Las subespecialidades médicas en Chile: situación actual / Medical subspecialties in Chile: current status

RESUMEN

There is no reliable registry of medical subspecialties in Chile. According to the records of the Autonomous National Corporation for Certification of Medical Specialties (CONACEM), the largest number of certifications is in internal medicine (n=681), followed by cardiology (n=153), respiratory medicine (n=106), gastroenterology (n=93), endocrinology (n=77), rheumatology (n=55), hematology (n=50), nephrology (n=50), and infectious diseases (n=31). Over 55 percent of those certified in internal medicine and 70 percent of those certified in medical subspecialties (except nephrology) live in the metropolitan region of Santiago. Almost 80 percent of university-trained internists have received their training at the University of Chile (1952-1995), whereas 52 percent of university-trained subspecialists have been trained at the Catholic University of Chile. A sizeable number of non official training programs are conducted at some universities at variance with their own official training policies. In internal medicine, a larger number of specialists have been trained by the universities that are certified by CONACEM, whereas the converse is true for medical subspecialists. More than 80 percent of the internists in Chile work for the Ministry of Health, who cares for 70 percent of the country's population. The best internist population ratio is in Arica and Valdivia and the poorest one in Arauco and in Viña del Mar/Quillota. According to estimations done by the Santiago Medical Society and its subspecialty affiliate societies, an adequate proportion of internists would be 1 for every 10.000 inhabitants and for subspecialists, 1 for every 100.000 inhabitants. More information is needed about the ideal distribution throughout the country. CONACEM needs to be strengthened, the universities should be able to certify non-university training centers and the migration of subspecialists out of Santiago should be encouraged