Medical graduates per 100,000 population, 2021: 14.2
Nursing graduates per 100,000 population, 2021: 23.0
Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.
“The number of doctors per 1,000 population in Spain is slightly above the EU average (see Section 4), but the distribution of physicians and nurses has persistently varied across ACs. Across the ACs in 2020, the number of primary care physicians ranged from 0.6 to 1.1 per 1 000 population while the number of primary care nurses ranged from 0.5 to 0.9 per 1 000. The number of specialist doctors varied from 1.5 to 2.6 per 1,000 population, and the number of specialist nurses ranged from 3.0 to 6.9 per 1 000.
“While in certain areas of the country (i.e. urban areas), filling vacancies for healthcare worker posts is rather easy, there are challenges in filling gaps for some specialist areas in Spain: family medicine, anaesthesiology, geriatrics, radiology and psychiatry have been identified as specialisations with the largest shortages and greatest future need. In 2023, for the first time, positions for specialists in child and adolescent psychiatry were offered in the Medical Internship Programme (MIR) training system – the nationwide specialisation programme, which provides entitlement to practise in the SNS. To address shortages, the government increased the number of vacancies in the MIR.”
Source: OECD/European Observatory on Health Systems and Policies (2023), Spain: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
“The number of physicians in Spain exceeds the EU average (see Section 4), but there are worrying trends in the health workforce. Both the rate of medical graduates (14.2 per 100,000 population) and the rate of nursing graduates (23 per 100,000) in Spain were below EU averages in 2021 (17.5 per 100,000 medical graduates and 44.3 per 100,000 nursing graduates) (Figure 19). However, nursing assistants are not included in these figures, so this under-estimates the number of new graduates from nursing-related programmes. Following a continuous decline between 2014 and 2018, the rate of nursing graduates in Spain has slightly risen from 2019 onwards. As the population ages and the burden of chronic conditions continues to grow (see Section 2), there are threats of shortages, particularly of nurses and specialist practitioners nationwide, and of GPs and paediatricians in remote areas of the country.
“The share of temporary employment contracts has contributed to healthcare staffing challenges.
“In the SNS, the issuing of temporary contracts increased from 28.5 % in 2012 to 41.9 % in 2020. In efforts to reverse this trend, in July 2022, the government took measures to reduce temporary employment in the SNS through a process – the largest in the history of the system – leading to the employment of 80,000 health professionals. This process also provides a new legal framework that places limits on temporary work through modification of the Framework Statute for Health Personnel.Specific measures to address shortages in certain medical specialities include increased vacancies in the MIR specialisation programme and in nurse training places (see Section 5.2).”
Source: OECD/European Observatory on Health Systems and Policies (2023), Spain: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
“Since 2010, a significant change of health personnel training was debated and has materialized in the RD 639/2014, affecting postgraduate medical internship programmes and regulating nurses’ specialization. Unlike the current system, with 46 medical specialties having separate medical internship programmes, the reform sought to establish a common 2-year training programme for postgraduate trainees before splitting into subspecialties for most of the medical specialties. This reform aimed to provide a common holistic base of knowledge for all health professionals in a way that improves their response to their patients’ complexity, mitigating care fragmentation and overcoming the current silo mentality that impedes flexibility in human resources management. The reform raised much controversy as some medical specialties were strongly opposed to entering the core modules of the medical or surgical specialties. The reform process has ended up in the courts of justice with a Supreme Court ruling declaring the RD 639/2014 void, leaving the current previous legislation in place (see section 5.2 in GarcíaArmesto et al., 2010).”
Source: Bernal-Delgado E, García-Armesto S, Oliva J, Sánchez Martínez FI, Repullo JR, PeñaLongobardo LM, Ridao-López M, Hernández-Quevedo C. Spain: Health system review. Health Systems in Transition, 2018;20(2):1–179.
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Page last updated March 6, 2025 by Doug McVay, Editor.