Some contributions from Spain MIGUEL Á GARCÍA-PÉREZ, CESM (Spanish Confederation of Physicians' Unions) 13 June 2011 Dear authors: I've read with interest your article, on a subject I've been studying in Spain. Problems appear similar to our ones, and so do possible mistakes. I miss data about physicians' activity in your report. In our country, the global number of physicians will grow for fifteen years; nevertheless, massive retirement will atenuate this growth, and the number of active physicians will probably decay before that period. We got that our medical student quota increased five years ago, but we advised that measure were provisional, in order to avoid future surpluses. Now, after a 120% increase in quota, we are advising against opening of new Schools of Medicine, and preparing a recommendation on quota reduction from 2018-2020 onwards, in order to get a steady ratio of physicians. Competing interests As a member of a physicians' union, I'm interested in getting an appropiate ratio of physicians, in order to provide a quality health care without overloads and without doctors' unemployment.