The selection of Médico Interno Residente (MIR) positions (specialty and training center) for the 2024-2025 cycle is approaching, and medical residents are beginning to weigh their options. Many factors influence specialty choice — not only vocation but also job stability, the community, and the hospital. However, for newer generations, factors beyond professional considerations are increasingly important, particularly the ability to balance work and personal life.

To find out how residents feel about this issue, we at El Médico Interactivo, part of the Medscape Professional network, spoke with Julissa E. Guerrero , treasurer of Asociación MIR España, (the Spanish association representing medical residents).

“There is broad agreement among future residents,” Guerrero said. According to the residents themselves, “specialties such as dermatology, ophthalmology, endocrinology, clinical pharmacology, and occupational medicine are often seen as ‘better’ for work-life balance and higher quality of life.” The reason is that these specialties are generally perceived to involve fewer on-call shifts or only on-call duties during residency, more stable schedules and fewer unpredictable emergencies. “If we look at the statistics, in recent years those who choose their specialties first tend to opt for specialties like dermatology, for example.”

At the opposite end are specialties such as anesthesiology, internal medicine, family and community medicine, emergency medicine, general surgery, and intensive care. Here the problem is workload, the number of on-call shifts and, above all, the lack of predictability. There are days when you simply don’t know what time you’ll get off, and that matters a lot when you’re thinking about life outside the hospital.

Does Work-Life Balance Influence Specialty Choice?

On whether this factor really influences specialty choice, Guerrero is clear: “Yes, and increasingly so. Vocation remains key, but it is no longer the only factor.”

The current generation is very aware of the toll residency and practice can take and wants to avoid sustained overload.

It is worth noting that, according to the data from the IKERBURN study, “From vocation to burnout,” presented this year by Spanish Medical Colleges Organization(Spain’s national medical association), 93.9% of young physicians show symptoms compatible with professional exhaustion and more than 50% meet full-burnout criteria on the Maslach Burnout Inventory-Human Services Survey. The study also found that although all specialties show significant prevalence, burnout was higher in surgical specialties and in urgent hospital care.

“Residency lasts 4 or 5 years, but when you finish, you will practice that specialty for your entire professional life,” Guerrero stressed. “No one chooses a specialty solely to ‘live better,’ but people do try to find a balance.”

Work-Life Balance for Men and Women

Another important shift among newer generations is that the concept of work-life balance used to be more closely associated with women — particularly with motherhood. Today, however, spending time with family or simply having space for private life transcends gender.

“Before, it seemed like a concern more associated with women, but that has changed a lot. Nowadays both men and women value time outside work. Before anything else, doctors are people and workers, and like any other group, we want to be able to reconcile our work and personal lives,” Guerrero insisted. “Even so, it’s true that certain differences still exist due to social factors, but the trend is clear: work-life balance matters to everyone.”

An Underlying Problem

Beyond choosing one specialty or another, Guerrero reflects that this is not a trivial issue but one with deep roots. She said “It shouldn’t depend on which specialty you choose but on how the system is organized. First and foremost, this requires rethinking the current model. It is not reasonable for hospitals to have the same person string together what in practice are three consecutive shifts — even if in theory they’re called on-call duties — without a real subsequent rest period. Meanwhile, we see colleagues who have shifts with real rest, as it should be for everyone. This leads us to work more hours than any other worker in the health system.”

According to Guerrero, the consequences are evident: the quality of care patients receive suffers and, above all, residents’ physical and mental health are harmed. “If this isn’t improved, people will end up avoiding certain specialties, not because of lack of interest but because of the conditions during residency and later as attending physicians. That is, in the medium term, it will be a serious problem for the system,” she concluded. Work-life balance should not be a luxury; it should be a basic right.

This story was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.