Analysis of Medical Salaries in Alicante: Monthly Earnings Between €3,600 and €4,700, with a Fifth from On-Call Duties

Health Minister Mónica García recently reignited the debate over doctors' pay by claiming that they earn, on average, the same as politicians. She later retracted her statement, acknowledging that doctors should earn even more than politicians and recognising the significant variability across regions and "poor working conditions that still persist."

The minister's comments may have further fueled controversy over the draft Statute Framework, prompting doctors to threaten a general strike next May. The draft presented by the Health Ministry fails to address long-standing demands, such as more restrictions on mandatory on-call duties, reducing the obligatory workweek from up to 48 hours, and ensuring on-call pay is considered overtime.

On-call duties significantly contribute to a doctor's salary, potentially exceeding a fifth of total earnings. According to a study by the Medical Union of Granada, which includes a detailed comparative table of salaries across regions, the difference in earnings for a doctor in Alicante with or without on-call duties is €841 monthly, and nearly €12,000 annually.

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The study considers four types of medical profiles. In the previous case, it assumes a doctor with a permanent position, ten recognised triennia, and the fourth level of professional career pay (or the maximum recognised in the Health Service), with exclusive dedication and the possibility of on-call duties. In this scenario, a doctor working in an Alicante hospital can earn up to €4,737 net per month (€7,322 gross), slightly above the national average but below the top mark set by the Basque Country, with €5,140 monthly. Without on-call duties, the figure drops to €3,896 monthly.

On the other end of the spectrum is the scenario of a doctor starting their professional activity as a temporary or substitute intern (aged 30 or older, the age at which they begin their career after MIR); with one recognised triennium, no paid professional career level, and no exclusive dedication. In these cases, salaries range from €2,691 net if not performing on-call duties to €3,607 if they do.

It is important to note that on-call duties are an obligation for hospital doctors, but not a right. That is, a doctor cannot demand them if they are not conducted in their hospital service or specialty. Moreover, they are required to perform them except in very limited circumstances, such as being over 55 years old or having a health-related incapacity.

These on-call duties are performed after regular working hours (generally from 3 p.m. to 8 a.m. the following day) and on Saturdays, Sundays, and holidays for 24 hours. However, unlike the general norm in most professional sectors, on-call hours are paradoxically paid less than regular hours.

In the Valencian health system, the extra hour payment is €15.92 on weekdays and €17.02 on holidays; nearly half of the gross amounts, which are €28.94 and €30.94 respectively. This significant difference occurs because, with progressive IRPF withholding, the new income will exponentially increase the withholding percentage of all payroll income.

Study authors also assert that "the tremendous additional effort required by on-call duties is not fairly compensated and is penalised by a highly progressive tax system."

They also claim that the nature of medical on-call work has changed over time, evolving from a "work expectation situation, which did not involve the rigour of uninterrupted work as in regular hours," to a "piecework job, which also does not respect breaks during it and involves a significant mental and stress load."