The development of internal medicine leads to the emergence of specialised fields

Dr Joaquín Tornos designed the department with an Internal Medicine Unit led by Dr Juan Pedro Botet, another under Dr Bacardí; a third headed by Dr Alvarez Buylla, and a fourth overseen by Dr Joaquín Tornos Solano himself. From the outset, he structured it this way, although he already believed that specialities would eventually be necessary – a view that faced significant opposition.

Meanwhile, in 1975, a Cardiology Department was established under the leadership of Dr Jordi Soler Soler, which became a flagship unit of Vall d’Hebron Hospital. The groundwork was also laid for the future Digestive Medicine Department, which was formally created in 1985 with Dr Juan Ramón Malagelada as its first head.

Haemato-oncology was separate from Internal Medicine from the outset and was already established at the hospital when Dr Agustí Pedro Pons arrived. The head of Haematology was Dr Triginer; Oncology and Radiotherapy were led by Dr Salvador, who was also the hospital’s director, and Radiology was headed by Dr Leandre Pedro Soler, another nephew of Dr Agustí Pedro Pons.

There was also the Laboratory, overseen by Dr Simon Schwartz, Microbiology, led by Dr Lluís Arcalís; and Pathological Anatomy under Dr Moragas, all of whom had trained at the Hospital Clínic under the guidance of Dr Agustí Pedro Pons. Paediatrics was headed by Dr Àngel Ballabriga.

By 1985, one of the four Internal Medicine Units remained as Internal Medicine with a focus on Hepatology, which included Dr Jaume Guardia and Dr Rafael Esteban. Another became the foundation for what would later evolve into the Infectious Diseases Department. A third Internal Medicine Service, led by Dr Miquel Vilardell (who succeeded Dr Joaquín Tornos Solano) eventually gave rise to the future Geriatrics, Rheumatology, Allergy and Systemic Autoimmune Diseases Departments, as well as an Internal Medicine Unit.  From the former Internal Medicine Service led by Dr Joan Pedro Botet, the Pneumology Section was established in 1975. Likewise, the Endocrinology Section was created in 1970 from the service directed by Dr Álvarez Buylla.

Over time, each speciality gradually established its own dedicated department, while the Internal Medicine Service continued under the leadership of Dr Miquel Vilardell.

This hierarchical organisation of medical departments significantly enhanced the hospital’s scientific reputation and prestige.

Today, Vall d’Hebron Hospital is the only hospital in Catalonia with departments covering all medical specialities, including a specialised unit for severe burn patients. 

The arrival of the first residents

In 1969, the first cohort of medical residents arrived, and in 1971, the hospital became affiliated with the Autonomous University of Barcelona (UAB). As a result, third-year medical students – who had previously trained at Hospital de Sant Pau – also began their training at Vall d’Hebron. Dr Joaquín Tornos assigned many teaching responsibilities to Dr Bacardí and Dr Guardia, with the latter playing a particularly significant role in developing the Vall d’Hebron Hospital teaching unit.

For some of the new residents who joined in the early 1970s, the existing system felt somewhat outdated. While the hospital had highly skilled internists, their approach was less specialised compared to Hospital de Sant Pau, which already had dedicated departments for digestive surgery and cardiology, among others. At the time, there were two distinct perspectives on internal medicine: one holistic and integrative, and another that advocated for increased specialisation.

Residents were primarily assigned to emergency care, as there were no available positions elsewhere. In reality, there was no dedicated Emergency Department – even though Dr Jaume Guardia being appointed as its head – because emergency cases were still handled by internal medicine ward doctors.