11-NecesidadesMEspecialistas(2010-2025).pdf [accessed 11.02.17].
[16]
Academia Curso MIR Asturias. Tu objetivo para la plaza de especialista. Available from: http://www.curso-mir.com/El-examen-MIR/Tu-objetivo-plaza-especialista.html [accessed 11.02.17].
[17]
E. Frank, J.E. McMurray, M. Linzer, L. Elon.
Career satisfaction of US women physicians.
Arch Intern Med, 159 (1999), pp. 1417-1426

Please cite this article as: Murias Quintana E, Sánchez Lasheras F, Fernández-Somoano A, Romeo Ladrero JM, Costilla García SM, Cadenas Rodríguez M, et al. Análisis de la elección de la especialidad de radiodiagnóstico en el examen MIR desde el año 2006 hasta 2015. Radiología. 2017;59:232–246.

Copyright © 2017. SERAM
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos