“Considering the number of young people we train in medicine [à hauteur de 10.500 par an aujourd’hui], I think we are not immune to one day finding ourselves in a situation of medical abundance.”warned Patrice Diot, honorary dean of the Faculty of Medicine of Tours (Indre-et-Loire), on Thursday, October 17, during a conference organized at the Academy of Medicine in Paris. “We constantly yo-yo”he lamented, while in recent years the emphasis and political will has been placed on training new doctors to respond to the problem of medical deserts.
Too many doctors in 2035?
The current difficulties in accessing care are partly linked to numerus claususa quota policy in the training of doctors, launched in the 1970s, which peaked in 1993, when France had only 3,500 second-year medical students in its faculties. The quota was gradually loosened in the late 1990s, and then eliminated at the initiative of Emmanuel Macron.
In April, Gabriel Attal, then prime minister, called for the faculties to give another major boost to student training, setting a target of 16,000 gunners trained a year.
Problem: these new students wouldn’t start working until around 2035 at the earliest, at which point retirements would drop drastically and medical density would begin to improve significantly.
“The figure of 16,000 is not scientifically documented”emphasized Benoit Veber, the president of the Deans’ Conference, which organized the conference. However, the deans are aware of the major current difficulties in accessing care. They suggest other ways to change the health system, even if it means raising sensitive issues in the sector, such as regulation of the employment of doctors.
“There will come a time when we will have to force ourselves a little, like the pharmacies did [et] promote installations in under-dense areas »did not hesitate to launch Professor Thierry Moulin, the Dean of the University of Besançon.
The idea of a “national medical service”
Thierry Moulin suggests questioning the national ranking of the boarding school competition, which every year causes many young boarders to leave their region of origin.
In dense areas, he says, “there are students educated in residential areas, from these residential areas” who should be able to stay there more easily if they wish.
Benoît Veber and Patrice Diot defend the principle of one “national medical service”a one-year contract to be offered to young doctors so they can settle in underpopulated areas.
Another attempt by deans in a sensitive area: delegating tasks or sharing skills with other caregivers (nurses, physiotherapists, pharmacists and other paramedical professions) who can help relieve overburdened doctors. A red flag for some doctors who fear seeing these carers encroaching on their land.
But that could free up time for the doctors, the deans note. “We have to break […] this patriarchy of the medical world on the artists”said Thierry Moulin in front of his colleagues. “The medical time must be reserved for complex things. What is less complex, we delegate and control”he added later.
“An advanced practice nurse is five years of study, which corresponds to an engineering degree. We can learn a certain number of things in that time”assessed Benoît Veber for his part.
For him, non-medical caregivers are needed “educated to support chronic diseases”or even prescription in certain cases, but which “will always practice their profession under the supervision of a doctor”.