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DOI: 10.1016/j.nefroe.2021.07.006
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Available online 7 August 2021
Teaching nephrology as part of a degree in medicine
La docencia de la nefrología en el grado de medicina
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Gabriel de Arribaa,
Corresponding author
gabriel.arriba@uah.es

Corresponding author.
, Alberto Ortiz Arduánb, José Carlos Rodríguez Pérezc, Alberto Tejedor Jorged, Rafael Santamaría Olmoe, Mariano Rodríguez Portilloe
a Hospital Universitario de Guadalajara, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain
b Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
c Hospital Universitario de Gran Canaria Doctor Negrín, Universidad de Las Palmas, Las Palmas de Gran Canaria, Spain
d Hospital Gregorio Marañón de Madrid, Universidad Complutense de Madrid, Madrid, Spain
e Hospital Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
Received 29 June 2020. Accepted 07 September 2020
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Tables (7)
Table 1. Spanish faculties where a degree in medicine is taught, alongside associated hospitals and their number of beds.
Table 2. Number of medical students per 100,000 inhabitants in each autonomous community.
Table 3. Universities where a degree in medicine is imparted with number of students and final grade requirements to be admitted in medicine.
Table 4. Beds in hospitals associated with universities per undergraduate medical student.
Table 5. Lecturers teaching nephrology in universities with their category and current situation.
Table 6. Analysis of course guides for courses including or relating to nephrology.
Table 7. Nephrologists working for the national Health System in each autonomous community.
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Abstract

The teaching of nephrology as part of a degree in medicine is potentially one of the most decisive factors when choosing a speciality. Until now, however, we have not had an overview of the teaching of nephrology in Spain. We have integrated information available in public databases with a survey and personal interviews with those responsible for teaching in Spanish medical faculties. In 2019, there were 44 universities offering a medicine degree in Spain, in 16 Autonomous Communities (34 of which were public and 10 private). For learning purposes, students have a number of hospital beds ranging from 0.2 to 4.7, and there are Autonomous Communities that have a higher proportion of students per inhabitant or per physician, such as Madrid or the Community of Navarra. In 16 universities there are tenured teaching staff (professors and lecturers), in eight contracted medical lecturers, and in two assistant lecturers. In 21 medical faculties, theoretical and practical nephrology is taught by associate lecturers. The subject is taught between the third and fifth years of the degree, the median being the fourth year. It is usually integrated with another subject and only in the University of Navarra is it an independent subject, with three credits. The total number of hours devoted to theoretical teaching (both theoretical classes and seminars) is highly variable and ranges from 11 to 35, with a median of 17.5. Variability is observed in both the number of theoretical topics (range 11–31) and seminars (range 0–9). Among the faculties that teach seminars, the ratio of theoretical topics to seminars ranges from 1.6 to 18. Most faculties evaluate clinical practices with various modalities and percentage of assessment. Knowledge is mostly assessed by a multiple choice exam.

In conclusion, there is a high level of variability in the curriculum for the teaching of nephrology as part of a degree in medicine in Spain. Teaching staff who are tenured or who have a stable affiliation with universities make up just 23% of the total and, in many faculties, teaching depends exclusively on associate professors.

Keywords:
Nephrology
University
Degree in medicine
Medical education
Resumen

La docencia de la nefrología en el grado de medicina es uno de los factores potencialmente más determinantes a la hora de elegir especialidad. Sin embargo, hasta ahora no había un mapa de la docencia de la nefrología en España. Hemos integrado información disponible en bases de datos públicos con una encuesta y entrevistas personales con los responsables de la docencia en las Facultades de Medicina españolas. En 2019, había 44 universidades que ofrecían el grado de Medicina en España en 16 Comunidades Autónomas (34 de ellas públicas y 10 privadas). Los alumnos disponen para su aprendizaje de un número de camas hospitalarias que oscila entre 0,2 y 4,7 y hay comunidades autónomas que tienen una mayor proporción de estudiantes por habitante o por médicos colegiados como Madrid o la Comunidad Foral de Navarra. En 16 universidades existen profesores vinculados (catedráticos y profesores titulares), en 8 profesores contratados doctores y en 2 profesores agregados. En 21 facultades de medicina la docencia teórica y práctica de Nefrología la llevan a cabo profesores asociados. La asignatura se imparte entre los años tercero y quinto de la carrera, siendo la mediana el cuarto año. Habitualmente está integrada con otra asignatura y solo en una Universidad de Navarra supone una asignatura independiente, con 3 créditos. El número total de horas dedicadas a la enseñanza teórica (clases teóricas y seminarios) es muy variable y oscila entre 11 y 35 con una media de 17,5. Se observa variabilidad tanto en el número de temas teóricos (rango 11 a 31) como de seminarios (rango 0 a 9). Entre las Facultades que imparten seminarios, el ratio temas teóricos: seminarios oscila entre 1,6 y 18. La mayoría de las Facultades realizan evaluación de las prácticas clínicas con varias modalidades y porcentaje de valoración. La evaluación de conocimientos se hace mayoritariamente con examen multirespuesta tipo test.

En conclusión, se aprecia una gran variabilidad en el curriculum de la enseñanza de la nefrología en el grado de medicina, en España. El profesorado con plaza vinculada o con adscripción estable a las universidades constituye sólo el 23% del total y la enseñanza en muchas facultades depende exclusivamente de profesores asociados.

Palabras clave:
Nefrología
Universidad
Grado de medicina
Educación médica
Full Text
Introduction

Since its foundation, the Spanish Society of Nephrology (Sociedad Española de Nefrología, SEN) has maintained a strong interest in the training of its members and in incorporating new scientific advances in the specialty's toolkit.1–3 In recent years, there has also been a growing interest in the training of medical students on renal diseases. A general concern among nephrologists is the growing lack of interest of medical students in choosing the specialty of nephrology.4 In this context, a plethora of initiatives aiming to facilitate learning and make the specialty more attractive to future junior doctors has been generated.5,6

One of these projects was the creation of the S.E.N. University group as a group open to members encouraged to participate and put forward proposals for improvement of the teaching of renal diseases. One of the objectives is to learn about different aspects of the nephrology teaching in medicine degrees in the medical schools of our country; this would a first step to analyse how the teaching of nefrology has been carried out since the implementation of the Bologna Plannification. This information will enable us to form common teaching strategies for all the profesors and students involved. In addition, it is also important to know teaching institutions that are associated to medical schools and specifically, the hospitals where students do their practical training.

Another key objective of the University group is to obtain information about the situation of the nephrology teaching staff. To date there have been no prior studies analyzing this situation. This is an information that will be necessary to implement corrective or stimulatory measures to help nephrologists improve their university credentials, that will certainly benefit our students.

For the present study, we used sources of information from public organisms and university websites. As there is no centralised registry of nephrology teaching staff, and each university has adapted its teaching to the instruments it has available, the procedure we chose was to conduct a survey through the SEN followed by directly contacting professors in each medical school to confirm the data.

Our study is the first to analyze teaching in medicine degrees in Spanish medical schools, and we believe that information obtained that will be useful to stablish common teaching strategies for students and professors in the subject of nephrology.

In the current context of the transformation of teaching in general, and particularly university teaching, this information will offer opportunities for collaboration among all SEN members, who will be able to share both teaching materials and teaching methodologies.

MethodsUniversities, medical schools and physicians

Information on the medical schools and associated hospitals, as well as the number of students in each medical schools and the grades required to be admitted in the different medical schools, was obtained from the websites of the Ministry of Education and Professional Training, the Ministry of Universities, the Vice-Chancellors’ Conference of Spanish Universities (Conferencia de Rectores de las Universidades Españolas, CRUE) and the National Conference of Deans of Spanish medical schools s of Medicine (Conferencia Nacional de Decanos de Medicina).7–9 Statistical data on population and the number of registered physicians in our country was obtained from the National Statistics Institute (Instituto Nacional de Estadística, INE).10 Information on the number of beds and characteristics of each hospital is available in the National Catalogue of Hospitals (Catálogo Nacional de Hospitales), the latest available update of which is dated in 31 December 2018.11 Information on a newly-created university hospital, or one not included in the catalogue was obtained from its website or through direct contact with those responsible at the university. Health centres and other care or teaching facilities such as skills laboratories or other types of laboratories were not included, due to their heterogeneity in each medical school.

The number of nephrologists working for the National Health System in each autonomous community was obtained from the Ministry of Health, Consumer Affairs and Social Services.12

Nephrology professors

This data was initially collected by a survey amonf the SEN members, which was later supplemented with confirmatory information through direct contact with prfessors at each university. The following categories of professors were considered.

  • Full professor, with tenure, who must be a titular professor, have completed at least two six-year periods of research, be accredited by the National Agency for Quality Assessment and Accreditation (Agencia Nacional de Evaluación de la Calidad y Acreditación, ANECA).

  • Titular professor on tenure accredited by ANECA.

  • Senior lecturer, PhD, accredited by ANECA or equivalent institutions in the autonomous communities.

  • Lecturer, PhD, accredited by ANECA or equivalent institution in the autonomous communities.

  • Senior lecturer (Catalonia and Basque Country), who must be accredited by the autonomous community.

  • Adjunct lecturer (equivalent to asistan professor), usually selected based on merit, on periodic contracts.

  • Emeritus professor, approved by the corresponding university, according to a number of criteria.

Although on many occasions data were received from colaborators professors, honorary professors, assistant teachers of patients care and other similar figures (such as having obtained habilitation [venia docendi]), these were not taken into account in the study due to their heterogeneity across different universities and the difficulty of being classified. We also omitted from our report some professors who, despite being members of the SEN, do not strictly teach nephrology and also teach other subjects.

Course guides: content and methods of assessment

A search was performed of each university’s website to obtain teaching guides for each course in which nephrology was imparted. The following data were collected:

  • Course name and materials taught therein.

  • Year in which it is taught and number of course credits.

  • Theory lectures.

  • Practical seminars.

  • Assessment methods: Examinations based on patients assessememt (case studies and simulation-based assessment, objective structured clinical examination [OSCE] or continuous assessment by tutors) and test theory knowledge (multiple-choice, short questions, case studies, etc.).13

ResultsStructure, physical resources and demographic data

Fig. 1 and Table 1 show the distribution of the medical schools where the degree in medicine is taught, along with the associated hospitals with them in the various autonomous communities. La Rioja is the only community without a medical school, as well as the autonomous cities of Ceuta and Melilla.

Fig. 1.

Map of Spain with the location of universities where the degree in medicine is taught.

(0.23MB).
Table 1.

Spanish faculties where a degree in medicine is taught, alongside associated hospitals and their number of beds.

Community  University  Teaching hospitals  Beds 
Andalusia  Cádiz [U. of Cádiz]  Hospital Universitario de Jerez [University H. of Jerez]  498 
  Cádiz [U. of Cádiz]  Hospital Universitario de Puerto Real [University H. of Puerto Real]  319 
  Cádiz [U. of Cádiz]  Hospital Universitario Puerta del Mar [University H. of Puerta del Mar]  738 
  Córdoba [U. of Córdoba]  Hospital Universitario Reina Sofía [Reina Sofia University H.]  1,233 
  Granada [U. of Granada]  Hospital Campus de la Salud [Campus de la Salud H.]  700 
  Granada [U. of Granada]  Hospital Universitario Clínico San Cecilio [San Cecilio Clinical University H.]  543 
  Granada [U. of Granada]  Hospital Virgen de las Nieves [Virgen de las Nieves H.]  711 
  Málaga [U. of Málaga]  Hospital Regional Universitario de Málaga [Málaga Regional University Hospital]  1,049 
  Málaga [U. of Málaga]  Hospital Universitario Virgen de la Victoria [Virgen de la Victoria University H.]  657 
  Sevilla [U. of Seville]  Hospital Universitario Nuestra Señora de Valme [Nuestra Señora de Valme University H.]  617 
  Sevilla [U. of Seville]  Hospital Universitario Virgen del Rocío[ Virgen del Rocío University H.]  1,350 
  Sevilla [U. of Seville]  Hospital Universitario Virgen Macarena [Virgen Macarena University H.]  960 
Aragón  Zaragoza [U. of Zaragoza]  Hospital Clínico Universitario Lozano Blesa [Lozano Blesa Clinical University H.]  807 
  Zaragoza [U. of Zaragoza]  Hospital Universitario Miguel Servet [Miguel Servet University H.]  1,213 
Asturias  Oviedo [U. of Oviedo]  Hospital Universitario Cabueñes de Gijón [Cabueñes University H., Gijón]  457 
  Oviedo [U. of Oviedo]  Hospital Universitario Central de Asturias [Central University H. of Asturias]  991 
  Oviedo [U. of Oviedo]  Hospital Universitario San Agustín de Avilés [San Agustín de Avilés University H.]  436 
Balearic Islands  Illes Baleares [U. of the Balearic I.]  Hospital Son Llátzer [Son Llátzer H.]  419 
  Illes Baleares [U. of the Balearic I.]  Hospital Universitario Son Espases [Son Espases University H.]  839 
Canary Islands  La Laguna [U. of La Laguna]  Hospital Universitario de Canarias [Canary Islands University H.]  826 
  La Laguna [U. of La Laguna]  Hospital Universitario Nuestra Señora de la Candelaria [Nuestra Señora de la Candelaria University H.]  1,066 
  Las Palmas de Gran Canaria [U. of Las Palmas de Gran Canaria]  Complejo Hospitalario Universitario Insular Materno-Infantil [Women's and Children's Island University H. Complex]  916 
  Las Palmas de Gran Canaria [U. of Las Palmas de Gran Canaria]  Hospital Universitario de Gran Canaria Dr. Negrín [Dr Negrín University H. of Gran Canaria]  828 
Cantabria  Cantabria [U. of Cantabria]  Hospital Sierrallana de Torrelavega [Sierrallana H., Torrelavega]  301 
  Cantabria [U. of Cantabria]  Hospital Universitario Marqués de Valdecilla [Marqués de Valdecilla University H.]  923 
Castile-La Mancha  Castilla-La Mancha Albacete [U. of Castile-La Mancha, Albacete Campus]  Complejo Hospitalario Universitario de Albacete [Albacete University H. Complex]  705 
  Castilla-La Mancha Ciudad Real [U. of Castile-La Mancha, Ciudad Real Campus]  Hospital General Universitario de Ciudad Real [Ciudad Real University General H.]  564 
Castile and León  Salamanca [U. of Salamanca]  Complejo Asistencial Universitario de Salamanca [Salamanca University Healthcare Complex]  914 
  Salamanca [U. of Salamanca]  Hospital de Ávila [Ávila H.]  430 
  Salamanca [U. of Salamanca]  Hospital de León [León H.]  1,056 
  Salamanca [U. of Salamanca]  Hospital de Zamora [Zamora H.]  540 
  Valladolid [U. of Valladolid]  Hospital Clínico Universitario [University Clinical H.]  777 
  Valladolid [U. of Valladolid]  Hospital Universitario de Palencia [Palencia University H.]  495 
  Valladolid [U. of Valladolid]  Hospital Universitario del Río Hortega [Río Hortega University H.]  606 
Catalonia  Autónoma de Barcelona [Autonomous U. of Barcelona]  Hospital Universitario de la Santa Creu i Sant Pau [Santa Creu i Sant Pau University H.]  644 
  Autónoma de Barcelona [Autonomous U. of Barcelona]  Hospital Universitario [Germans Trias i Pujol University H.]  516 
  Autónoma de Barcelona [Autonomous U. of Barcelona]  Hospital Universitario Parc Taulí [Parc Taulí University H.]  861 
  Autónoma de Barcelona [Autonomous U. of Barcelona]  Hospital Universitario Vall D’Hebron [Vall D’Hebron University H.]  1,315 
  Girona [U. of Girona]  Hospital Universitario Dr. Josep Trueta [Dr Josep Trueta University H.]  431 
  Lleida [U. of Lleida]  Hospital Universitario Arnau De Vilanova [Arnau De Vilanova University H.]  463 
  Lleida [U. of Lleida]  Hospital Universitario Santa María [Santa María University H.]  229 
  Pompeu Fabra [U. Pompeu Fabra]  Hospital Universitario del Mar [University H. del Mar]  470 
  Rovira i Virgili [U. of Rovira i Virgili]  Hospital Psiquiátrico Universitario Institut Pere Mata [Pere Mata Institute University Psychiatric H.]  727 
  Rovira i Virgili [U. of Rovira i Virgili]  Hospital Universitario Joan XXIII de Tarragona [Joan XXIII University H., Tarragona]  372 
  Rovira i Virgili [U. of Rovira i Virgili]  Hospital Universitario Sant Joan de Reus [Sant Joan University H., Reus]  313 
  Barcelona [U. of Barcelona]  Hospital Clínic [Hospital Clínic]  844 
  Barcelona [U. of Barcelona]  Hospital de Sant Joan de Déu [SJD Barcelona Children's H.]  401 
  Barcelona [U. of Barcelona]  Hospital Uiversitario Mútua Terrassa [Mútua Terrassa University H.]  460 
  Barcelona [U. of Barcelona]  Hospital Universitario de Bellvitge [Bellvitge University H.]  1,022 
  Internacional de Catalunya [UIC Barcelona]  Fundación Hospital Asilo de Granollers [Asilo de Granollers H. Foundation]  306 
  Internacional de Catalunya [UIC Barcelona]  Hospital Universitario General de Cataluña - Grupo Quirónsalud [General University Hospital of Catalonia - Quirónsalud Group]  297 
  Internacional de Catalunya [UIC Barcelona]  Red Asistencial Universitaria de Manresa [Manresa University Healthcare Network]  309 
  Internacional de Catalunya [UIC Barcelona]  Hospital Plató [Plato H.]  161 
  Internacional de Catalunya [UIC Barcelona]  Hospital de Mollet [Mollet H.]  164 
  Vic [U. of Vic]  Hospital Universitario de Vic [Vic University H.]  292 
  Vic [U. of Vic]  Hospital Universitario de Sant Joan De Déu (Manresa) [SJD Manresa University Hospital]  280 
Extremadura  Extremadura [U. of Extremadura]  Complejo Hospitalario Universitario de Badajoz [Badajoz University H. Complex]  915 
  Extremadura [U. of Extremadura]  Hospital Universitario de Cáceres [Cáceres University H.]  520 
Galicia  Santiago de Compostela [U. of Santiago de Compostela]  Hospital Clínico Universitario [University Clinical H.]  1,395 
  Santiago de Compostela [U. of Santiago de Compostela]  Complejo Hospitalario Universitario de A Coruña [A Coruña University H. Complex]  1,341 
  Santiago de Compostela [U. of Santiago de Compostela]  Complejo Hospitalario Universitario de Vigo [Vigo University H. Complex]  1,273 
  Santiago de Compostela [U. of Santiago de Compostela]  Complejo Hospitalario Universitario de Ourense [Ourense University H. Complex]  869 
Madrid  Alcalá [U. of Alcalá]  Hospital General Universitario de Guadalajara [Guadalajara University H. Complex]  432 
  Alcalá [U. of Alcalá]  Hospital Universitario Central de la Defensa Gómez Ulla [Gómez Ulla Military University H.]  475 
  Alcalá [U. of Alcalá]  Hospital Universitario Príncipe de Asturias [Príncipe de Asturias University H.]  507 
  Alcalá [U. of Alcalá]  Hospital Universitario Ramón y Cajal [Ramón y Cajal University H.]  901 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital de la Cruz Roja [Red Cross H.]  154 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital Universitario del Tajo [University H. del Tajo]  98 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital Universitario Severo Ochoa [Severo Ochoa University H.]  386 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital Virgen de la Poveda [Virgen de la Poveda H.]  202 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Instituto Psiquiátrico José Germain [José Germain Psychiatric Institute]  178 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital la Luz [La Luz H.]  180 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital San Francisco de Asís [Francisco de Asís H.]  168 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital los Madroños [Los Madroños H.]  53 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital Quirón Sur-Alcorcón [Quirónsalud South Hospital, Alcorcón]  81 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Clínica Santa Elena [Santa Elena Clinic]  76 
  Alfonso X el Sabio [Alfonso X el Sabio U.]  Hospital de Ciempozuelos [Ciempozuelos H.]  332 
  Autónoma de Madrid [Autonomous U. of Madrid]  Hospital Niño Jesús [Niño Jesús H.]  170 
  Autónoma de Madrid [Autonomous U. of Madrid]  Hospital Universitario Puerta de Hierro Majadahonda [Puerta de Hierro Majadahonda University H.]  613 
  Autónoma de Madrid [Autonomous U. of Madrid]  Hospital Universitario de La Princesa [La Princesa University H.]  524 
  Autónoma de Madrid [Autonomous U. of Madrid]  Hospital Universitario Fundación Jiménez Díaz [Jiménez Díaz Foundation University H.]  659 
  Autónoma de Madrid [Autonomous U. of Madrid]  Hospital Universitario La Paz [La Paz University H.]  1,268 
  CEU San Pablo [CEU San Pablo U.]  Hospital de Móstoles [Móstoles H.]  332 
  CEU San Pablo [CEU San Pablo U.]  Hospital HM Madrid [HM Madrid H.]  99 
  CEU San Pablo [CEU San Pablo U.]  Hospital Montepríncipe [Montepríncipe H.]  170 
  CEU San Pablo [CEU San Pablo U.]  Hospital Nuevo Belén [Nuevo Belén H.]  60 
  CEU San Pablo [CEU San Pablo U.]  Hospital Sanchinarro [Sanchinarro H.]  198 
  CEU San Pablo [CEU San Pablo U.]  Hospital Torrelodones [Torrelodones H.]  86 
  CEU San Pablo [CEU San Pablo U.]  HM Vallés [HM Vallés H.]  20 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Clínico San Carlos [San Carlos Clinical H.]  861 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario 12 de Octubre [12 de Octubre University H.]  1,196 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Gregorio Marañon [Gregorio Marañon University H.]  1,349 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Infanta Cristina [Infanta Cristina University H.]  188 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Infanta Leonor [Infanta Leonor University H.]  361 
  Europea de Madrid [European U. of Madrid]  Hospital La Fuenfría [La Fuenfría H.]  192 
  Europea de Madrid [European U. of Madrid]  Hospital José Germain [José Germain H.]  178 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Asisa-Moncloa [Asisa-Moncloa University H.]  235 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario de Getafe [Getafe University H.]  510 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Quirón-Madrid [Quirónsalud University H., Madrid]  81 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Santa Cristina [Santa Cristina University H.]  156 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Infanta Sofía [Infanta Sofía University H.]  271 
  Europea de Madrid [European U. of Madrid]  Hospital Ruber Juan Bravo [Ruber Juan Bravo H.]  70 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital de Guadarrama [Guadarrama H.]  144 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Dr. Rodríguez Lafora [Dr Rodríguez Lafora H.]  334 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital El Escorial [El Escorial H.]  91 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Universitario de Móstoles [Móstoles University H.]  332 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Universitario Infanta Elena [Infanta Elena University H.]  158 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital del Henares de Coslada [Henares H., Coslada]  243 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital del Sureste de Arganda [South-eastern H., Arganda]  132 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital de Torrejón [Torrejón H.]  220 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Sanitas La Zarzuela [Sanitas La Zarzuela H.]  116 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Sanitas La Moraleja [Sanitas La Moraleja H.]  126 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital San Rafael [San Rafael H.]  188 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Beata María Ana [Beata María Ana H.]  160 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Asepeyo Coslada [Asepeyo H., Coslada]  133 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital MD Anderson [MD Anderson H.]  99 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario de Alcorcón [Alcorcón University H.]  400 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario de Fuenlabrada [Fuenlabrada University H.]  406 
  Rey ]  Hospital Clínico San Carlos [San Carlos Clinical H.]  861 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario 12 de Octubre [12 de Octubre University H.]  1,196 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Gregorio Marañon [Gregorio Marañon University H.]  1,349 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Infanta Cristina [Infanta Cristina University H.]  188 
  Complutense de Madrid [U. Complutense de Madrid]  Hospital Universitario Infanta Leonor [Infanta Leonor University H.]  361 
  Europea de Madrid [European U. of Madrid]  Hospital La Fuenfría [La Fuenfría H.]  192 
  Europea de Madrid [European U. of Madrid]  Hospital José Germain [José Germain H.]  178 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Asisa-Moncloa [Asisa-Moncloa University H.]  235 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario de Getafe [Getafe University H.]  510 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Quirón-Madrid [Quirónsalud University H., Madrid]  81 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Santa Cristina [Santa Cristina University H.]  156 
  Europea de Madrid [European U. of Madrid]  Hospital Universitario Infanta Sofía [Infanta Sofía University H.]  271 
  Europea de Madrid [European U. of Madrid]  Hospital Ruber Juan Bravo [Ruber Juan Bravo H.]  70 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital de Guadarrama [Guadarrama H.]  144 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Dr. Rodríguez Lafora [Dr Rodríguez Lafora H.]  334 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital El Escorial [El Escorial H.]  91 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Universitario de Móstoles [Móstoles University H.]  332 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Universitario Infanta Elena [Infanta Elena University H.]  158 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital del Henares de Coslada [Henares H., Coslada]  243 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital del Sureste de Arganda [South-eastern H., Arganda]  132 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital de Torrejón [Torrejón H.]  220 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Sanitas La Zarzuela [Sanitas La Zarzuela H.]  116 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Sanitas La Moraleja [Sanitas La Moraleja H.]  126 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital San Rafael [San Rafael H.]  188 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Beata María Ana [Beata María Ana H.]  160 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital Asepeyo Coslada [Asepeyo H., Coslada]  133 
  Francisco de Vitoria [Francisco de Vitoria U.]  Hospital MD Anderson [MD Anderson H.]  99 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario de Alcorcón [Alcorcón University H.]  400 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario de Fuenlabrada [Fuenlabrada University H.]  406 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario de Móstoles [Móstoles University H.]  332 
  Rey Juan Carlos [Rey Juan Carlos U.]  Hospital Universitario Rey Juan Carlos [Rey Juan Carlos University H.]  364 
Murcia  Murcia [U. of Murcia]  Hospital General Universitario Morales Meseguer [Meseguer University General H., Morales]  394 
  Murcia [U. of Murcia]  Hospital General Universitario Reina Sofía [Reina Sofia University General H.]  339 
  Murcia [U. of Murcia]  Hospital Universitario Virgen de la Arrixaca [Virgen de la Arrixaca University H.]  920 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Universitario Santa Lucía de Cartagena [Santa Lucía University H., Cartagena]  691 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Universitario del Vinalopó de Elche [Vinalopó University H., Elche]  214 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Universitario de Torrevieja [Torrevieja University H.]  269 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital La Vega [La Vega H.]  123 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Mesa del Castillo [Mesa del Castillo H.]  76 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Quirónsalud Murcia [Quirónsalud H., Murcia]  131 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital de Molina [Molina H.]  83 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Comarcal del Noroeste de Caravaca [Northwest Regional H., Caravaca]  103 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital Virgen del Alcázar de Lorca [Virgen del Alcázar H., Lorca]  175 
  Católica de Murcia [San Antonio Catholic U. of Murcia]  Hospital de la Vega Lorenzo Guirao de Cieza [La Vega Lorenzo Guirao H., Cieza]  125 
Navarre  Navarra [U. of Navarre]  Clínica Universidad de Navarra [University of Navarre Clinic]  241 
  Pública de Navarra [Public U. of Navarre]  Complejo Hospitalario de Navarra [Navarre H. Complex]  1,086 
Basque Country  País Vasco [U. of the Basque Country]  Hospital Universitario Araba [Araba University H.]  811 
  País Vasco [U. of the Basque Country]  Hospital Universitario de Basurto [Basurto University H.]  733 
  País Vasco [U. of the Basque Country]  Hospital Universitario de Cruces [Cruces University H.]  912 
  País Vasco [U. of the Basque Country]  Hospital Universitario Donostia [Donostia University H.]  1,054 
Valencian Community  Jaume I [Jaume I U.]  Consorcio Hospitalario Provincial de Castellón [Castellón Provincial H. Consortium]  257 
  Jaume I [Jaume I U.]  Hospital General Universitario de Castellón [Castellón University General Hospital]  580 
  Jaume I [Jaume I U.]  Hospital Universitario de La Plana [La Plana University H.]  258 
  Católica de Valencia [Valencia Catholic U. Saint Vincent Martyr]  Hospital Universitario de La Ribera (Alzira) [La Ribera University H., Alzira]  301 
  Católica de Valencia [Valencia Catholic U. Saint Vincent Martyr]  Grupo Vithas 9 de Octubre [Vithas Group - 9 de Octubre]  300 
  Católica de Valencia [Valencia Catholic U. Saint Vincent Martyr]  Grupo Vithas Virgen del Consuelo [Vithas Group - Virgen del Consuelo]  156 
  Católica de Valencia [Valencia Catholic U. Saint Vincent Martyr]  Grupo Vithas Valencia al Mar [Vithas Group - Valencia al Mar]  70 
  Católica de Valencia [Valencia Catholic U. Saint Vincent Martyr]  Hospital Intermutual de Levante [Eastern Mutual H.]  230 
  CEU Cardenal Herrera Castellón [CEU Cardenal Herrera U., Castellón Campus]  Hospital de Sagunto [Sagunto H.]  252 
  CEU Cardenal Herrera Castellón [CEU Cardenal Herrera U., Castellón Campus]  Hospital de Vinaros [Vinaros H.]  150 
  CEU Cardenal Herrera Castellón [CEU Cardenal Herrera U., Castellón Campus]  Hospital Provincial [Provincial H.]  257 
  CEU Cardenal Herrera Castellón [CEU Cardenal Herrera U., Castellón Campus]  Hospital Rey Don Jaime [Rey Don Jaime H.]  96 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Hospital Arnau De Vilanova [Arnau De Vilanova H.]  302 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Hospital de Manises [Manises H.]  115 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Grupo Vithas 9 de Octubre [Vithas Group - 9 de Octubre]  300 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Grupo Vithas Virgen del Consuelo [Vithas Group - Virgen del Consuelo]  156 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Grupo Vithas Valencia al Mar [Vithas Group - Valencia al Mar]  70 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Hospital IMED Valencia de Burjassot [IMED Valencia H., Burjassot]  207 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Hospital Quirón [Quirónsalud H.]  88 
  CEU Cardenal Herrera-Valencia [CEU Cardenal Herrera U., Valencia Campus]  Instituto Valenciano de Oncología [Valencian Institute of Oncology]  160 
  U. Miguel Hernández [Miguel Hernández U.]  Hospital General Universitario de Alicante [Alicante University General H.]  794 
  U. Miguel Hernández [Miguel Hernández U.]  Hospital General Universitario de Elche [Elche University General H.]  492 
  U. Miguel Hernández [Miguel Hernández U.]  Hospital General Universitario de Elda [Elda University General H.]  513 
  U. Miguel Hernández [Miguel Hernández U.]  Hospital Universitario San Juan de Alicante [San Juan University H., Alicante]  396 
  Valencia [U. of Valencia]  Hospital Clínico Universitario [University Clinical H.]  582 
  Valencia [U. of Valencia]  Hospital General Universitario de Valencia [Valencia University General H.]  546 
  Valencia [U. of Valencia]  Hospital Universitario Doctor Peset [Doctor Peset University H.]  539 
  Valencia [U. of Valencia]  Hospital Universitario y Politécnico La Fe [University and Polytechnic La Fe Hospital]  1,000 
Total      78,369 

Table 2 shows the number of students per 100,000 inhabitants in each autonomous community. In general, there is a consistent ratio of number of students per inhabitants, with an average of 15 students per 100,000 inhabitants, with two exceptions: the Chartered Community of Navarre has a higher and the Balearic Islands a lower ratio (Fig. 2). Regarding the the number of physicians the National Institute of Employement (INE) in 2016 reveals that Madrid is the region with greatest amount of physicians per 100,000 inhabitants (594), while Andalusia (386) and Castile-La Mancha (366) have the fewest (Appendix B Supplementary Table S1). However, the analysis of the ratio of medical students per 100 physicians reveals a different picture: the Chartered Community of Navarre, Cantabria and Murcia have the highest ratio and could be considered a priori as exporters of new physicians, while the Balearic Islands have the lowest (Fig. 3).

Table 2.

Number of medical students per 100,000 inhabitants in each autonomous community.

Autonomous community (AC)  Students per AC  Inhabitants per AC  Students/100,000 inhabitants 
Andalusia  988  8,460,261  12 
Aragón  224  13,287,53  17 
Asturias  153  1,018,706  15 
Balearic Islands  60  1,018,706 
Canary Islands  265  2,174,474  12 
Cantabria  119  582,796  20 
Castile-La Mancha  200  2,044,408  10 
Castile and León  360  2,393,285  15 
Catalonia  1,134  7,778,362  15 
Extremadura  120  1,063,575  11 
Galicia  360  2,700,269  13 
Madrid  1,478  6,778,382  22 
Murcia  290  1,510,951  19 
Navarre, Chartered Community of  260  660,887  39 
Basque Country  330  2,219,777  15 
Valencian Community  770  5,054,796  15 
Total  7,111  46,788,388  15 
Fig. 2.

Number of medical students per 100,000 inhabitants in each autonomous community.

(0.1MB).
Fig. 3.

Ratio of students per 100 physicians in the different autonomous communities.

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Table 3 shows the different medical schools in which the degree in medicine is taught, together with the number of students in the 2019−2020 academic year and the final grade requirement for each.

Table 3.

Universities where a degree in medicine is imparted with number of students and final grade requirements to be admitted in medicine.

University  Website  Name  Students  Grade req. 
Andalusia-Cádiz [U. of Cádiz]  https://medicina.uca.es/  Faculty of Medicine  154  12.709 
Andalusia-Córdoba [U. of Córdoba]  http://www.uco.es/medicinayenfermeria/es/  Faculty of Medicine and Nursing  130  12.791 
Andalusia-Granada [U. of Granada]  https://medicina.ugr.es/  Faculty of Medicine  253  12.904 
Andalusia-Málaga [U. of Málaga]  https://www.uma.es/facultad-de-medicina/  Faculty of Medicine  160  12.845 
Andalusia-Sevilla [U. of Seville]  https://medicina.us.es/  Faculty of Medicine  291  12.89 
Aragón-U. Zaragoza/Huesca [U. of Zaragoza, Huesca Campus]  https://medicina.unizar.es/  Faculty of Medicine  224  12.516 
Asturias-U. de Oviedo [U. of Oviedo]  https://www.unioviedo.es/medicina  Faculty of Medicine and Health Sciences (Medicine, Nursing and Physiotherapy).  153  12.487 
Balearic Islands-U. de les Iles Baleares [U. of the Balearic I.]  https://fmedicina.uib.es/  Faculty of Medicine  60  12.209 
Canary Islands-La Laguna [U. of La Laguna]  https://www.ull.es/grados/medicina/  Faculty of Health Sciences  130  12.706 
Canary Islands-Las Palmas [U. of Las Palmas de Gran Canaria]  http://www.fccs.ulpgc.es/node  Faculty of Health Sciences (Medicine, Nursing and Physiotherapy)  135  12.498 
Cantabria-U. de Cantabria [U. of Cantabria]  https://web.unican.es/centros/medicina  Faculty of Medicine  119  12.355 
Castile-La Mancha-Albacete [U. of Castile-La Mancha, Albacete Campus]  https://blog.uclm.es/medicinaab/  Faculty of Medicine  200  12.668 
Castile-La Mancha-Ciudad Real [U. of Castile-La Mancha, Ciudad Real Campus]  http://medicina.cr.uclm.es/webmedicina/  Faculty of Medicine  60  12.668 
Castile & León-Salamanca [U. of Salamanca]  https://facultadmedicina.org/  Faculty of Medicine  180  12.44 
Castile & León-Valladolid [U. of Valladolid]  http://www.med.uva.es/grado-en-medicina/  Faculty of Medicine  180  12.476 
Catalonia-Barcelona-Autónoma de Barcelona [Autonomous U. of Barcelona]  http://www.ub.edu/medicina/es/  Faculty of Medicine  320  12.3 
Catalonia-Girona [U. of Girona]  https://www.udg.edu/es/estudia/Oferta-formativa/Graus/Fitxes?IDE=907&ID=3109G0111  Faculty of Medicine  80  12.197 
Catalonia-Lleida [U. of Lleida]  http://www.udl.cat/ca/es/centros/facultad_medicina/  Faculty of Medicine  110  12.18 
Catalonia-Barcelona-Pompeu Fabra [Pompeu Fabra U.]  https://www.upf.edu/es/web/graus/grau-medicina  Faculty of Medicine  60  12.494 
Catalonia-Tarragona- Reus- Rovira i Virgili [U. of Rovira i Virgili]  http://www.urv.cat/es/estudios/grados/oferta/graudemedicina/  Faculty of Medicine and Health Sciences  125  12.182 
Catalonia-Universidad de Barcelona [U. of Barcelona]  https://www.ub.edu/portal/web/medicina-ciencies-salut/graus/-/ensenyament/detallEnsenyament/4798347  Faculty of Medicine  259  12.458 
Catalonia-Universitat Internacional de Catalunya [UIC Barcelona]  https://www.uic.es/en/studies-uic/health/bachelors-degree-medicine/curriculum  Faculty of Medicine  100   
Catalonia-Vic [U. of Vic]  https://www.uvic.cat/es/grado/medicina  Faculty of Medicine  80   
Extremadura-Badajoz-Universidad de Extremadura [U. of Extremadura]  https://www.unex.es/conoce-la-uex/centros/medicina  Faculty of Medicine  120  12.547 
Galicia-La Coruña- Santiago [U. of Santiago de Compostela]  https://www.usc.gal/es/centros/medodo/  Faculty of Medicine and Dentistry  360  12.408 
Madrid-Alcalá [U. of Alcalá]  http://medicinaycienciasdelasalud.uah.es/  Faculty of Medicine and Health Sciences  145  12.918 
Madrid-Alfonso X [Alfonso X el Sabio U.]  https://www.uax.es/grado-medicina.html  Health Sciences and Sport  132   
Madrid-Autónoma De Madrid [Autonomous U. of Madrid]  http://www.uam.es/Medicina/Home/1234890379763.htm  Faculty of Medicine  240  13.056 
Madrid-CEU San Pablo [CEU San Pablo U.]  https://www.uspceu.com/es/alumnos/facultad-medicina/presentacion/index.aspx  Faculty of Medicine  176   
Madrid-Complutense [Complutense U. of Madrid]  https://medicina.ucm.es/  Faculty of Medicine  295  13.044 
Madrid-Europea [European U. of Madrid]  https://universidadeuropea.es/madrid/titulacion/grado-medicina  Faculty of Medicine  220   
Madrid-Francisco de Vitoria [Francisco de Vitoria U.]  https://www.ufv.es/estudiar-en-ufv/titulaciones-de-grado/  Faculty of Medicine  120   
Madrid-Rey Juan Carlos [Rey Juan Carlos U.]  https://www.urjc.es/estudios/grado/596-medicina  Faculty of Medicine  150  12.794 
Murcia-Murcia [U. of Murcia]  https://www.um.es/web/medicina/contenido/estudios/grados/medicina/2019-20/guias  Faculty of Medicine  200  12.644 
Murcia-Católica San Antonio [San Antonio Catholic U. of Murcia]  https://www.ucam.edu/estudios/grados/medicina-presencial/plan-de-estudios  Faculty of Medicine  90   
Navarre-Navarra [U. of Navarre]  https://www.unav.edu/web/grado-en-medicina/plan-de-estudios  Faculty of Medicine  200   
Navarre-Universidad Publica de Navarra [Public U. of Navarre]  http://www.unavarra.es/fac-cienciasdelasalud  Faculty of Health Sciences  60  12.5 
Basque Country-País Vasco [U. of the Basque Country]  https://www.ehu.eus/es/grado-medicina  Faculty of Medicine  330  12.361 
Valencia-Castellón- Jaume I [Jaume I U.]  https://www.uji.es/estudis/oferta/base/graus/actual/medicina-p17/coneixer/organitzacioestudi/  Faculty of Medicine  80  12.37 
Valencia-Universidad Católica San Vicente Mártir [Valencia Catholic U. Saint Vincent Martyr]  https://www.ucv.es/oferta-academica/grados/grado-en-medicina/seccion/guias-docentes  Faculty of Medicine  120   
Valencia-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  https://www.uchceu.es/estudios/grado/medicine/plan-estudios  Faculty of Medicine  50   
Valencia-Castellón-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  https://www.uchceu.es/estudios/grado/medicine/plan-estudios  Faculty of Medicine  70   
Valencia-Alicante-Miguel Hernández [Miguel Hernández U.]  https://umh.es/contenido/Estudios/:asi_g_1956_M1/datos_es.html  Faculty of Medicine  130  12.59 
Valencia-Valencia [U. of Valencia]  https://www.uv.es/uvweb/universidad/es/estudios-grado/grau-1285846094474/Titulacio.html?id=1285847387054  Faculty of Medicine and Dentistry  320  12.509 
Total      7,171   

Table 4 details the beds theoretically available in hospitals per student studying in each faculty. The mean number of beds per student is 1.8, with a range from 0.2 beds at the Universidad de Navarra to 4.7 at CEU Cardenal Herrera – Castellón Campus.

Table 4.

Beds in hospitals associated with universities per undergraduate medical student.

University  Students  Associated hospitals and beds  Beds per student 
Andalusia-Cádiz [U. of Cádiz]  154  1,555  1.7 
Andalusia-Córdoba [U. of Córdoba]  130  1,233  1.6 
Andalusia-Granada [U. of Granada]  253  1,954  1.3 
Andalusia-Málaga [U. of Málaga]  160  1,706  1.8 
Andalusia-Sevilla [U. of Seville]  291  2,927  1.7 
Aragón-U. Zaragoza/Huesca [U. of Zaragoza, Huesca Campus]  224  2,020  1.5 
Asturias-U. de Oviedo [U. of Oviedo]  153  1,884  2.1 
Balearic Islands-U. de les Iles Baleares [U. of the Balearic I.]  60  1,258  3.5 
Canary Islands-La Laguna [U. of La Laguna]  130  1,892  2.4 
Canary Islands-Las Palmas [U. of Las Palmas de Gran Canaria]  135  1,744  2.2 
Cantabria-U. de Cantabria [U. of Cantabria]  119  1,224  1.7 
Castile-La Mancha-Albacete [U. of Castile-La Mancha, Albacete Campus]  140  705  0.8 
Castile-La Mancha-Ciudad Real [U. of Castile-La Mancha, Ciudad Real Campus]  60  564  1.6 
Castile and León-Salamanca [U. of Salamanca]  180  2,940  2.7 
Castile and León-Valladolid [U. of Valladolid]  180  1,878  1.7 
Catalonia-Barcelona-Autónoma de Barcelona [Autonomous U. of Barcelona]  320  3,336  1.7 
Catalonia-Girona [U. of Girona]  80  431  0.9 
Catalonia-Lleida [U. of Lleida]  110  692  1.0 
Catalonia-Barcelona-Pompeu Fabra [Pompeu Fabra U.]  60  470  1.3 
Catalonia-Tarragona- Reus- Rovira i Virgili [U. of Rovira i Virgili]  125  1,412  1.9 
Catalonia-Universidad de Barcelona [U. of Barcelona]  259  2,727  1.8 
Catalonia-Universitat Internacional de Catalunya [UIC Barcelona]  100  1,237  2.1 
Catalonia-Vic [U. of Vic]  80  572  1.2 
Extremadura-Badajoz-Universidad de Extremadura [U. of Extremadura]  120  1,435  2.0 
Galicia-La Coruña- Santiago [U. of Santiago de Compostela]  360  4,878  2.3 
Madrid-Alcalá [U. of Alcalá]  145  2,315  2.7 
Madrid-Alfonso X [Alfonso X el Sabio U.]  132  1,908  2.4 
Madrid-Autónoma De Madrid [Autonomous U. of Madrid]  240  3,234  2.2 
Madrid-CEU San Pablo [CEU San Pablo U.]  176  965  0.9 
Madrid-Complutense [Complutense U. of Madrid]  295  3,955  2.2 
Madrid-Europea [European U. of Madrid]  220  1,693  1.3 
Madrid-Francisco de Vitoria [Francisco de Vitoria U.]  120  2,476  3.4 
Madrid-Rey Juan Carlos [Rey Juan Carlos U.]  150  1,502  1.7 
Murcia-Murcia [U. of Murcia]  200  1,653  1.4 
Murcia-Católica San Antonio [San Antonio Catholic U. of Murcia]  90  1,990  3.7 
Navarre-Navarra [U. of Navarre]  200  241  0.2 
Navarre-Universidad Pública de Navarra  60  1,086  3.0 
Basque Country-País Vasco [U. of the Basque Country]  330  3,510  1.8 
Valencia-Castellón- Jaume I [Jaume I U.]  80  1,095  2.3 
Valencia-Universidad Católica San Vicente Mártir [Valencia Catholic U. Saint Vincent Martyr]  120  1,057  1.5 
Valencia-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  70  755  1.8 
Valencia-Castellón-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  50  1,398  4.7 
Valencia-Alicante-Miguel Hernández [Miguel Hernández U.]  130  2,195  2.8 
Valencia-Valencia [U. of Valencia]  320  2,667  1.4 
Total  7,111  78,369  1.8 

Table 5 shows the characteristics of the nephrology teaching staff at the various universities, indicating the type of lecturer. In all the medical schools both nephrology theory and practical seminars are taught by nephrologists. On occasion, (data not shown) the course coordination may include other subjects for which other specialists are responsible.

Table 5.

Lecturers teaching nephrology in universities with their category and current situation.

University  Full professor  Titular professor  Senior lecturer/Dr  Senior lecturer  Temp. senior lecturer  Adjunct lecturer  Emeritus 
Andalusia-Cádiz [U. of Cádiz]             
Andalusia-Córdoba [U. of Córdoba]       
Andalusia-Granada [U. of Granada]           
Andalusia-Málaga [U. of Málaga]           
Andalusia-Sevilla [U. of Seville]             
Aragón          10   
Asturias           
Baleares [U. of the Balearic I.]             
Canary Islands-La Laguna [U. of La Laguna]           
Canary Islands-Las Palmas [U. of Las Palmas de Gran Canaria]           
Cantabria-Santander [U. of Cantabria, Santander Campus]           
Castile-La Mancha-Albacete [U. of Castile-La Mancha, Albacete Campus]             
Castile-La Mancha-Ciudad Real [U. of Castile-La Mancha, Ciudad Real Campus]             
Castile and León-Salamanca [U. of Salamanca]           
Castile and León-Valladolid [U. of Valladolid]             
Catalonia-Autónoma de Barcelona [Autonomous U. of Barcelona]        11 
Catalonia-Girona [U. of Girona]             
Catalonia-Lleida [U. of Lleida]             
Catalonia-Pompeu Fabra [Pompeu Fabra U.]             
Catalonia-Reus Tarragona-Rovira i Virgili [U. of Rovira i Virgili]           
Catalonia-Universidad de Barcelona [U. of Barcelona]      12 
Catalonia-Universitat Internacional de Catalunya [UIC Barcelona]             
Catalonia-Vic [U. of Vic]         
Extremadura [U. of Extremadura]           
Galicia-Santiago [U. of Santiago de Compostela]             
Madrid-Alcalá [U. of Alcalá]        11   
Madrid-Alfonso X [Alfonso X el Sabio U.]             
Madrid-Autónoma De Madrid [Autonomous U. of Madrid]       
Madrid-CEU San Pablo [CEU San Pablo U.]           
Madrid-Complutense [Complutense U. of Madrid]        10   
Madrid-Europea [European U. of Madrid]          11   
Madrid-Francisco de Vitoria [Francisco de Vitoria U.]           
Madrid-Rey Juan Carlos [Rey Juan Carlos U.]             
Murcia [U. of Murcia]           
Murcia-Católica [San Antonio Catholic U. of Murcia]             
Navarra [U. of Navarre]         
Universidad Pública de Navarra [Public U. of Navarre]               
Basque Country-País Vasco [U. of the Basque Country]            12   
Valencia-Castellón             
Valencia-Universidad Católica San Vicente Mártir [Valencia Catholic U. Saint Vincent Martyr]             
Valencia-CEU Cardenal Herrera [CEU Cardenal Herrera U.]             
Valencia-CEU Cardenal Herrera-Castellón             
Valencia-Elche [U. Miguel Hernández, Elche]             
Valencia-Valencia [U. of Valencia]           
Totals  13  11  187 
Organisation and teaching content in nephrology

Table 6 shows the distribution of nephrology among the different medical schools, the year in which it is imparted and the overall number of credits for each subject. It also shows the distribution in hours for lectures and seminars, as well as assessment methods.

Table 6.

Analysis of course guides for courses including or relating to nephrology.

University  Year  Topics  Theory hours  Theory topics  Seminar hours  Seminar topics  Theory topic/seminar ratio  Total hours  Comments  Assessment 
Andalusia-Cádiz [U. of Cádiz]  Medical pathology of the nephro-urinary system, neurology and geriatrics  14  14  7.0  16  With urology, neurology and geriatrics  Practical tutor-assessment and multiple choice and/or short questions exam 
Andalusia-Córdoba [U. of Córdoba]  Module 1: Renal diseases, hypertension and hydroelectrolytic and acid–base balance disorders  12  12  6.0  14  Course with urology  Multiple choice exam and coursework assessment 
    Module 2: Urological and male reproductive system diseases                 
Andalusia-Granada [U. of Granada]    Pathology of the urinary system and infectious diseases, 8 credits  15  12  2.4  20  With urology and infectious diseases  Practical assessments. Multiple choice exam 
Andalusia-Málaga [U. of Málaga]  Diseases of the gastrointestinal and genito-urinary system  12  10  0.0  12  With urology and gastroenterology  Multiple choice exam 
Andalusia-Sevilla [U. of Seville]  Endocrinology, rheumatics, nephrology, infectious diseases  13  13  3.3  17  With various  Multiple choice exam 
Aragón-U. Zaragoza/Huesca [U. of Zaragoza, Huesca Campus]  Locomotor system and nephro-urology  1.6  13  With trauma, rheumatics and urology  Multiple choice exam 
Asturias-U. de Oviedo [U. of Oviedo]    Nephro-urological pathology  17  17  4.3  21  With urology  Multiple choice exam 
Balearic Islands-U. de les Iles Baleares [U. of the Balearic I.]  Medical/surgical: Urinary system  17  17  5.7  20  With urology  Assessment of practical work, seminars, coursework and multiple choice exam (50%) 
Canary Islands-La Laguna [U. of La Laguna]  Renal, urinary tract and male reproductive system pathology  12  12  0.0  12  With urology  Multiple choice exam 
Canary Islands-Las Palmas [U. of Las Palmas de Gran Canaria]  Diseases of the urinary and male reproductive system  23  17  4.3  28  With urology  Multiple choice exam with case studies (90%) and practical work (10%) 
Cantabria-U. de Cantabria [U. of Cantabria]    17  17  0.0  17  With endocrinology  Multiple choice (30%) and short questions (70%) exam 
Castile-La Mancha-Albacete [U. of Castile-La Mancha, Albacete Campus]  Nephro-urological pathologies  15  13  2.6  24  With urology  Practical assessment (30%) and theory 70% (modular and final exams) 
Castile-La Mancha-Ciudad Real [U. of Castile-La Mancha, Ciudad Real Campus]  Nephro-urological pathologies  15  13  2.6  24  With urology  Practical assessment (30%) and theory 70% (modular and final exams) 
Castile and León-Salamanca [U. of Salamanca]  Nephrology and urology  19  17  4.3  23  With urology  Multiple choice exam (50%) with open-ended questions (25%) and two case studies (25%) 
Castile and León-Valladolid [U. of Valladolid]  Medical/surgical pathology of the urinary system  13  12  0.0  13  With urology  Multiple choice exam (100%) 
Catalonia-Barcelona-Autónoma de Barcelona [Autonomous U. of Barcelona]  Medicine and surgery III (gastroenterology, nephro-urology and geriatrics)  13  12  3.0  17  With gastroenterology, urology and geriatrics  Assessment of practical (seminars 20% and practicals 10%) and theory work (70%) 
Catalonia-Girona [U. of Girona]  Intake, processing and elimination systems 3 Water, electrolytes and excretion  12  12  0.0  12  With urology  Multiple choice exam and case studies 
Catalonia-Lleida [U. of Lleida]  Cardiological and nephrological diseases  20  17  4.3  24  With cardiology   
Catalonia-Barcelona-Pompeu Fabra [Pompeu Fabra U.]  Medical/surgical pathology IV: nephrology, urology and infectious diseases  13  13  3.3  17  With urology and infectious diseases  Multiple choice exam (90%) and practical assessments (10%) 
Catalonia-Tarragona-Reus-Rovira i Virgili [U. of Rovira i Virgili]  Renal and urinary diseases  20  14  14.0  24  With urology  Multiple choice exam 
Catalonia-Universidad de Barcelona [U. of Barcelona]  Diseases of the renal system and male reproductive system  14  12  0.0  14  With urology  Practical work (care, portfolio and clinical evidence) and theory exam (60%) 
Catalonia-Universitat Internacional de Catalunya [UIC Barcelona]  Nephrology  14  14  2.3  20  Nephrology only  Multiple choice exam 
Catalonia-Vic [U. of Vic]  Intake processing and elimination systems III. Water, electrolytes and excretion  12  10  0.0  12  With urology  Group work (25%), participation (10%) and exam (65%) 
Extremadura-Badajoz-Universidad de Extremadura [U. of Extremadura]  Nephrology and urology  22  16  0.0  22  With urology  Assessment of practical work and seminars (10%) and multiple choice exam (90%) 
Galicia-La Coruña- Santiago [U. of Santiago de Compostela]  Renal and urinary diseases  23  18  9.0  25  With urology  Assessment of practical work (10%) and multiple choice exam (90%) 
Madrid-Alcalá [U. of Alcalá]  Medical pathology 2  12  12  2.4  17  With infectious diseases, rheumatology, haematology and endocrinology  Multiple choice exam 
Madrid-Alfonso X [Alfonso X el Sabio U.]  Medical/surgical pathology 2  24  18  6.0  28  With urology, endocrinology, neurology and neurosurgery  Continuous assessment (10%) and multiple choice exam (90%) 
Madrid-U. Autónoma de Madrid [Autonomous U. of Madrid]  Nephrology and urology  12  12  2.4  18  With urology  Continuous assessment (30%) and multiple choice exam (70%) 
Madrid-CEU San Pablo [CEU San Pablo U.]  Medical pathology IV  31  20  5.0  35  With neurology  Continuous assessment (10%) and theory/practical exam (90%) 
Madrid-Complutense [Complutense U. of Madrid]  Medical pathology 2  16  14  2.3  22  With infectious diseases, endocrinology and neurology  Theory exam (multiple choice or short questions) 
Madrid-U. Europea [European U. of Madrid]  Endocrinology and the nephro-urinary and reproductive system  14  14  0.0  14  With endocrinology and urology  Assessment of clinical skills (15%), practical work (35%) and objective evidence (50%) 
Madrid-Francisco de Vitoria [Francisco de Vitoria U.]  Medical/surgical pathology – Nephro-urinary system  12  11  11.0  14  With urology  Practical assessments (35%) and multiple choice exam (65%) 
Madrid-Rey Juan Carlos [Rey Juan Carlos U.]  Medical/surgical pathology of the genito-urinary system  19  16  5.3  23  With urology  Multiple choice and practical exam (not specified) 
Murcia-Murcia [U. of Murcia]  Urinary system (nephrology and urology)  20  14  0.0  20  With urology  Practical assessment (10%) and theory assessment with multiple choice exam and short questions (90%) 
Murcia-Católica San Antonio [San Antonio Catholic U. of Murcia]  Nephro-urology  15  15  0.0  15  With urology  Practical assessments (OSCE 10% and practical work 10%) and multiple choice exam (80%) 
Navarre-Navarra [U. of Navarre]  Nephrology-  27  18  9.0  30  Nephrology  Multiple choice exam 
Navarre-Universidad Pública de Navarra [Public U. of Navarre]  Nephro-urology          0.0  With urology   
Basque Country-País Vasco [U. of the Basque Country]  Medical pathology 1  11  10  10.0  12  With others  Assessment of seminars (15%), practical work (5%) and multiple choice exam (80%) 
Valencia-Castellón- U. Jaume I [Jaume I U.]  Cardio-circulatory and nephro-urological diseases  22  18  18.0  24  With cardiology and urology  Assessment with skills workshop (20%) and theory assessment with multiple choice exam and case studies (80%) 
Valencia-Universidad Católica San Vicente Mártir [Valencia Catholic U. Saint Vincent Martyr]  Medicine and surgery of the nephro-urinary system  19  17  0.0  19  With urology  Practical assessment (20%) and multiple choice and open-ended questions exam (80%) 
Valencia-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  Nephro-urology  22  14  7.0  24  With urology  Continuous assessment (OSCE, periodic assessment: 45%) and final exam (55%) 
Valencia-Castellón-CEU Cardenal Herrera [CEU Cardenal Herrera U.]  Pathology: nephro-urology  22  14  7.0  24  With urology  Continuous assessment (OSCE, periodic assessment: 45%) and final exam (55%) 
Valencia-Alicante-Miguel Hernández [Miguel Hernández U.]  Medical/surgical pathology of the urinary system  15  13  0.0  15  With urology  Practical assessments (20%), multiple choice exam (30%) and resolution of case studies (50%) 
Valencia-Valencia [U. of Valencia]  Nephrology and urology  11  10  2.5  17  With urology  Practical exam (50%) and theory exam with multiple choice questions and case studies (50%) 

The subject is taught between the third and fifth years of the degree, the median being the fourth year. The total number of hours (lectures and seminars) is very variable and oscillates between 12 up to 35 h at CEU de Madrid, with a median of 18.5 h (Fig. 4). This variability is seen in both the number of topics (range 8–20, median 14) and the number of seminars (range 0–9, median 2) (Figs. 5 and 6). The highest number of seminars corresponds to the Universidad Complutense and the Internacional University of Catalunya. Thirteeen (31%) of medical schools do not include seminars. Among those who include seminars, the ratio of number of lecture topics/seminars varies between 1.6 and 18, with a median of 4.25 (Fig. 7).

Fig. 4.

Total number of hours of theory lectures and seminars in medical schools.

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Fig. 5.

Number of theory topics timparted in the different medical schools.

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Fig. 6.

Number of seminars taught in medical schools.

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Fig. 7.

Number of theory topics/seminars ratio in medical schools.

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Supplementary Table S2 details the hours dedicated to theory teaching (both lectures and seminars) in the different universities, as well as the specific topics imparted.

The theory topics presented are very variable (Fig. 8), and although it is to be hoped that the main topics are included in all universities, the distribution of lectures topics and seminars is variable, as are the titles and descriptions under which they are included. The most common topics are chronic kidney disease, acute kidney injury, chronic tubulointerstitial nephropathies, glomerulonephritis, systemic autoimmune diseases, renal vascular diseases and hydroelectrolytic disorders and acid–base status. With regard to seminars, the most commonly taught were on acute kidney injury, nephrotic syndrome and hydroelectrolytic disorders and acid–base status (Fig. 9).

Fig. 8.

Distribution of theory topics among the different medical schools.

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Fig. 9.

Distribution of seminars among the different faculties of medicine.

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Nephrology is usually integrated with another broader subject and only in the Universidad de Navarra is it an independent course, with three credits. The field most commonly combined with nephrology is urology, although it was also combined with endocrinology, infectious diseases, rheumatology, neurology, the digestive system, cardiology, haematology, geriatrics, and even traumatology and neurosurgery (Fig. 10). Assessment often includes a practical part and another part assessing theory knowledge. In almost all cases the test are multiple-choice questions, and many medical schools also use teststhat includes short questions and/or case studies.

Fig. 10.

Combination of nephrology with other subjects in the degree in medicine.

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Finally, Table 7 shows the number of nephrologists in each autonomous community working for the National Health System, the percentage of men and women and the ratio per 100,000 inhabitants. In our country, there is an acceptable number of nephrologists within the National Health System; the ratio of nephrologists per 100,000 inhabitants ranges from 1.38 in Cantabria to 3.68 in Catalonia. We have also observed that there are more women than men in almost all autonomous communities. In the some community the ratio is lower, but they also have more nephrologists working in private hospitals.

Table 7.

Nephrologists working for the national Health System in each autonomous community.

Autonomous community  Nephrologists  % Female  % Male  % Over age 50  Nephrologists/100,000 inhabitants ratio 
Andalusia  174  64.4  35.6  37.9  2.07 
Aragón  40  52.5  47.5  50  3.04 
Asturias  29  48.3  51.7  41.4  2.82 
Balearic Islands  33  60.6  39.4  36.4  2.84 
Canary Islands  68  63.2  36.8  39.7  3.14 
Cantabria  50  50  1.38 
Castile-La Mancha  55  69.1  30.9  40  2.70 
Castile and León  80  58.8  41.2  42.5  3.30 
Catalonia  274  58.4  41.6  49.3  3.68 
Extremadura  31  51.6  48.4  29  2.89 
Galicia  71  59.2  40.8  46.5  2.77 
Madrid  172  65.7  34.3  34.3  3.17 
Murcia  43  74.4  25.6  44.2  2.92 
Navarre, Chartered Community of  11  72.7  27.3  18.2  1.72 
Basque Country  57  64.9  35.1  40.4  2.63 
Valencian Community  92  54.3  45.7  38  2.29 
La Rioja  11  54.5  45.5  54.5  3.52 
Ceuta and Melilla  100  50  2.35 
Total  1,253         
Discussion

This is the first study on the situation of nephrology teaching in our country since the degree in medicine was standardised according to the Bologna process.

We have observed that there are differences between the various autonomous communities with regard to the number of nephrologists working in the National Health System, and we have also noted the growing female presence and the high proportion of nephrologists under 50 years of age.

One important fact should be highlighted, the grade requirements to be admitted in medicine at public universities continue to be very high, reflecting the attractiveness of the medical profession among young students. This is a situation that repeats year after year and it is a privilege for lecturers to have students with an excellent cognitive profile on entry to our institutions.

Our study brings to light that numerous healthcare institutions are available to students during their training. We have not been able to analyse in detail the availability of health centres or other primary or specific care facilities. The number of beds per student is very heterogeneous varying between 0.2 and 4.7 beds and it is related to the number and type of hospitals associated with the medical schools. Although the number of beds can be used as a guide, our study has not been able to analyse other teaching environments that are also very useful for training, such as outpatient clinics or special units (such as peritoneal dialysis, haemodialysis, interventional nephrology, imaging techniques, etc.). Without doubt, these other alternatives make a decisive contribution to training as they enable the student to come into contact with patients with very diverse pathologies. We also feel that in order to optimise practical training, it has to be organised appropriately, taking into account the periods of rotation through healthcare institutions of the various year groups in each medical school.

With regard to teaching staff, we note the low number of tenured professors or those with a stable connection with the university. Full professors and titular professors represent only 13% of the lecturers. Just 16 medical schools have either full or titular professors, two universities from Cataluña have senior lecturers and eight universities have PhD professors. Therefore it is necessary to have a significant number of associate professors to provide an additional theaching activity which includes lectures and patients care teaching. Moreover, it has been observed that during last three years six professors (full and titular) became emeritus professors. Of the 10 current full professors, seven plan to retire before 2025, and of the 12 titular professors, five plan to do so by the same date. Ultimately, a majority of the tenured professors are over 55 years of age. On the other hand, the distribution of these professors is heterogeneous and they are concentrated fundamentally in universities in Madrid, Catalonia and Andalusia.

Some communities have created the role of senior lecturer for physicians with the PhD degree, which may help to alleviate the situation of the limited number of lectures. It requires accreditation from ANECA or the equivalent organism in the autonomous community; this accreditation is currently less rigorous than that for a titular professor. In Catalonia, there is also the role of senior lecturer with a stable relationship with the university.

Although the role of adjunct professors is undeniable, we believe that the work requested is too much relative to the amount being paid, which in some cases does not cover for the months of the summer. We want to call attention to this aspect, which is a clear weakness in our teaching system. On the other hand, it is important to note that sometimes the selection of adjunct lecturers is modern criteria and at times it lacks transparency. Finally, although the ideal would be for all of them to have the PhD degree this is often not the case.

The proposal of the SEN University Group is to take actions to strengthen cooperative research between groups to improve the research curriculum vitae of its members since the weakness of the applicants in the ANECA accreditation system is often research. In addition, we propose the creation of an advisory committee within the group that would provide information and assistance to nephrologists for eventual accreditation within current institutions (such as ANECA at the national level or the responsible agencies in the autonomous community) as either senior lecturer with the title of Doctor or titular professor, as well as boosting training in the educational skills that are so important in the teaching of medicine.

Our study has also revealed other relevant aspects. One of the most significant has been the observation of the heterogeneity of the content imparted at the various universities. Based on an exhaustive review of course guides, all students on medicine degrees have contact with nephrology during practical training. However, it is surprising the large disparity in terms of the year in which the subject is taught (predominantly the fourth), its combination with other specialties (with urology in most medical schools) and the distribution of theory teaching (both theory classes and seminars). This situation goes against the aims of the Bologna process, which was to facilitate the mobility of students between universities. The traditions of the universities and their independence when designing teaching programmes, guides and courses has contributed to this reality. Theory syllabi and seminars are completely heterogeneous and although they contain, as they must, the principal nephrology topics, each institution does things differently. We feel that attempting to standardise course guides in our country is not a task for the SEN University group, since nephrology is locked into other courses, including in relatively rigid teaching plans. We propose a different plan; the generation of common teaching materials that can be freely used by lecturers, junior doctors and students, taking into account the experience of other countries as well as new clinical practice models based on the ageing of the population, the growing presence of comorbidities and interaction with primary care.

We were also surprised by the different methods of assessment of knowledge. Our proposal would not be to use identical assessments, but rather sharing experiences of practical assessment (such as the use of similar portfolios by agreement, use of the miniCEX, skills workshops, assessment with case studies, OSCEs, etc.) or provide the posibliity to hava access to series of common questions that can be used by all lecturers if they wish. Lastly, it is important to encourage our students to learn nephrology and to apply this knowledge as junior doctors and throughout their career.

Finally, we would not want to miss the opportunity to point out that the way of teaching in general and medicine in particular is changing at an accelerated pace.14,15 The incorporation of simulation-based teaching and online methods more generally in our medical schools is a fascinating challenge, even more so since we’ve found ourselves in the current healthcare crisis in 2020. Although these methods are not a panacea, as physicians also need to learn attitudes and values relating to communication, teamwork and ethical aspects, among others, we have no doubt that technology today will lead us to change many things, including how we teach. There are many teaching experiences we can make use of that will help our students to understand the complexity of nephrology. It is essential to be able to transmit our passion for the specialty, with strategies that have been successful in other countries that highlight the value of care for patients with chronic kidney disease, our capacity to understand their personal and social problems associated with chronic disease, our enthusiasm when evaluating the lab work alterations, haemodialysis and peritoneal dialysis techniques, the assessment of kidney biopsies, the general incorporation of diagnostic techniques such as ultrasound, and the multitude of opportunities within our reach.16,17 In today’s world, we cannot forget the possibilities offered by technology, and in particular social networks; the use of videos, podcasts, blogs, webinars and others is revolutionising teaching at all levels and nephrology must not be left on the sidelines, as has already been pointed out by many authors.18–21

Moreover, our students are also demanding that we teach them other, not strictly scientific, aspects of medicine and nephrology, such as training in bioethics, skills for communicating with patients and how to manage the emotional burden of clinical practice.22 Our patients always offer us this opportunity, since they suffer from chronic diseases and frequently with have to deal with ethical problems relating to their diagnosis and treatment. Moreover, our specialty has also been characterised since its origins by its tendency to overlap with other specialties to decide strategic planning of patient management, such as patient safety, organisation of material and human resources, disease prevention and other aspects that are becoming more important in the work of tomorrow’s physicians.

From the S.E.N. University group, we can give an important boost to these new forms with standardised teaching materials for the whole country, created by nephrologists with expertise on each topic, using case studies for students, creating OSCE designs with patients, assisting one-another in the design and preparation of our students’ theses, etc. Ultimately, fulfilling our ethical obligation to teach students, and by extension junior doctors and nephrology colleagues, with activities and materials that should not be limited to the academic sphere, but should transcend even our specialty to be used by other professionals in primary or specialist care.

Finally, our society should continue to have an open attitude towards these new ways of teaching, incorporating all useful innovations that might improve the training of students, junior doctors and nephrologists.

Funding

This study has received no specific funding from public, private or non-profit organisations.

Conflicts of interest

The authors have no conflicts of interest to declare.

Acknowledgements

We would like to thank all the members of the S.E.N. for their cooperation in providing information on their situation with respect to teaching, as well as the invaluable assistance of the SEN’s secretaries, and the assistance provided by the National Conference of Deans of Spanish medical schools and by medicine students through the State Council of Medical Students (Consejo Estatal de Estudiantes de Medicina).

Our particular recognition goes to Dr Alberto Tejedor Jorge and his family, who has been a constant example since his time as a student, junior doctor, specialist and university lecturer for many generations of junior doctors and students, and who from the start has been an indispensable mentor and coordinator for the S.E.N. University group.

Appendix A
Members of the S.E.N. University Group

Manuel Arias Rodríguez, Aleix Cases Amenós, Gabriel de Arriba, Carmen Díaz Corte, Mario Espinosa Hernández, Josep María Galcerán Gui, Nuria García Fernández, Emilio González Parra, Pedro Ramón Gutiérrez Hernández, Pedro Antonio López Cillero, Alejandro Martín Malo, Alberto Ortiz Arduán, Antonio Osuna Ortega, Javier Pérez Contreras, María Dolores del Pino y Pino, José Ramón Pons Prades, José Carlos Rodríguez Pérez, Mariano Rodríguez Portillo, Diego Rodríguez-Puyol, Ana Sánchez Fructuoso, Mercedes Salgueira Lazo, Rafael Santamaría Olmo, Ramón Saracho, Patricia de Sequera Ortiz, Alberto Tejedor Jorge.

Appendix B
Supplementary data

The following are Supplementary data to this article:

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Please cite this article as: de Arriba G, Ortiz Arduán A, Rodríguez Pérez JC, Tejedor Jorge A, Santamaría Olmo R, Rodríguez Portillo M. La docencia de la nefrología en el grado de medicina. Nefrologia. 2020. https://doi.org/10.1016/j.nefro.2020.09.007

Copyright © 2020. Sociedad Española de Nefrología
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