Guillermo Martín Carballo, Vice President of Primary Care of the AEP.
The Spanish Association of Pediatrics (AEP) calls for the creation of a total of 19 Specific Training Areas (ACE) to ensure the correct subspecialization of its professionals. Such is the need for these specialists who have recently published a White book in which they establish the 19 pediatric ACEs that they consider “essential”, a copy that the AEP has presented to the Ministry of Health. For this reason, paediatricians have been caught by surprise by the Government’s decision to not having an ACE for Primary Care and assure that “politicians are wrong and, as always, they look at the short term and not the long term”, underlines Guillermo Martín CarballoVice President of Primary Care of the AEP, to Medical Writing. A discomfort that has increased at the news that “Health wants to recognize two very specific ACEs: Neonatology and pediatric intensive care“, as they have been able to know from the AEP.
As Martín Carballo points out, “each and every one of the 19 pediatric ACEs they have to be recognized, for the safety of the children, since they are all necessary and equal”. He also adds that “for the AEP, a pediatrician who does Neonatology or Intensive Care is of no more value than one who does Endocrinology or Hospital Internal Pediatrics, for example”. According to Martín Carballo, this refusal to recognize a Pediatric Primary Care ACE gives rise to “creating first and second class pediatricians, which will lead to total disaster”. And if, currently, “there are few paediatricians in Primary Care, after this there will be almost no one”, fears Martín Carballo.
The pediatrician recalled that “in the last OPE called in Madrid, the Ministry has taken out the Hospital Care places outlined for the specialties of Neonatology and Pediatric Intensive Care. So, in a way, they recognize that kids need specialists too to be treated depending on the pathology they suffer from, but we do not agree that some are recognized and others are not”.
“If the Primary does not work, everything falls into a cascade, including hospital Pediatrics”
In addition, Martín Carballo highlights that “Recognizing pediatric ACE in Primary Care is necessary since the pediatricians who represent the hospital specialties recognized at the last AEP Congress that the situation experienced by Pediatric Primary Care is already having repercussions at the hospital level”. What these specialists observe is that “children are sent to hospitals when it shouldn’t, which makes waiting lists collapse; and also, on many occasions, they send minors to the hospital later than they should to deal with certain pathologies“. To all this, according to Martín Carballo, is added the fact that “emergencies are also experiencing an increase in visits by minors.” In this regard, the pediatrician points out that “if the Primary does not work, everything falls into a cascade, including the hospital pediatrics“.
A situation in which “the minister Carolina Darias is not aware since, just two days after sending the White book of the pediatric ACE of the AEP, recognizes that it is not going to test the Primary Care ACE“.
More Primary Care training in the Pediatric MIR
The White Book that the AEP has already published includes a total of 19 pediatric ACEswhich “must be approved and recognized all together because they are all important and have their different training pathways“, adds Martín Carballo. This, for the pediatrician, is necessary since “there must be pediatric specialties just like there are in adults, that is, if an adult has the right to be seen by a cardiologist or a urologist, the child has it too.”
Something that also happens “in Primary Care, since they are as specialized as the others.” Also, as Martín Carballo emphasizes, “the other specialists are focused on the hospital and do not know as much about what Pediatrics is in general, such as everything that concerns vaccines or community carefor instance”.
For Martín Carballo, paediatricians also have another limitation that makes it difficult for them to expand their training in Primary and that is that “in the MIR, when they are trained, they do so much at the hospital level that a lot of Primary Care trainingwhich implies that for Primara anyone is worth it and it is not like that”.
The 19 ACE that Pediatrics requests from Health
In the White Paper published by the AEP, the following are specified: 19 pediatric ACEs:
Primary / Outpatient Care
Inborn errors of metabolism
Gastroenterology, Hepatology and Nutrition
Clinical Immunology and Allergology
Hospital Internal Pediatrics
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