At the beginning of 2025, the Madrid College of Physicians (Ilustre Colegio Oficial de Médicos de Madrid, ICOMEM) faced an unprecedented financial downturn. While there were more than 4 million euros in the organization’s accounts at the start of 2024, that figure has now dropped to just 66,000 euros. Over the past year, the institution’s budget has all but vanished, and the reasons behind this collapse have sparked intense debate within the College itself.
Internal disagreements among the leadership have only added fuel to the fire. After the annulment of the December 2024 election results—when the elected president, Tomás Merina, was unable to take office due to challenges to his candidacy—the College was plunged into uncertainty. The interim head, Manuel Martínez-Sellés, continues to lead the organization despite his term having expired, while legal proceedings over the legitimacy of the administration have dragged on for months.
Renovation and expenditures
The main reason for the financial losses was the extensive renovation of the College’s historic building on Santa Isabel Street, 51. The original plan was to spend 1.1 million euros on repairs in 2023, but the final amount ballooned to 4.4 million. In 2024, the situation repeated itself: instead of the planned 1.4 million euros, expenses soared to 4.7 million. The cost overrun exceeded 220% of the initial budget.
Some spaces, such as the Jiménez Díaz auditorium, saw costs rise from €441,000 to over one million euros. The renovation of the entrance area and lobby ended up costing €704,000 instead of €150,000. Additionally, unexpected extra work came up during the process, adding another €1.5 million to the total expenses.
The management attributes these expenses to the complexity of working in a designated World Heritage Site and to the need to comply with strict requirements for preserving its historical appearance. However, the opposition accuses the current administration of mismanagement and lack of transparency.
Revenue Shortfall
It was expected that renting out the renovated spaces would bring the College around two million euros in 2024. In reality, revenue reached only €809,000. According to critics, the rental prices were uncompetitive and demand lower than forecast. As a result, the financial independence the management had hoped for was not achieved.
The budget took another hit when membership fees for the region’s 52,000 doctors were reduced. Critics call this a populist move that led to an additional €2.5 million in losses over the year. Now, the College relies almost entirely on regular fee payments, which are quickly spent on current needs.
Loans and Risks
In March 2025, the Colegio signed a credit line with Banco Santander for 1.5 million euros. Although these funds have not yet been used, the opposition fears they may be needed to cover staff salaries — a purpose that alone requires 240,000 euros annually. The Colegio itself claims the loan was taken out as a precaution for unforeseen expenses and has not been utilized so far.
The loan was arranged without approval from the Assembly of Representatives, sparking a new wave of criticism. The leadership explains that ongoing legal disputes have effectively paralyzed the Assembly’s work. Questions about the transparency and legality of such decisions remain unresolved.
Internal conflict
Inside the Colegio, a fierce struggle continues between supporters of the current leadership and the team of Tomás Merina. The opposition accuses Martínez-Selles of authoritarian management and of trying to conceal the real state of affairs. In their view, the financial crisis and managerial chaos are two sides of the same coin.
At the same time, the current head insists on the organization’s stability and claims there is no threat to its operations. He emphasizes that all obligations to employees are being met and that financial difficulties are temporary. However, as long as the legal disputes remain unresolved, the Colegio is left in limbo, raising more and more questions among Madrid’s medical community about its future.
