Mexico’s Healthcare Crisis: The Urgent Need to Reform Medical Resident Training

Web Editor

July 2, 2025

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Introduction

Mexico’s healthcare sector faces a multifaceted crisis, ranging from resource and supply shortages to corruption and mismanagement in hospitals. However, a pressing issue that demands immediate attention is the systemic violence in the training of medical specialists. The current model, built on abuse, excessive workloads, humiliation, and inhumane treatment of residents, is unsustainable.

The Tragic Case of Abraham Reyes Vázquez

Abraham Reyes Vázquez, a 30-year-old aspiring cardiologist from Chihuahua, took his own life recently in Monterrey. His suicide is not an isolated incident; it’s one of many tragic endings stemming from a flawed system that leaves residents with no escape. Abraham’s dream was to become a cardiologist, but he faced relentless pressures from medical residency: grueling hours, harassment by superiors, and a toxic environment where reporting abuse could jeopardize one’s career. His death sparked collective grief and outrage on social media, highlighting the unsustainable nature of a system that normalizes resident suffering.

The Role of Institutions

Marilú Acosta, in her piece “Me Dolió Tu Muerte, Abraham,” published in Opinion 51, vividly portrays the impact of this tragedy. She laments that the Instituto Mexicano del Seguro Social (IMSS), an institution she once admired for its patient commitment, has lost its way and now permits abuse disguised as education. Acosta criticizes the Federal Labor Law for shielding superiors who perpetuate these practices, compelling residents to obey degrading orders, such as carrying dog tags. The death of Abraham serves as a stark reminder that there’s still a long way to go in eradicating abuse in medical training and building an ethical healthcare system.

Understanding the Mexican Medical Landscape

Roberto Castro Pérez, a doctor in medical sociology and investigator SNI III at the Centro Regional de Investigaciones Multidisciplinarias (CRIM) of the UNAM, provides insight into this issue in his study “Genesis and Practice of the Autoritarian Medical Habitus in Mexico,” co-authored with Marcia Villanueva. According to Castro, the Mexican medical field is structured around rigid hierarchies and fierce competition for prestige and cultural capital. Residents are trained through an “autoritarian habitus,” a set of automated practices that normalize suffering as a pedagogical method. “They are taught through punishments,” explains Castro.

Castro reveals in an interview that medical professionals internalize these dynamics from undergraduate studies and replicate them in their practice. A survey of over 600 residents found that 54% reported experiencing violence during their training, from constant reprimands to sexual harassment, particularly targeting female medical students and nurses. This environment reflects in patient care, especially in gynecology-obstetrics, where feminist movements have highlighted obstetric violence—instances of mistreatment, unconsented procedures, and humiliation during childbirth. Castro explains that this dehumanizing treatment is an extension of the “autoritarian habitus” learned during training, where emotionally drained doctors unconsciously transfer their frustration onto patients.

The Devastating Consequences and the Path Forward

These consequences are detrimental to everyone involved. It’s high time for universities and hospitals to transform medical education into a human and ethical process. We cannot continue tolerating a system that equates rigor with cruelty. Reforming medical training is urgent: integrating socioemotional skills education, limiting residents’ work hours, ensuring safe reporting channels, and establishing citizen oversight mechanisms, as proposed by Castro Pérez, are essential steps.

Undoubtedly, the medical profession must open itself to public scrutiny; these are not merely internal matters of the medical community. To build a genuinely helpful healthcare system, we must first ensure that those sustaining it are as healthy and balanced as possible.

Additional Healthcare Issues in Mexico

Violation of Human Rights in Healthcare

Regarding violence in the medical sector, it’s worth noting that the ISSSTE, under Martí Batres’ leadership, has defiantly refused to comply with a Commission for Human Rights (CNDH) recommendation in a clear case of medical negligence. This demonstrates how the healthcare sector in Mexico has broken down the human rights protection framework.

Political Undertones in Appointments

There’s an undeniable political undercurrent in appointing López-Gatell to represent Mexico in Geneva, similar to Juan Ferrer’s appointment as Mexico’s envoy to UNESCO in France, following his tenure at the now-defunct Insabi. These moves suggest an effort to reposition these individuals close to President López Obrador in international spaces. Is this to distance them from domestic scrutiny or protect unconfessed actions from the previous administration? It’s worth recalling that Juan Ferrer, as subsecretary, was mainly involved in the Tren Maya project. Rewarding them with European positions amidst Mexico’s healthcare crisis, marked by medication shortages, substandard services, and public distrust—problems partly inherited from the management of both Ferrer and others—is indeed disheartening.

AMIIF Innovation Week

The National Innovation Week, organized annually by the Mexican Association of Pharmaceutical Research Industries (AMIIF) under Larry Rubin’s leadership, will take place from July 9 to 11. Notable figures shaping current healthcare decisions will attend, including Secretary David Kershenobich, Deputy Secretaries Eduardo Clark and Ramiro López, Economy Secretary Vidal Llerenas, Cofepris authorization commissioner Rafael Hernández, Bioethics commissioner Patricio Santillan, Salubridad Council secretary Patricia Clark, Jorge Gaviño and Rosana Pelayo from the IMSS, Oscar Arrieta of the Cancer Institute (Incan), Raúl Carrillo of the National Association of Medicine, and Guadalupe Guerrero from IMSS Bienestar in Edomex.