Looking into the future: The updated Endocrinology and Nutrition residency training program in Spain

Endocrinology and Nutrition residency training in Spain (MIR program) is undergoing a major update for the first time since 2006, reflecting rapid advances in endocrine science, technology, and educational standards. Internationally, the European Society of Endocrinology (ESE) has introduced a unified curriculum to harmonize specialist training across Europe, highlighting core competencies and the need for longer training. This article outlines the renewed Spanish Endocrinology-Nutrition MIR program proposal, detailing its modernized curriculum, innovative assessment methods, and the debate on extending training duration.

The updated program highlights emerging areas such as molecular endocrinology, technology-enhanced diabetes care, diagnosis and prevention of arteriosclerotic vascular disease, metabolism and rare endocrine disorders, multidisciplinary obesity management, and the central role of nutrition in patient care. These priorities reflect current trends in clinical practice and the forefront of endocrine research.

New evaluation methods focus on competency-based training, with progressive responsibility, portfolios, workplace-based assessments and entrustable professional activities (EPAs) to ensure trainees attain defined skills. Formal examinations and objective assessments are introduced to standardize certification.

A pivotal discussion is whether to extend the residency from 4 to 5 years. Given the breadth of endocrinology and ESE recommendations of a 6-year combined internal medicine-endocrinology training, Spanish experts argue a 5th year is "reasonable" to accommodate new technologies and growing complexity although no consensus has been attained so far.

The renewed program aligns with international standards and future-proofs endocrinologist training. It balances broad endocrine-nutrition competencies with specialized skills, modern assessment, and potentially longer training to produce experts equipped for evolving healthcare needs.