Among young doctors, the most remunerative specialities win out. A European comparison

The MIR system remains the main channel of access to medical specialisations in Spain, with more than 9,000 places allocated each year. In 2025, all available positions have been filled and, from 2026, the new specialisation in Emergency-Urgency Medicine will also enter.

For the tenth year running, dermatology is confirmed as the most sought-after specialisation, sold out on the first day of allocation, followed by plastic surgery, ophthalmology and maxillo-facial surgery. Driving the choices, according to the MIR Association, are above all the working conditions: no night guards, more predictable working hours and the possibility of private practice. A trend that reflects an increasing focus on the balance between professional and personal life.

In Bulgaria, the preferences of young doctors reflect strong historical disparities in the financing of the healthcare system. The most lucrative specialisations - cardiology, surgery, gastroenterology and gynaecology - remain well-preserved, while others suffer from chronic shortages.

Over the last few years, however, the attractiveness of paediatrics has been growing, and it is now the first choice among new graduates of Sofia University, also driven by new hospital investments. On the other hand, interest in anaesthesia and resuscitation has fallen sharply. Positive signs are emerging on the 'brain drain' front: the proportion of young doctors intending to stay in the country is increasing, although the main demands remain higher salaries, better management and modern technological equipment.

In France, the specialisations most in demand in 2024-2025 are plastic surgery, ophthalmology, dermatology, maxillofacial surgery and cardiology. The choices fluctuate from year to year, but factors related to flexibility, technical content and economic prospects remain central.

Alongside the highly attractive 'classic' specialities, areas such as medical biology and occupational medicine also register a sustained demand, signalling a more diversified system than in other European countries.

In Romania, the specialisation competition shows a strong polarisation. Among the candidates with the highest scores, cardiology is clearly the first choice, followed by radiology, neurology and psychiatry.

What is striking, however, is the rise of specialities related to aesthetic medicine: dermatovenerology and plastic surgery were among the first to run out of available places, although with lower absolute numbers than other disciplines. On the other hand, general surgery, anaesthesia and family medicine remain unattractive, despite the high demand. A sign of 'defensive medicine' and the search for professional paths perceived as less burdensome.

In Austria, the distribution of specialisations reflects a more traditional structure: general medicine is by far the most represented, followed by internal medicine and anaesthesia-resuscitation.

The most popular specialities also include gynaecology, general surgery, paediatrics, radiology and orthopaedics. The picture paints a picture of a system in which primary care maintains a central role, also in numerical terms.

In Ireland, general practice remains the most sought-after specialisation, especially in rural areas, where the health system struggles to fill permanent posts. Alongside traditional specialist training paths, however, there is a growing use of so-called locums, doctors hired temporarily to cover shifts or staff shortages in hospitals.

Another growing phenomenon is that of doctors working outside recognised specialisation routes: professionals who accumulate clinical experience but without a structured pathway leading automatically to the title of specialist. Over the last ten years, this component has grown faster than that of junior doctors.

The result is a system that is more flexible in the short term, capable of responding to personnel emergencies, but also more fragile in the long term, because it makes the path to a stable specialist career less linear and less attractive.

In Lithuania, dermatology and cardiology are among the most competitive specialisations, especially at the universities of Vilnius and Kaunas. Family medicine remains very popular, but the country faces a structural shortage of doctors that will worsen by 2030, particularly in emergency, internal medicine and paediatrics.

The fact that some trainees have to self-finance their studies still weighs heavily, an anomaly in the European context that drives some young doctors to emigrate. The government has initiated investment plans to attract and retain professionals, but the deficit remains significant.

* This article is part of the European collaborative journalism project 'Pulse' and was contributed by Andrea Muñoz Marín (El Confidencial, Spain), Martina Bozukova (Mediapool.bg, Bulgaria), Alina Neagu (HotNews, Romania), Kim Son Hoang (Der Standard, Austria), Noel Baker (The Journal, Ireland), Lina Kocienė (ELTA, Lithuania).