The ax fell. Elisabeth Borne pressed 49.3 on Wednesday evening to have the entire Social Security financing bill (PLFSS) adopted, which contains a very controversial article among medical students. Namely the addition of a fourth year of internship for general practitioners, which would be carried out “as a priority in areas where the medical demography is under-dense”, according to the bill. A provision that will apply to students starting the third cycle at the start of the academic year 2023.
The news aroused the ire of the main concerned, who first condemned the method. “The government refused any dialogue with us. Failing this, we have done months of work with parliamentarians to explain to them why this fourth year of internship was not wise. And there, the government comes in force, ”deplores Théophile Denise, vice-president of Isnar-IMG, national union of general medicine interns.
In response, his union called the interns to strike from this Thursday evening, until November 2: “We purely and simply want article 23 to be withdrawn”, he declared to 20 Minutes. The National Intersyndicale des Interns (Isni) has also called for a strike from Friday until next Wednesday.
“We refuse to make up for the lack of doctors”
This opposition can be explained by several reasons. Students take a very dim view of the government’s incentive to do this fourth year in areas with few doctors, knowing that at present, 6 to 7 million French people do not have a doctor. “We refuse to make up for the lack of doctors and a year of operation where we will work 48 hours while being paid 2,500 euros gross per month. The lack of a doctor had been foreseeable for years, it is not up to us to pay the price”, sums up Théophile Denise.
The interns are always afraid of not being sufficiently well supported in the field: “We still have no assurance of having enough internship supervisors, knowing that 25% of those currently working will retire in the next five years. And we fear that the supervision will mainly be done remotely, ”says Théophile Denise. The latter also denounces the fact “that the educational content of this fourth year is still not known. »
The deans of medicine favor the measure
For their part, the deans of the faculties of medicine are more nuanced. During their press conference on Thursday, they recalled that they agreed with the principle of this fourth year of internship: “We are in favor of this consolidation phase. Because general medicine was the only medical specialty to have only three years of internship. There was a real educational need,” said Professor Didier Samuel, president of the Conference of Deans of the Faculties of Medicine.
Regarding the internship supervisors, the deans also want to be reassuring: “We currently have 11,800 internship supervisors, and even if some are going to retire, we have three years to recruit others. And we agree with the students on the fact that tele-supervision should not be exclusive”, indicates Benoît Veber, vice-president of the Conference.
Another point where the deans join the students: “We are against the coercion of interns to go to under-dense areas. Even if we must be wary of the term “medical desert”. Because we are not going to send the interns to the Sahara. There are under-dense areas a few kilometers from Paris, ”underlines Didier Samuel.