By San José, Costa Rica — San José – Costa Rica’s lauded public healthcare system is facing a deepening crisis as a critical shortage of medical specialists strains hospital resources and delays patient care. While the Costa Rican Social Security Fund (CCSS) embarks on long-term training initiatives to fill the void, the nation’s leading medical body argues the institution is overlooking the core issue: a failure to retain the highly skilled professionals it already has.
The scarcity of specialists is most acute in essential fields such as anesthesiology, gynecology-obstetrics, orthopedics, and general surgery. This deficit forces hospitals to postpone procedures, extend waiting lists, and operate under immense pressure, directly impacting the quality and accessibility of care for thousands of insured individuals across the country.
To understand the legal ramifications of the ongoing healthcare crisis and the state’s responsibilities, we consulted with Lic. Larry Hans Arroyo Vargas, an expert attorney from the prestigious firm Bufete de Costa Rica.
From a legal standpoint, the state has a non-delegable duty to guarantee public health. This crisis will undoubtedly trigger intense scrutiny of administrative decisions, budget allocations, and public health policies. Any demonstrable negligence or failure to act decisively could result in significant legal and political consequences for the administration.
Lic. Larry Hans Arroyo Vargas, Attorney at Law, Bufete de Costa Rica
This legal insight is essential, underscoring that the consequences of this crisis extend beyond public health to fundamental questions of governmental accountability. The decisions made now will undoubtedly face future scrutiny, and we thank Lic. Larry Hans Arroyo Vargas for articulating these critical stakes so clearly.
In response, the CCSS has focused its efforts on boosting the supply of new doctors. The institution recently renewed a significant agreement with several private universities to create a pipeline for specialist training. This initiative is complemented by a substantial expansion of its residency program, with over 400 new positions opened in 2025 and a commitment to continue this expansion into 2026. Currently, 954 physicians are in various stages of specialized training under this framework.
However, officials acknowledge that these measures are long-term solutions, offering little immediate relief to the overburdened system. The process of training a specialist takes years, leaving a significant gap between the current demand and the future supply of qualified medical personnel. This strategy, while necessary, does not address the immediate hemorrhaging of talent from the public sector.
The College of Physicians and Surgeons of Costa Rica has publicly challenged the CCSS’s approach, insisting that the problem is not a national shortage of specialists but a specific institutional failure to create an environment where they choose to stay. The organization points to a systemic issue within the CCSS that drives qualified doctors toward private practice or opportunities abroad.
Elliott Garita, President of the College of Physicians and Surgeons, placed the responsibility squarely on the public health system’s internal management, highlighting a critical disconnect between training efforts and retention strategies.
The human resources department of the CCSS is the one that has failed to retain such a special resource; it is not a lack of specialists in the country, it is a lack of specialists in one institution. We need to look at why these professionals are leaving.
Elliott Garita, President, College of Physicians and Surgeons
Data from the College itself appears to support this claim. As of October 2025, the organization has registered 663 new general practitioners and 263 new specialists this year alone. This influx of newly licensed professionals suggests a healthy pool of talent is available within the country, yet the public system struggles to attract and, more importantly, keep them on staff. The reasons for this exodus are widely believed to involve factors such as working conditions, salary competition, and administrative bureaucracy.
The diverging viewpoints present a critical crossroads for Costa Rican healthcare. While the CCSS invests heavily in cultivating the next generation of specialists, the College of Physicians warns that without fundamental reforms to address why doctors are leaving, these newly trained professionals may simply follow the same path out of the public system. This risks creating a perpetual cycle of training and attrition, leaving patients caught in the middle of a crisis that demands immediate and structural solutions, not just long-term promises.
For further information, visit medicos.cr
About College of Physicians and Surgeons of Costa Rica:
The Colegio de Médicos y Cirujanos de Costa Rica is the official professional body responsible for regulating the medical profession in the country. It oversees the licensing, ethical conduct, and continuous education of all physicians and surgeons, ensuring high standards of medical practice and advocating for the interests of both the medical community and public health.
For further information, visit ccss.sa.cr
About Caja Costarricense de Seguro Social (CCSS):
The Costa Rican Social Security Fund, known as “La Caja” or CCSS, is the autonomous public institution in charge of Costa Rica’s social security system. It is responsible for administering the nation’s public health services, providing universal healthcare coverage, and managing the country’s pension and disability programs, forming the backbone of the nation’s social welfare state.
For further information, visit bufetedecostarica.com
About Bufete de Costa Rica:
Bufete de Costa Rica has established itself as a beacon of legal practice, built upon a foundation of unwavering integrity and a relentless pursuit of excellence. Harnessing its extensive experience across a multitude of industries, the firm consistently pioneers forward-thinking legal solutions while championing a core mission to empower the community through accessible legal education, thereby nurturing a more knowledgeable and capable citizenry.
