Top-Ranked Junior Doctors Snap Up Dermatology, Plastic Surgery and Ophthalmology as Family and Internal Medicine Struggle for Takers

The best-ranked new doctors choosing their specialist training this autumn went first for dermatology, plastic surgery and ophthalmology, and the places in those three specialties at hospitals across the country were gone in the first session of the selection, Público reported on Sunday. Family medicine, which trains the SNS's future family doctors, and internal medicine, the hospital specialty most geared to older patients with several illnesses, are again struggling to attract candidates.

The choice is part of the internato médico (medical residency), the specialist training that new doctors begin in January 2027 at SNS hospitals and health centres. The selection runs until Tuesday 10 November, Público said.

Well paid in private practice, away from A&E

According to Público, the specialties chosen first share two features: they pay well in the private sector and carry little emergency work. Internal medicine and intensive care are among the least attractive. Internal medicine doctors warned the paper that "within a few years, there will be no internists to treat patients in hospitals". Público linked the family medicine crisis to bureaucracy and political decisions.

According to Observador's morning news bulletin, which summarised the Público report, the president of the Portuguese Society of Internal Medicine, Luís Duarte Costa, says the shortage is particularly dangerous as the population ages and more older patients live with several illnesses at once. The society is preparing proposals to send to the government by next summer, the bulletin said. Up to 2,449 young doctors could be competing for the 2,338 places.

Where the places are

The official map of places, published in the Diário da República on 6 October, gives 675 places to family medicine and 1,595 to hospital specialties. Internal medicine has the most hospital places, at 216, followed by paediatrics (110) and anaesthesiology (102). Intensive care has 69 and emergency medicine 42.

This is also the first year the choice is made online, in batches, rather than in person in strict ranking order. The Northern Doctors' Union complained to the Ombudsman in September that candidates must list their preferences without knowing which places will still be free, Lusa reported.

Last year's pattern

In last year's round about 20 percent of the 2,331 places went unfilled, according to the National Federation of Doctors (FNAM), RTP reported. Family medicine and internal medicine were left with the most empty places, and most of the empty family medicine places were in Lisbon and the Tagus Valley.

The health system's administration, ACSS, then surveyed the 507 doctors who finished their general year in 2025 but did not take up a specialty. Of the roughly half who replied, 63 percent put not getting the specialty they wanted as the main reason, and 80.7 percent planned to resit the national access exam to improve their ranking. ACSS found their preferences leaned to hospital specialties, especially surgical ones, rather than family medicine and public health.

What it means for you

• An empty family medicine place means one fewer family doctor in training. That matters most in Lisbon and the Tagus Valley, the region with the worst shortage of family doctors, RTP noted. Our earlier report looks at when every SNS patient could have one.
• Internal medicine is considered crucial to the running of hospital A&E departments, RTP noted, and Público reports that the pressure of emergency work is what drives young doctors away from it.
• The final count of filled and empty places will only be known after the selection closes on Tuesday. The places on offer are set out in our October report on the vacancy map.