General practitioners: the fourth year of internship arouses tensions

Posted on September 27, 2022 at 19:06

At a time when doctor shortages are a concern, the government would do well without a white coat strike. On Monday, the Intersindical Nacional de Internos (ISNI) and the Young Doctors union promised to launch a “great mobilization that will reach the strike of all the inmates” in October.

The organizations are concerned about the project to create a fourth year of the general medicine career, as part of the Social Security budget project for 2023 (PLFSS) presented this Monday. This fourth year “would be encouraged in territories with fewer general practitioners,” the government said.

Leave your family at 30

The executive has promised to give, in the wake of the National Refoundation Council, answers to the difficulties of the hospitals and the medical deserts in the city and in the countryside.

However, many doctors are very attached to freedom of installation. And the project of conducting a new study in areas with few doctors has made some young doctors jump. “We cannot impose [à des médecins généralistes en formation]over 30 years old, to go away from their families”, write ISNI and Jeunes Médecins.

“To think that the fourth year would be the solution to the problems of medical demography is a mistake”, declares for its part the union of general practitioners, MG France, for which all of France suffers from a “global shortage”. On the other hand, the organization considers that general medicine “requires a professionalizing year like all other specialties”.

internship supervisors

Today, general medicine is the only medical specialty that has only three years of internship, “recalls the government. According to the latter, the current system “does not favor immediate installation at the end of the course.” Young general practitioners would not have enough life experience in practice to decide directly to leave their studies and would prefer to be substitutes.

Hence the desire that this fourth year be carried out “exclusively with liberal doctors” with training as “supervisors of university practices”. “This fourth year is done to improve the training of general practitioners, not at all to solve the problem of medical deserts,” Health Minister François Braun told franceinfo on Tuesday.

consultation mission

The Minister also denies imposing a destination on the students. “It is not mandatory, it is a strong incentive for them to go to these territories,” he said, referring to incentives such as housing aid, etc. These measures will be worked “together with local authorities”, specifies the Social Security budget project.

Anxious to “associate all the actors in this reform”, he entrusted a “mission” to four experts on Sunday. The conclusions of the mission are expected before the end of the year. The measure should be applied from next year for those who enter the first year of the specialty of general medicine.

In other words, it is not about immediately encouraging young doctors at the end of their training to go to areas with few doctors.

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