Spain caps resident doctors' on-call shifts at 17 hours as decree passes

What the decree changes

The Council of Ministers approved on Tuesday, 3 November 2026, a royal decree that rewrites working conditions for resident doctors, known in Spain as MIR. It removes 24-hour on-call shifts and caps each guard at 17 hours, counted together with ordinary hours. A resident who has already worked seven ordinary hours can therefore be on guard for up to 10 more. Residents must have 12 continuous hours of rest between shifts and 24 uninterrupted hours of weekly rest, and these breaks cannot be waived or made up later.

According to the Ministry of Health, residents may work up to four guard modules a month, each 17 hours long, with one extra module allowed only for justified teaching reasons. Residents may also volunteer for up to seven a month. Ordinary hours plus guards may not exceed 45 hours on a quarterly average. Secretary of State for Health Javier Padilla ruled out exceptions for weekends or hard-to-cover days, and gave a short reason:

“Resident staff are not structural staff.”

Pay and the training supplement

Residents keep their base salary, and the decree adds a training supplement calculated on it. Minimum rates are 18% in the first year, 28% in the second, 38% in the third, 48% in the fourth and 58% in the fifth, and regions may pay more. A separate guarantee covers pay during temporary incapacity, birth, adoption, fostering and pregnancy or breastfeeding risk. Within six months of entry into force, the Consejo Interterritorial del Sistema Nacional de Salud must set common criteria for a residence allowance covering living costs, housing, island status and rurality.

Year 118%

Year 228%

Year 338%

Year 448%

Year 558%

Year 1

18 %

Year 2

28 %

Year 3

38 %

Year 4

48 %

Year 5

58 %

Data from the article text

Pay changes apply from 1 January 2027, and El Mundo reports that residents sitting the MIR exam in January 2027 will be the first to get the full package. Residents have long relied on guards to lift their income, and the Sindicato Médico Andaluz puts average gross pay at 1,477 euros in Spain, varying by region.

Residents reject the reform

The Asociación MIR España (AME) rejects the decree, though it welcomes gains on hours, rest and risk prevention. Its main objection is that fewer guards without adequate compensation would cut residents' monthly income, a problem for those who depend on guards to earn a decent wage. The association adds that the reform lacks consensus and extra budget for specialised health training. Internal AME surveys show more than 90% of consulted residents oppose the current text, and the group will ask political parties to repeal it. In one line, it sums up its position:

“It forces us to choose between resting more or earning less.”

Medical college welcomes the text with caveats

The Organización Médica Colegial (OMC) takes a more positive view. Juan Pablo Carrasco, its national representative of young doctors, said the text already includes many of the college's submissions. He framed the next test in one sentence:

“The challenge is that the regulatory framework it sets out is complied with.”

He added that rules on paper do not guarantee better conditions, and that the reform is a first step toward keeping and attracting talent.

Timing and background

The decree follows the lapse of the Estatuto Marco, a framework law covering other doctors that failed when the election was called. Before the vote, the Ministry had said it would speed up approval of several pending rules, including this one. Government spokesperson Elma Saiz announced the approval. The decree enters into force the day after its publication in the Boletín Oficial del Estado (BOE), and its hours limits apply from 1 September 2027.