Geriatrics residents must:

• Know the most prevalent diseases in elderly people, their symptoms, the diagnostic processes and the interdisciplinary pharmacological and non-pharmacological therapeutic approaches.
• Know and be able to identify geriatric syndromes: delirium, falls, immobility, malnutrition or pressure ulcers. -ç
• Know and be able to identify frail patients in routine clinical practice.
• Know and be able to use geriatric assessment tools. These are tools specific to the field of geriatrics.
• Be aware of the proper use of drugs, taking into account the pharmacokinetic and pharmacodynamic changes that occur in elderly patients, the proper prescription of drugs, possible adverse events, polypharmacy and drug interactions.

Residents are thus trained to offer a high quality service whereby a strong focus on the patient, with the help of the interdisciplinary team (medicine, nursing, social work, physiotherapy, psychology, etc.) and coordination with other primary care specialists, the intermediate care hospital and acute care hospital are vital.

This 4-year specialisation programme is split into two training periods:

• Basic training period over the first two years of the residency, including general rotations in the Internal Medicine, Neurology, Cardiology, Psychiatry, Radiology and A&E departments in addition to various elective rotations.
• Specific geriatrics training period over the next two years, in which the geriatrics resident will rotate between intermediate and acute care facilities.
  • Intermediate care (third year): Parc Sanitari Pere Virgili Intermediate Care Hospital. Rotations in sub-acute, palliative, convalescent and long-stay hospitalisations. Specific outpatient appointments and home care services. Casernes-Vall d’Hebron Complex Care Support Team. Consultations and day hospital.
  • Acute care (fourth year). Functional Geriatrics Unit (consultation team). Acute Fragile Patient Hospitalisation Unit (acute medical hospitalisation). Orthogeriatrics Unit (acute traumatic hospitalisation). Cardiogeriatrics (external consultations). Oncogeriatrics (external consultations).

Both the basic and specialised formative periods offer ample opportunities for elective rotations, including an external rotation during the final year.

The Geriatrics Teaching Unit encourages research, and offers the opportunity to do a doctoral thesis at the Autonomous University of Barcelona (UAB). Attendance at national and international geriatrics congresses, as well as that of the Catalan Geriatrics and Gerontology Society (SCGiG), is always encouraged.

Why practise this speciality at Vall d'Hebron?

• Because our residents receive training in a tertiary hospital that is considered world-leading in many areas.
• Because the volume of patients at our hospital offers great potential for teaching and gaining experience.
• Because the hospital covers most medical specialities, and you'll have the chance to study complex pathologies and apply cutting-edge diagnostic and treatment methods.
• Because you’ll have the opportunity to do rotations in other centres that specialise in geriatrics, palliative care and psychogeriatrics.
• Because in this unit we place an emphasis on the functional recovery of patients, allowing them to carry out their day-to-day activities with confidence.
• Because we understand the importance of the doctor-patient relationship and other recurring aspects in the field of geriatrics, such as the appropriate treatment of patients suffering from chronic pathologies.

The Cardiac Surgery Teaching Unit  works with teams from General Surgery, Thoracic Surgery, Vascular Surgery and Anaesthesia and Resuscitation. There are three accredited places available. Residents in this specialisation assist in the operating room and with preoperative assessments, where they provide surgical indications according to their level of training. In addition, they work in intensive care, postoperative care, and carry out patient monitoring on the hospital wards.

Cardiac surgery residents are incorporated into the team gradually according to the relevant stage of their training. Their work is based in state-of-the-art operating theatres, Intensive Care, hospital wards and rooms, and outpatient appointments. During this time, they become familiar with the different surgical and preparatory techniques for cardiac surgery, as well as preoperative and postoperative monitoring.

Rotations through different Departments is essential. Residents therefore spend time in Cardiology and Pacemakers, giving them the chance to learn about cardiac disorders and surgical indications. The rotation in Thoracic and Vascular Surgery, and active participation in lung transplants, enables them to broaden their knowledge of the most advanced surgical techniques in the specialisations.

The final year is spent on duty shifts and in Adult Cardiac Surgery, with three months in Paediatric Cardiology.

We are an active research group applying scientific methodology that allows residents to get closer to basic research or experimental surgery projects in the unit. We also offer the chance to obtain grants.

In terms of research, we undertake to help residents present a research project and to write their doctoral thesis.

Why specialise at Vall d’Hebron? 

• Because right from the start we encourage residents to get involved in writing scientific papers and publications for national and international congresses.
• Because we are committed to quality through the analysis of surgical outcomes, and we keep up to date with the specific features of the specialisation.
• Because we hold a weekly professional development, literature review and research training session, a session on surgery, a session on mortality, a medical-surgical session, and a session on medical-surgical advances given by a guest physician of national or international prestige in the field.
• Because we strive for quality through a system of monitored training objectives, which includes meetings between tutors, residents, consultants, heads of department and section, and the Training Department.
• Because we create value for residents and assess their internal and external rotations with contributions from the attending physicians, tutors, heads of section, heads of department and the Training Department.
• Because we support attendance at the annual Cardiac surgery course for residents, and we organise weekly clinical sessions and various courses on key areas such as basic resuscitation, the latest cardiac surgery advances, and treatment for arrhythmia and pacemakers.
• Because we work to attract financing for the European Cardiac Surgery course in Bergamo (Italy), which accredits surgeons to perform cardiac surgery throughout the European Union.

The Cardiology Department Teaching Unit at Vall d’Hebron Hospital is divided into nine operational units. These include Outpatients, conventional wards, the Day Hospital, the Coronary Care Unit, Intensive Coronary Care, Semi-critical Care, Echocardiography and Cardiac Imaging, Haemodynamics and Angiocardiography, Arrhythmia, Nuclear Cardiology and the Experimental Laboratory. It should be said that the Cardiovascular Epidemiology Unit, part of the Cardiology Department, is unique within Spain.

We work in multidiscipline areas to treat specific medical problems such as Marfan syndrome and Congenital Heart Disease, and are national leaders in both fields. Our activity is always patient-centred and aims to maximise outpatient care and general cardiology. To this end we regularly run clinical care and scientific sessions that involve all professionals in the Department.

During training, residents progressively increase their level of skill, from taking medical histories at the start of their training, for example, to the use of automatic defibrillators in the final phase of their residency. 

During the first year residents undertake shifts in Internal Medicine, with one shift a month in Cardiology. In the second and third year they do shifts in clinical cardiology within the Accident and Emergency Department. The fourth and fifth year include shifts in the Coronary Care Unit and Haemodynamics.     

In terms of training, there are sessions, seminars and courses, and residents’ participation in national and international congresses, conferences, seminars and courses is encouraged.

At the end of the cardiology residency, it is possible to continue training in research as part of the Riu Ortega programme for the Carlos III Health Institute. We also take part in undergraduate and postgraduate research staff training programmes run by the Generalitat of Catalonia’s Department for Education and Universities and the Ministry of Education.

Research activities  of note include collaboration with the International Doctorate School on myocardial consequences, in cooperation with the University of Giessen (PROMISE), funded by the German organisation DFG and BIOCAT.

Why should you specialise at Vall d’Hebron?

• Because the Multidiscipline Unit of Adult and Adolescent Congenital Heart Disease is a leader within Spain.
• Because we are a national point of reference through the development of the European Cardiology Society’s clinical practice guides for disorders such as valvulopathy, endocarditis, aortic pathology, coronary syndrome, syncope, congenital heart disease, acute coronary syndrome and pericardium disease.
• Because we are national and international pioneers who have been developing our own healthcare protocol for each cardiac pathology since 1981.
• Because we offer residents shifts in Cardiology within the Accident and Emergency Department, supported by a consultant and two residents in person, and a haemodynamics specialist who can be reached if necessary.
• Because in Cardiac Care we have a daily meeting with the previous shift attended by the team on duty, the Head of Department and the Heads of Unit.
• Because we have a daily Coronary Care Unit meeting at the end of every day, attended by staff doctors, residents, and the consultant and resident who have been on duty.
• Because we organize two weekly nuclear cardiology sessions, attended by the cardiologist in charge of the section, the cardiology resident and doctors from Nuclear Medicine.
• Because we carry out three cardiac imaging sessions a week, attended by the doctors training in the echocardiography and ergometry unit, during which cardiac MRI and CT scans are discussed, along with echocardiographic and magnetic resonance assessments of particular interest.
• Because we hold a weekly session on electro physiology and arrhythmia with paediatric cardiology and adult congenital heart disease.
• Because we deal with infectious endocarditis (in collaboration with Bacteriology, Infectious Diseases and Cardiac Surgery) in a dedicated weekly session.
• Because we hold weekly seminars in the Experimental Cardiology Laboratory, and fortnightly seminars from the Vall d’Hebron Research Institute.
• Because the top cardiologists and cardiovascular researchers in Spain and Europe take part in our clinical sessions, which are recognised by the SNS (National Health Service) Continuous Professional Development Commission, and the Catalan Council for Continuing Medical Education.
• Because every year we offer courses in echocardiography, pacemakers and arrhythmia, adult congenital heart disease and nuclear cardiology, and Advanced cardiopulmonary resuscitation courses organised for Cardiology residents, in addition to other courses.
• Because we encourage residents to take part in the National Cardiology Congress and the European Cardiology Congress during the final years of their residency.
• Because we enable residents to undertake part of their residency training in other centres, particularly in New York, Washington, London and Cologne.

The teaching unit comes under the Digestive System and Liver Department which combines Digestive System, Endoscopy and Hepatology departments, although we also work in collaboration with Internal medicine, Intensive care medicine, Emergencies and Radiodiagnosis, Nutritional support and Digestive Surgery Departments. 

In daily practice, resident doctors visit the patients along with their staff doctors, preparing the clinical record and making the physical examination under their supervision. They also make an assessment of the supplementary tests such as endoscopic, radiology, manometric, and anatomy and pathology examinations needed for proper decision making and to diagnose disorders of the oesophagus, stomach, intestine, colon, pancreas, liver and bile ducts. During residency, doctors get to know about the most frequent conditions in the speciality, and often have the opportunity to come across more complex cases, which are a model for interaction with other units at the hospital. In Hepatology they have the opportunity to learn about the features of severe or chronic hepatitis, or hepatic cirrhosis, as well as carrying out the diagnosis, serological tests, treatment and the possible complications, if there are any, and prevention. During their turn in Endoscopy they have gradual, supervised training that covers all from diagnostic examinations to basic therapeutic endoscopy, as well as assisting those responsible for advanced endoscopy techniques, such as endoscopic ultrasound and endoscopic retrograde colangiopancreatography.

Residents in the Digestive Department are on call for internal medicine during the first year and, subsequently, from the second year of residency onwards, are specialist on-call doctors (approximately 4 shifts per month), alongside a physically present department member.

The Digestive System Programme also carries out significant scientific work at the Vall d’Hebron Research Institute and CIBERehd, with five lines of research:

• Gastrointestinal motility: clinical research into the digestive system’s sensory-motor function and its relation to diet, and abdominal and microbiota content.
• Inflammatory bowel disease: basic, translational and clinical research into inflammatory bowel diseases on subjects such as: interaction of intestinal microbiota with the intestinal mucous membrane; validation of biomarkers relating to clinical remission and response to treatment; the effect on intestinal microbiota of interventions with probiotics and prebiotics; validation of pharmacokinetic models; research into vaccine response or quality of life and patient satisfaction.
• Intestinal microbiota: the aim of this line of research is to understand the role of intestinal microbiota in digestive disorders using “omics” techniques.
• Pancreas and bile duct disorders: development of new experimental models to study the genes regulating the appearance of chronic pancreatitis and pancreatic tumours.
• Neuroinmunogastroenterology: basic, translational and clinical research into disorders related to brain-intestinal axis dysfunction, such as irritable bowel syndrome and functional dyspepsia and chronic inflammatory illnesses such as microscopic colitis, coeliac disease, eosinophilic oesophagitis or diarrhoea caused by bile acids.

We offer you a teaching programme designed following the National Council for Digestive System Speciality’s programme. Internationally the department is recognised as a European Training Centre by the European Community's European Gastroenterology Board and as a receiving centre for the UEG Clinical and Research Visiting Fellowship programme and as a collaborator in the Rome Foundation Research Institute’s Investigator Network. Treatment-wise we have membership in national units of reference, such as the Neuroendocrine Tumours Committee and the Adult Primary Immunodeficiency Committee. Furthermore, from the research point of view, our unit has been recognised as a group of excellence by AGAUR (University and Research Grant Management Agency) since 2009 and as a CIBERehd (Centre for Network Biomedical Research on Hepatic and Digestive Disorders) group since 2008.

 Why practise this speciality at Vall d'Hebron?

• Because we have around 1,000 admissions to the hospital wards each year, which enables the acquisition of very broad clinical and care experience.
• Because we have a Semi-critical unit with 4 continuous 24 hour care beds where we look after patients with serious digestive disorders (digestive haemorrhage, acute pancreatitis, serious complications from cirrhosis and acute cholangitis) where a multi-disciplinary team works assembled from Hepatology, General surgery, Endoscopy, Radiology and Surgical vascular radiology.
• Because we are a part of the Specialist Outpatients Network (RAE/CAE): 3 specialist outpatient clinics making an average of 10,000 visits to the community annually.
• Because when on-call, the resident is supervised by the associate doctor on-call in the Semi-critical Unit during the three final years of residency, to ensure effective, safe learning.
• Because we have an accredited Crohn-Colitis Care unit where, apart from conventional medical care, patients are monitored biologically, psychologically and socially. We currently monitor a total of 2,800 patients, which means we can carry out clinical and basic research in the experimental laboratory.
• Because the Gastrointestinal Motor Disease Unit is a national and international benchmark for the study of patients with serious motor and functional disorders.
• Because we have the Pancreas unit, specialising in dealing with complex illnesses such as cystic fibrosis, serious pancreatitis, chronic pancreatitis, pancreatic tumours and bile conditions, which are addressed by various committees in a multi-disciplinary manner.
• Because in the Hepatology Unit you have the most modern diagnostic procedures at your disposal and you will be able to participate in the treatment of portal hypertension-related complications, liver transplants and the use of the pioneering drugs.
• Because the Digestive Endoscopy Unit has the capacity to carry out 15,000 diagnostic and therapeutic examinations annually.
• Because we have state-of-the-art technology and equipment for diagnostic and therapeutic endoscopy, including the most recent advances in surgery by mouth (POEM), enabling gastroscopy, duodenoscopy, colonoscopy, colangiopancreatography and endoscopy to be performed.
• Because we offer you, and, during residency, encourage you to collaborate in, research lines in the department, to learn scientific method, to read and write articles in a critical way, to take part in research studies and present the results at conferences and in publications to complement you training and CV, and to increase your competitiveness after the residency.
• Because at the end of the residency we support your incorporation into one of the research lines and your application for pre-doctorate grants to be able to do your doctoral thesis.
• Because the Digestive System Unit at Vall d'Hebron is in contact with the majority of the national and international scientific societies of reference, which makes internships abroad easier at the end of the residency.

The Angiology and Vascular Surgery Teaching Unit has one accredited position. It is part of the  Angiology and Vascular Surgery Department, but General, Cardiac and Thoracic Surgery are also involved. This ensures there is an opportunity to work in multidisciplinary teams.

The specialisation is carried out in the Outpatient Clinic, in Haemodynamics, on the wards, in surgery, and in the Accident and Emergency Department. It works both in Internal Medicine and Paediatrics.

During the training period, tutors supervise residents in a progressive way. Depending on which part of the training they are in, residents may carry out preoperative diagnostics and give surgical indications during operations and for immediate postoperative care. In addition, they carry out postoperative care on the hospital wards.

Other skills you will acquire include diagnostic imaging using all available methods: ultrasound, computed tomography (CT) scans, and magnetic resonance angiography among others, in addition to using the most advanced angiography techniques and therapeutic endovascular procedures.

If you do your residency with us, you will also have the opportunity to actively participate in organizing and developing courses, to analyse the Department’s surgical outcomes, to conduct literature reviews and be up to date with the latest innovations and aspects specific to the specialisation.

Angiology residents work with scientific research methodology and are equipped to write different kinds of publications in this field. Their objectives include two publications as first author and the presentation of two papers at scientific events. It is also recommended to dedicate time to the doctoral thesis, or least to start it.

Why should you specialise at Vall d’Hebron?

• Because the comprehensive care allows vascular specialists to offer patients the best of the effective therapies available, and makes it possible for residents to take part in diagnosis, medical treatment and surgical problems.           
• Because resident’s work in Angiology and Vascular Surgery encompasses both adults and paediatrics.
• Because you will undertake complementary training in areas of special interest for the specialisation that correspond to units or sections of the Department.
• Because the technical aspects include conventional and endovascular techniques specific to the specialisation, and also percutaneous techniques and intraoperative direct treatment.
• Because residents receive scientific training and write scientific publications for the Department and present papers at conferences in the specialisation at a regional, national and international level.  
• Because we offer continuous professional development, literature training and provide monthly research sessions, daily sessions on the healthcare activity, and a monthly mortality review.           
• Because we have courses related to cerebrovascular topics and endovascular techniques with international implications.   
• Because we offer the option to have a stay abroad in a hospital of your choice.
• Because we have a daily review system with department meetings held every morning. 

Our Teaching Unit attracts medical students from the Autonomous University of Barcelona, residents and specialists. Every year, it teaches over 120 resident doctors (45 of whom are the service's own residents) in the cross-cutting, specific skills of Anaesthesia and Resuscitation, and in Entrustable Professional Activities (EPA) for anaesthesia, and complements the training of over 20 specialists in anaesthesia and other specialities. It also offers an advanced international training programme in Paediatric Anaesthesia. 

On our Campus, you have the opportunity to attend, learn and reflect on the care performed for all kinds of pathologies. In order to facilitate integration into the service and speciality, during the first month of rotation, the resident is trained in cross-cutting skills, via the Hospital's Teaching Unit, and in the basics of Anaesthesia and Resuscitation, through a personalised training plan. In addition to assisting in various areas, sessions and compulsory courses, the individual training plan for our residents includes participation in the theory-practical modules specifically designed for each training year. These are run by experts in the specific subject skill of the module.

The efforts of our Teaching Unit are directed towards training excellent, thoughtful professionals with a critical spirit, by and for our present-day society. 

In 2023 Dr. Marc Mendo, resident of Anesthesiology in Vall d'Hebron, wins the Jo Innovo Award 2023. His innovative project, 'High Level Support for Critical Situations', revolutionizes the response to cardiac arrest with a unique application. The award includes support from Vall d’Hebron to implement the idea, as well as an experience at the Karolinska Institute.

Why practise this speciality at Vall d'Hebron?

• Because the teaching here ensures safe, high-quality clinical practice, with Teaching Coordination that continually reviews and supervises the protocols and knowledge that are taught.
• Because we prepare you for a future in which residents can perform anaesthesia and resuscitation applied to all existing specialities and in any healthcare hospital.
• Because we have trained over 400 professionals and we have had extensive experience in training Anaesthesia and Resuscitation specialists since 1972.
• Because we offer residents a weekly course where practice and simulation is the most commonly used methodology, in order to ensure real, high-quality learning.
• Because we foster the participation of residents in existing lines of research.
• Because we also offer residents the opportunity of doing their doctoral thesis with us.
• Because we are the cutting edge and we include new surgical techniques, new diagnostic methods and treatments on demand. 
• Because the training we offer is cross-cutting and residents learn not only the most common, but also the most complex procedures.

The Allergology Unit has been training residents since 1982, and is where most heads of allergology divisions in Catalonia did their training.

We attend to outpatients regarding allergic respiratory disease, paying special attention to asthma, complex food allergies, hymenoptera allergies, chronic urticaria, atopic dermatitis, and drug allergies.

The Day Hospital carries out controlled drug exposure tests and chemotherapy and other drug desensitization therapies. The paediatric unit carries out food desensitization therapies. We also deal with hospital consultations on a daily basis.

The unit carries out clinical research  in the fields of  anaphylaxis, hereditary angioedema, food allergies  and  chronic urticaria. In terms of  experimental research , we offer the opportunity to carry out specific immunoglobulin E and G tests by biochip, and  basophil activation tests. Five doctoral theses have been supervised by the Unit and all its staff physicians are qualified Doctors of Medicine.

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining experience.
• Because we cover most specialisations and you will have the opportunity to see complex pathology and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.
• Because you will have the opportunity to see complex pathology and use cutting-edge diagnostic techniques and treatments, such as monoclonal antibodies, the application of drug desensitization protocols and the management of hereditary angioedema.
• Because you will have the opportunity to present papers at national and European allergy conferences. At the most recent events we received awards for the best paper in several areas.
• Because we give fourth year residents contacts to assist with research and stays abroad. In recent years our residents have spent time in clinical allergy units in Rome and Montpellier, and in research centres such as the Karolinska Institute in Stockholm, Sweden. All fourth year residents are offered funding for the European Examination in Allergology and Clinical Immunology, which 85% of our residents have successfully passed to date.
• Because your knowledge will be continuously updated through a programme of specialised, literature and clinical sessions, which take place four days a week.
• Because in 2010 the Allergology Teaching Unit was assessed by the Allergology Department of the European Union of Medical Specialists, who accredited it as a Specialised Allergy and Immunology Training Unit.

Urology deals with the study, diagnosis and treatment of medical-surgical conditions associated with the urinary and retroperitoneal system of both sexes. It also includes the male reproductive system of any age group, that may have congenital, metabolic, obstructive or oncological disorders, or injuries due to trauma.

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining experience.
• Because we cover most specialisations and you will have the opportunity to see complex conditions and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.

Prospective radiologists need a solid medical foundation to work closely with specialists from other medical disciplines. For this reason, training in diagnostic imaging, clinical radiology and bioethics is complemented with knowledge on pathological and functional aspects of diseases. 

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining of experience.
• Because we cover most specialisations and you will have the opportunity to see complex conditions and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.

Pneumology deals with the physiology and pathology of the respiratory system. Its principle purpose is the study of the aetiology, epidemiology, physiopathology, diagnosis, treatment, prevention and rehabilitation of respiratory diseases. The therapeutic and diagnostic principles of respiratory medicine are similar to those of internal medicine, although there are differences that clearly distinguish each of the specialisations. The most important difference is their reliance on and mastery of specific techniques. Diagnostic techniques include lung function analysis, respiratory or thoracic endoscopy, polysomnography and cardiorespiratory polygraphy; while mechanical rehabilitation and ventilation are used therapeutically.

Why specialise at Vall d’Hebron?

• Because as a participant on the Pneumology training programme you will observe, study and treat patients (hospital admissions and outpatients) with a wide range of respiratory diseases.
• Because at the end of the residency you will be able to show competency and technical expertise in the diagnosis and treatment of a broad spectrum of acute and chronic respiratory conditions, both within and outside the hospital environment.
• Because you will be able to implement programmes related to prevention, healthcare promotion and education with patients, their families and their communities.
• Because you will have come into contact with experimental and/or epidemiological clinical research that will help you approach scientific literature with a critical mindset and develop the foundation for continuous self-learning.