Patrice Diot, dean of the Faculty of Medicine of Tours and former president of the National Observatory of the demography of health professions, believes that the increase in the number of trained doctors will not be enough. We now have to demonstrate political bravery “, according to him, and move towards a “ regulation » the installation of doctors in the territories, for young doctors, but also the oldest, by playing on the agreement.
The medical deserts extend in the rural territories, and also in town. How did we get here ?
We are in a situation of catastrophic medical demography in many territories, including the Centre-Val de Loire region in the first place. The situation is no longer tenable and I understand the uneasiness of the population, society is on the verge of explosion, emergency measures are needed.
This is largely explained by the fact that for fifty years, the numerus clausus [le nombre d’étudiants autorisés à poursuivre des études de médecine] was used by public authorities as a regulatory tool, which was absurd. Result: we arrived at this extremely low level of 3,500 places in medicine at the end of the 1990s. It was then estimated that there were too many doctors in France, they were charged with the deficit accounts of the Medicare.
Since then, we have loosened the vice, we reached 7,000 to 8,000 young people trained in the 2010s, but the damage was done, the deficit widened to such a level that it still explains our current difficulties.
A reform of the numerus clausus, replaced by a higher “numerus apertus” set by the universities, was initiated in 2020. Is this enough?
The increase in the number of students has indeed been significant, with 10,500 students entering their second year of medicine in 2021, 20% more than in 2020. Several presidential candidates argue that more needs to be done, by training, for example, “20,000 doctors”, but we have arrived, with the current resources of the faculties of medicine, at the maximum of what we can do in terms of training without degrading its quality.
Above all, do we need to train twice as many doctors? I’m not sure of it. Mechanically, this number problem should be resolved in the coming years. There are good reasons to think that in ten to fifteen years, with the current level, it will be good, even if I can see that this message is not heard today. Even taking into account the fact that a retirement of a general practitioner would only be compensated today thanks to two or three doctors – the younger generations having a lower volume of hours and wishing to preserve a balance between professional and life personal. Or even with the aging of the population, requiring more care, and more chronic diseases to follow.
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