By Wendy Anders

An interview with Pablo Guzman Stein, director of the private Medical Sciences University (Ucimed), located west of La Sabana Park in San José, Costa Rica, revealed the ways in which specialists in certain medical fields are actively maintaining a shortage in such areas to curtail competition, reported La Nación, Costa Rica’s mainstream Spanish daily recently.

Relectant to relinquish their control over the selection process and resident training for medical specialists in the country, it took a high court case to require the University of Costa Rica and the Costa Rican Social Security Board (CCSS) to allow private universities to participate in these processes, reports La Nación.

Even though the court ruled favorably for such participation in May 2015, it was not until this month, nearly a year-and-a-half later, that UCIMED’s Guzman managed to secure a meeting with the UCR’s medical heads to initiate their involvement in the selection and medical residency processes, explained Guzman to La Nación.

Guzmán says that Costa Rican dermatologists, orthopedists and anesthesiologists are not interested in more specialists being trained in these areas as it would mean more competition for them.

These are the precisely the areas that the Costa Rican Social Security Fund (CCSS) has repeatedly urged they need more specialists for in their hospitals and clinics throughout the country, said Guzman to La Nación.

According to Guzman, lack of planning by the CCSS, and vested interests within certain specialties are the two main reasons for the shortage of dermatologists, orthopedists, anesthesiologists, among other specialists in Costa Rica.

Guzman claims that when medical residents pass to the final stage for licensing, there are instances where not a single student out of 400 has been approved by the jury of specialists in their area. Recently, medical students filed suit saying the selection procedures were changed at the last minute.

“The truth is that the country needs specialists, and the medical specialist associations have to accept [this]…But…for example, the dermatology association has said they wouldn’t be training any more specialists,” said Guzman to La Nación.

At this time, neither the World Health Organization (WHO) nor the Pan American Health Organization (PAHO) have guidelines indicating exactly what ratio of specialists is needed in relation to a country’s population.

Costa Rica has 23 studies by the CCSS analyzing their health sector, and they all say more specialists are needed, but this is not acted upon, said Guzman to La Nación.

Recently, the Costa Rican medical professions association (Colegio de Médicos) rejected dozens of foreign specialists selected by the CCSS to help ease the country’s shortages, reported La Nación recently.