The number of specialists is lower than that internationally recommended and insufficient to cover the health needs of the country. Gender distribution is shifting towards a more equitable one. Specialists are mainly grouped in urban areas. This is the first census of specialists based on total verifiable number of physicians, which will allow the design of policies for human resources planning in health.

Introduction.In 2016, there were 4,393 psychiatrists in Mexico, with an estimated rate of 3.68 per 100,000 inhabitants. It is essential to keep this information updated in order to achieve the overall objectives of mental health care. Objective. Estimate the total number of psychiatrists and paidopsychiatrists in Mexico in 2018; identify their geographical distribution, and compare the results with those obtained in 2011 and 2016. Method. Comparative, longitudinal study. Various sources were consulted to update the number of psychiatrists and paidopsychiatrists in 2018 and to determine their sociodemographic characteristics. These characteristics were compared with those found in 2011 and 2016. Results. A total of 4,999 specialists in psychiatry practiced their specialty in Mexico in 2018, 365 of whom are child and adolescent psychiatrists. A rate of 3.71 psychiatrists per 100,000 inhabitants was obtained for a population of 124,737,789. Regarding pedopsychiatric specialists, if we consider a population of 37,714,991 inhabitants under 16, the corresponding rate is .96 child and adolescent psychiatrists per 100,000 minors. These specialists are unevenly distributed throughout the country. Approximately 60% of all psychiatrists and child and adolescent psychiatrists practice in the three largest cities in Mexico. Discussion and conclusion. Although the national rate of psychiatrists was increased in comparison with 2016, it is still lower than that recommended by the World Health Organization (WHO). The geographical distribution of psychiatrists is uneven due to centralization and economic factors as happens in many countries in the world.

Methods A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented. Results Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content. Discussion The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.

through the Post-degree Committee, is the coordinating agency of the National Exam for Medical Residence Aspirants (ENARM -Examen Nacional para Aspirantes a las Residencias Médicas). In 2016, 38 077 general physicians contested for the 7805 available posts to start specialization training. 5 The National Health System has 81 specialty courses available, 5 out of which 78 are offered by the

Objective: to analyze the educational quality of graduates through the following academic indicators: a. Occupational mobility, b. Number and type of scientific publications, c. Publication of chapters or medical literature, d. Postgraduate studies, and e. Certification by the corresponding specialty board. Method: descriptive cross-sectional study. Different databases were reviewed, the following stand out: 1. List of graduates. 2. Registry of the different specialties; National Regulatory Committee of Medical Specialties Councils to know both the certification status, and in the General Management of Professions, belonging to the Ministry of Public Education, the professional certificate status. 3. Index of journal authors (PubMed, Embase, Medline), 4. Databases of medical insurance and health institutions in Mexico and 5. Databases of Postgraduate Degrees in Medicine Results: The academic indicators of 14,770 medical specialists who graduated from the Sub-direction of Medical Specialties of the unam in the last six years were analyzed. The trajectory of the graduates shows a gradual increase in the percentage of board certifications, number of published articles, and postgraduate courses. Nearly 60% of the specialists work in Mexico’s three largest cities. Conclusion: the number of graduated specialists is insufficient in quantity and distribution to cover the health needs of the country. Despite the increase in scientific production, there is still a need to increase the number of research projects, and scientific publications by graduates. It is necessary to rethink medical specialty programs in accordance with health care needs, and the international context.