Background: Medical residents play two roles that enter into conflict during their educational period: trainees and workers. This dual role can lead to dissatisfaction among residents that can affect both the quality of the services they provide to citizens and the proper functioning of the health services model itself. Aim: To analyse discrepancies between the preferences and expectations of first-year medical residents and whether these differences affect satisfaction with the residency. Method: A questionnaire was administered on-line to the entire population of first-year medical residents of the Autonomous Community of Andalusia (Spain) in 2008. We performed a means contrast test between the indicator discrepancy (difference between preferences and expectations during the residency as a training or a working period), overall satisfaction with the residency and their relationship to other expectations of medical residents. Results: Respondents showing greater discrepancy have a more negative opinion about the residency. Conclusion: There is a gap between what residents prefer and what they expect from the residency, giving rise to dissatisfaction. This gap must be bridged to improve the quality of training received by these new physicians, their satisfaction and hence the delivery of health services to citizens.

Frente a los grandes rituales colectivos y el sentido trascendente que le otorgaban las comunidades tradicionales, la Modernidad habría reducido la muerte al silencio y convertido el morir en un proceso solitario e institucionalizado. No obstante, en las últimas décadas un nuevo modelo de la muerte podría estar emergiendo en nuestras sociedades: el modelo neo-moderno, pues no cuestiona el papel central del sistema sanitario en la gestión de la muerte, pero trata de corregir los huecos que este no ha satisfecho. La muerte, así, volvería paulatinamente al espacio público, pero de forma fragmentaria y descentralizada, como un conjunto de prácticas y discursos dispersos que tendrían en común un renovado interés en hablar de la muerte y el morir. En este artículo me propongo comprobar la posible presencia del modelo neo-moderno de la muerte en una serie de productos y prácticas culturales muy diferentes. Discutiré si, en efecto, todas ellas tienen un hilo común en el modelo neo-moderno o si, como afirman otros autores, son más bien producto de la tendencia a la hipertransparencia mediática y la búsqueda de sensaciones fuertes propios de la sociedad consumista. Asimismo, examino algunas críticas formuladas al modelo y sus contradicciones internas. Concluyo tratando de anticipar tendencias futuras en el modo de morir a la luz de la evidencia presentada.Opposite to the great collective rituals and the transcendent meaning granted by traditional communities, Modernity would have reduced death to silence and transformed the act of dying into a solitary and institutionalized process. Nevertheless, in the last decades a new model of death could be emerging in our societies: the neo-modern model, since it doesn't question the central role of the sanitary system in the management of death, but tries to correct the gaps that the latter didn't achive to satisfy. Death would thus gradually return to the public space, but in a fragmented and decentralized way, as a set of scattered practices and discourses that would have in common a renewed interest in talking about death and dying. In this article I intend to verify the possible presence of the neo-modern model of death in a series of very different cultural products and practices. I will discuss whether all of them have a common thread in the neo-modern model or if, as other authors claim, they are rather a product of the tendency towards media hyper-transparency and the search for strong sensations typical of the consumerist society. I also examine some criticisms to the model and its internal contradictions. I conclude by trying to anticipate future trends in the way of dying in light of the evidence presented.

El concepto de muerte asistida comprende una heterogénea variedad de prácticas, cuyo denominador común es garantizar al ciudadano su derecho a participar en las decisiones relacionadas con su propio proceso de muerte, para que sea tan acorde a sus preferencias como sea posible. Se trata de uno de los temas más polémicos y discutidos en las últimas décadas, tanto en el ámbito académico como en la opinión pública. En este artículo se examinan las dos principales justificaciones favorables a su legalización: garantizar la autonomía individual como en los demás ámbitos de la vida y evitar un sufrimiento innecesario al moribundo. Se argumentará que, si bien ambas se encuentran relacionadas y en las dos se anudan la ética del cuidado con la de la autonomía del sujeto, la justificación por la autonomía es más sólida y resiste mejor las objeciones de los contrarios a la legalización de este derecho. The concept of assisted death includes a heterogeneous variety of practices, whose common denominator is to guarantee citizens their right to participate in decisions related to their own death process, to make it as consistent with their preferences as possible. It’s one of the most controversial and discussed topics in recent decades, both in the academic field and in public opinion. This paper examines the two main justifications for its legalization: to guarantee individual autonomy as in other areas of life, and to avoid unnecessary suffering to the dying. It will be argued that, although both are related and both tie the ethics of care with the autonomy of the subject, the justification for autonomy is stronger and resists better the objections of those opposed to the legalization of this right. 

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