Talent: A Long Road With a Near Horizon

The historical fragmentation of the Mexican health system, the epidemiological change impacting the country, the emergence of cutting-edge technology, the gradual digitalization of processes and the aging of the population have highlighted a glaring gap in the country’s health services: talent

As Mexico grapples with a fragmented health system that is struggling to serve the medical needs of the population, the private sector, the public sector, academia, even patients and users, are not oblivious to that singular reality that Mexico needs to train, attract and retain the talent necessary to continue meeting health-related objectives.

The health industry is changing rapidly, with the digitalization of processes, the modernization of medical services, ambitions to rise up the clinical research chain, the emergence of new drugs and the creation of stateof-the-art medical devices. Both academia and the public and private sectors need to keep pace by providing the educational plans and training programs that will supply the skilled talent the sector increasingly requires.

“The market evolves faster than the higher education centers that guide students in various lines of study or specialization. It is true that the health industry requires new skills, but there are not enough people who can offer them. The sectors that pay the best in Mexico, Brazil, Argentina, Peru, Colombia and Chile are technology, banking and health, which on average pay between 28 and 35 percent more than other industries. These industries pay more because there is a lack of market focus on knowledge. For this reason, companies bring people from abroad or from other industries,” says Consuelo Pi, Manager of Healthcare Division of Michael Page.

EDUCATION AS A CATALYST

One of the starting points to finding a solution should be, therefore, education. This not only refers to education related to health professionals but to the country’s entire system of education.

In 2016, according to CONACYT, 6,606 students graduated in fields related to the health industry, a small decrease compared to 2015, when 6,668 students graduated. The issue, however, is in how these newly graduated professionals are distributed throughout the republic. According to the OECD, Mexico has 2.4 doctors per 1,000 inhabitants, a number that is below the average of the countries in the organization. “The inclusion of clinical research as an optional or mandatory class at universities and colleges is key to promoting the development of clinical research in Mexico. We need medical students to embrace research. Educational programming should also include opportunities to work in pharmaceutical clinical research and basic research. If students leave university with knowledge about clinical research and its basic elements, when they enter the industry they will be competitive professionals.”

According to the OECD Report on the Health of Mexicans published in 2016, between 2005 and 2014 the number of professionals related to healthcare increased by 215,000, a period in which the state of Nuevo Leon led growth with three workers per 1,000 inhabitants. Chiapas was last on the list. Contrast this with Mexico City, which had more than three times as many health workers as Chiapas. These significant differences represent a real challenge for the authorities, since the centers that depend on the public sector are not able to meet the demands of the entire population, who often must travel hundreds of kilometers to see a specialist or pay out of pocket for a treatment in the private sector. And it is not just an issue of doctors. Mexico has 2.9 nurses per 10,000 inhabitants, well below the OECD average, which stands at nine nurses per 10,000 habitants.

IMPACT OF ECONOMIC GROWTH

The economic growth Mexico has enjoyed since the beginning of the 21st century has pushed the country closer to the figures of the most developed members of the OECD in some areas, but it has also led to the appearance of problems unthinkable a few years ago that are reflected in the current health system. One is the epidemiological change that the country is experiencing, caused mainly by two factors: the aging of the population as a consequence of the increase in life expectancy and the appearance of chronic noncommunicable diseases. Thus, the prevention and education of professionals capable of working with new diseases and pathologies must be key for Mexico to continue developing an equitable health system in accordance with the times. “During the 1970s, Mexico was praised by the international community for its excellent results in birth control. However, the effectiveness of this policy now shows its negative side, since the age of the population will change in a very short period of time. This will require a complete change of Mexico’s healthcare system as it will have to focus on geriatrics,” says Enrique Cabrero, Director General of CONACYT.

As Mexico has become one of the fastest-growing countries in the Americas region in the sectors of clinical devices, pharmaceuticals and clinical research, there have also been significant benefits. International companies are increasingly arriving and they require not only skilled talent but local knowledge, says Cédric Trantoul, Managing Director of Morgan Philips Group. “We are seeing an increasing number of international laboratories being headed by Mexican directors, as multinational companies understand that having a local manager is advantageous because they have a better understanding of the market and its regulations. Foreigners sometimes work with a local counterpart to understand the culture but it is not enough,” he explains.

TRAINING MEDICAL SPECIALISTS

The Ministry of Health is responsible for the National Exam for Applicants to Medical Residences (ENARM), an instrument used to measure knowledge for the practice of general medicine, as well as the first stage of the process to enter the National System of Medical Residences. The purpose of this examination is to select Mexican and foreign general practitioners who aspire to perform a medical residency to qualify for one of the 27 specialties offered by the system.

According to a report elaborated by the National Academy of Medicine of Mexico and CONACYT, the distribution of places for specialists is inadequate and most are centralized in urban areas; therefore, the lack or excess of offers related to some specialties can cause the teaching-learning cycle to be truncated and generate a bias in human resources infrastructure to train specialists. “Recent medical graduates are more interested in working with patients and hospitals but the life sciences industry could benefit from their knowledge too,” says Johannes Viholainen, Partner at Jobplex.

“Universities would do well to explain the broad range of possibilities their degree offers them.” While universities launch students down the road to greater knowledge, companies should continue the process. “It may be good for the industry to create talent programs inside organizations, something that has worked in the banking and technology sectors,” says Conzuelo Pi, from Michael Page, adding that “the responsibility should fall on the companies, because if we want the industry to become professional it is important to be responsible for their training.”