Lisbon's Hospitals in Crisis: Half of New Specialist Doctor Positions Remain Unfilled

Hospitals Conduct Competitions but Weak Ability to Attract Doctors Persists

Since 2024, the competitions for placing newly specialized hospital doctors—who typically finish their training in March—have been decentralized. This means that the Local Health Units (ULS) themselves launch the competitions, unlike General and Family Medicine and Public Health, whose placements are centralized in the Central Administration of the Health System, an arm of the Ministry. Last year, the placement process for family doctors was also decentralized but did not go well, leaving new specialists waiting for months to be contracted, which led the government to decide to reassume the process this year with a single competition.

In the case of hospitals, the responsibility lies with the ULS. On April 17, the offices of the Minister of Health, Ana Paula Martins, and the Minister of Finance, Joaquim Miranda Sarmento, published the map of vacancies for the first placement competition of 2025, with each ULS then opening competitions, one per specialty, with the vacancies deemed necessary, respecting the defined limits. In 2025, competitions began to open in most cases in May, but some only opened in June or even July.

Each ULS must form a jury for each competition, define classification criteria, organize evaluations, and sign contracts with the specialists it hires, a process that can drag on for weeks.

The lack of attractiveness of hospitals in the Lisbon area is a reality that has persisted for years, hindering the renewal and reinforcement of services and harming the response to populations.

In the analysis of competitions for the placement of new specialists, the ULS of Lezíria and Oeste had the worst performance. In Lezíria, only seven of 41 vacancies (17%) were filled, with nuclear specialties, such as those essential for emergency services like Anesthesiology and Pediatrics, remaining empty. Of the eight vacancies opened for Internal Medicine, only two were filled. In the ULS of Oeste, the scenario was even worse in terms of the absolute number of doctors placed: only six for 37 vacancies (16%). Here, none of the eight vacancies for Internal Medicine (the foundational specialty for emergencies) were occupied, and the three vacancies for Gynecology/Obstetrics also remained empty.

Hospitals North of Lisbon Filled Only About One-Fifth of Vacancies

In another ULS with a chronic deficit of specialists in various areas and an evident difficulty in attracting doctors, the Estuary of the Tagus, the scenario was no better: only 9 out of 42 vacancies were occupied, equivalent to 21% of the total, with most specialties remaining without placements (notably Cardiology, Surgery, Pediatrics, or Orthopedics). In this ULS, which serves an area with almost 300,000 inhabitants, Internal Medicine teams were reinforced with only two doctors when five vacancies had been made available. Of the three vacancies for the Oncology service, none were occupied.

"These overall results demonstrate that the attractiveness of the career in Lisbon and Vale do Tejo is minimal," says the general secretary of the Independent Union of Doctors, Nuno Rodrigues. Meanwhile, the president of the National Federation of Doctors describes the scenario in the Lisbon region as "dramatic" and blames the government, particularly for decentralizing the competitions to the ULS and for the lack of measures to improve doctors' working conditions.