The Spanish Society of Rheumatology and the Mexican College of Rheumatology (CMR for its initials in Spanish) have been firmly united since 20051.

Spain has shared its current situation in a manuscript by Sanchez-Piedra et al., where emphasis is placed on the total number of rheumatologists per inhabitant, finding an overall density of 2.17 per 100,000 inhabitants, however, emphasising that this density varies in different communities from 1.7 to 3.62. Grados et al.3 mention the weakness of these studies and expand on the need for a more detailed census of rheumatologists, as well as mentioning that it should not be inferred that the highest percentage of active rheumatologists belong to the Spanish Society of Rheumatology.

A search was therefore carried out in the databases of the country's rheumatology associations. By the year 2021 in Mexico there was a total of 1053 doctors who had completed their training in rheumatology (1975–2021). Of this total, 954 practised in adult rheumatology and 99 in paediatrics. However, 320 physicians were not found to have current certification in 2020, which suggests that they are no longer alive or no longer practising the speciality. There are a total of 733 active rheumatology physicians in Mexico, of whom 77/733 (11%) are paediatric rheumatologists and 656/733 (89%) are adult rheumatologists.

Taking into account that the CMR database shows data for 679 rheumatologists, we can assume that 93% of rheumatologists with current certification belong to the CMR, very similar to the figure estimated by Sánchez-Piedra et al.2

For the year 2020, the Mexican population was 126,014,024 inhabitants4; when calculating the density of rheumatologists for the general population, we found a density of .58 per 100,000 inhabitants; which is not promising, as in 2015 a density of .62 was reported in two different cohorts. However, we do not know the number of active physicians on that occasion and there is discrete variety in the total figure (722 vs. 755) which increases the importance of more detailed censuses5,6.

One possibility is that our current figure is underestimated, due to the lack of recertification of some physicians. Despite this, and with respect to an encouraging scenario where the 926 members of the CMR were active, the density would still be low with a total of .73, not approaching the suggested minimum of at least 1.0 per 100,000 inhabitants5.

It is striking that the main metropolitan areas, Mexico City, Nuevo Leon and Jalisco have 424/733 (58%) of the total number of rheumatologists, with very variable densities in different states from .2 to 3.0, showing a clear centralisation of physicians in metropolitan areas (Fig. 1).

Fig. 1.

Density of rheumatologists per 100,000 inhabitants in selected states. Demographic data taken from the National Institute of Statistics and Geography (INEGI for its initials in Spanish).

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It is of interest that 390/733 (53%) female rheumatologists were found, very similar to the figure of 59.7% found in Spain.2

In 2007 Badia-Flores et al.7 estimated that for 2020 there would be a population of 115 million, with 732 rheumatologists in Mexico. Although the estimated number of rheumatologists almost enigmatically coincides with the active certificates, the increase in population has grown exponentially in recent years, showing even more evident the need for rheumatologists mainly in non-metropolitan areas.

Currently, an average of 32 rheumatology specialists graduate per year. However, considering the population growth, the need for a detailed census of rheumatologists and the expansion of medical specialisation programmes are of vital importance to meet the demands of the specialty in the future.