Doctors and deans propose changing access to medical schools in Catalonia

BarcelonaIn Spain, universities operate under a "single district" system: regulations allow students to access any university in the country, regardless of the autonomous community to which the institution belongs or where the applicant completed their secondary education and university entrance exams. However, some sectors have long argued that this homogeneity creates inequalities among Catalan students. One example is medicine, where in recent years there has been an increase in the percentage of students from other regions enrolling in Catalan medical schools. Now, the Council of the College of Physicians of Catalonia (CCMC) and some deans of medical schools have submitted a proposal to the Catalan Government to modify the admissions process for this degree and thus "guarantee fair and equitable access."

Broadly speaking, the proposal that doctors and deans submitted a few months ago to the Ministry of Research and Universities and to President Salvador Illa suggests that university entrance exam scores be ranked by percentiles within each autonomous community before comparing students at the national level. They argue that this would promote more equitable access without having to abandon the single admissions district.

To understand why the doctors and deans have gone so far as to propose a change in university access, it is necessary to look at several facts. The first is that last year Four out of ten students who enrolled in medicine at a Catalan faculty were from outside Catalonia"In 2000, 100% of students at Catalan medical schools resided in Catalonia, but with the implementation of the single district system, this has gradually changed to the point that now 45% of students are from outside the region," explains Dr. Josep Vilaplana, president of the Girona Medical Association and one of the driving forces behind the proposed change. Vilaplana details that this means only 60% of students who take the MIR (Medical Residency Exam) live in Catalonia, and therefore, the remaining places are filled by students from elsewhere. "It's a vicious cycle that ultimately leads to a shortage of specialists in Catalonia. Studies show that 68% of students who reside in Catalonia and take the MIR end up working here, while only 9% of those who reside outside Catalonia end up working here," the doctor emphasizes. Beyond the shortage of doctors, the College of Physicians also warns that the differences in the proportion of students achieving excellent grades on university entrance exams across the various regions ultimately create unfair inequalities between students from different areas. "There are different exams, different grading methods, different curricula... If you implement a single district system, everyone is judged by their score, leading to bias," criticizes Vilaplana. In fact, according to data from the Ministry of Science, Innovation and Universities, in the 2024 entrance exams for medical degrees, 7% of students in Catalonia achieved excellent grades, while in other regions this proportion soared to 20%, as in Murcia; to 17% in Extremadura and Asturias; and to 14% in Madrid. "We must assume that intelligence is statistically distributed across all autonomous communities; therefore, these differences should compensate for each other," explains the president of the Girona Medical Association.

Faced with all these distortions, the College of Physicians asked mathematicians Xavier Fernández-Real and Xavier Ros-Oton to devise a way to equalize access to medical school for students across the country, which is the proposal they have now submitted to the Government. The two mathematicians propose the following: first, ranking students by grade in each region, and then calculating the percentile. This involves dividing the student's ranking in their region by the total number of students on the list and multiplying the result by 100. Once the percentile is calculated, it reduces the biases that could arise from differences in how students are evaluated in each region. According to Vilaplana, when they presented the proposal, "the Government liked it," but he laments that "as always, this is an issue that depends on Madrid." So far, the Ministry of Research and Universities has not issued any assessment.

A district of Catalonia

This Tuesday, Junts per Catalunya presented a bill in Congress to establish a separate university district in Catalonia. According to the party, the goal is for Catalonia to exercise "powers regarding universities, access, admission, and the organization of the university system." The party, led by Carles Puigdemont, maintains that the proposal does not seek "under any circumstances" to create a closed district or exclude students from other regions, although they cite the situation in medical degrees as an example to justify the proposal. "Catalonia trains excellent professionals, for example, in the field of medicine, but, conversely, it lacks doctors. This is one of the effects that the single university district has generated, and which we want to reverse by restoring our own university district," argued Josep Pagès, a member of parliament for Junts per Catalunya. In this regard, the Junts party warns that there is a certain inequality in the level of rigor of the education system in each autonomous community, which ends up generating "an effect that is very detrimental to the right of Catalan students to access Catalan universities." The proposed law also alleges a linguistic conflict. According to Junts, the unique position of the Catalan language in university faculties "is erased" by the national regulations governing university access. Thus, they assert that a separate district would allow for "the natural and non-conflictive integration of the Catalan language as a central pillar of the university system" and guarantee "its effective presence" in access, teaching, and academic life.