Could the undergraduate French and Belgian training program explain the shortage of GPs in both countries?

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15th W

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2009 B

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15th Wonca Europe Conference 2009 Basel

32nd National SSMG/SGAM Congress

«The Fascination of Complexity Dealing with Individuals in a Field of Uncertainty»

«The Fascination of Complexity – Dealing with Individuals in a Field of Uncertainty»

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Could the undergraduate French and Belgian training

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program explain the shortage of GPs in both countries?

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Introduction:

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Introduction:

Dumontier E

1. , Vignon G.

1 , Jamoulle M.

2

Shortage of manpower in GP/FM is a serious problem in Belgium and France. Despite

Dumontier E , Vignon G. , Jamoulle M.

1

2

S o tage o a po e G / s a se ous p ob e e g u a d a ce esp te the advertisement of some authorized voices, the evolution of the medical cursus in

Pestiaux D

1 Minguet C

2

,

medicine has been oriented towards technology and specialties in the last 40 years and

Pestiaux D. , Minguet C.

the low number of medical students attracted by the profession of GP is now a fact.

Ai Aim:

to identify the elements of the cursus influencing the choice of the career of general to identify the elements of the cursus influencing the choice of the career of general Medicine by the students including the differences between the Family Medicine

Medicine by the students including the differences between the Family Medicine Training Program in France and Belgium

Training Program in France and Belgium

Methods:

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• Exploring the training programs of the two structures one in Reims, France and one in B l (U i f L i ) B l i

Conclusion for the improvement of general practice

Brussels (Univ of Louvain), Belgium

Participating to the ocational training sessions in both sites to meet the former

In the faculty of medicine

• Participating to the vocational training sessions in both sites to meet the former

undergraduate students

In the faculty of medicine

COMPETENCES

undergraduate students

• Conducting an inquiry with trainees in GP/FM in both sites about their choice of career

_COMPETENCES

• Conducting an inquiry with trainees in GP/FM in both sites about their choice of career

Qualitative study on student’ opinions S ti i f F h d Same questionnaires for French and

Belgian students

¾ General medicine must find its place in the course of the

Belgian students

96 French & 35 Belgian.

¾ General medicine must find its place in the course of the

university as other specialties

Closed questions : multiple choice Simple quantitative analysis (%)

university as other specialties.

Simple quantitative analysis (%)

¾ The ambulatory medicine rotation must be established early in

Results:

¾ The ambulatory medicine rotation must be established early in

the studies and should be mandatory

Results:

_{the studies and should be mandatory.}

¾ The selection of future specialty must take into account the

Women ; 66% (French) 76% (Belgians)

¾ The selection of future specialty must take into account the

motivations of the student

Women ; 66% (French) 76% (Belgians)

_{motivations of the student.}

15% of the students of the Master of family medicine in Belgium and France are not % y g

¾ A real chair of general medicine to create and be recognized

willing to become GP

¾ A real chair of general medicine to create and be recognized

within the university

g

within the university.

Place of general medicine until the end of the second cycle of medical studies

_{General practice is central to the system of care}

m

between DMG-Reims and CAMG-UCLg . y

General practice is central to the system of care

om

UCL (B ) REIMS (F )

and must be the center of the Medical Faculty

.co

UCL (Be) REIMS (Fr)

y

ail.

ma

L T t l f 120 h T t l f 38 h

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Lesson Total of 120 hours Total of 38 hours

@gr@

I hi T l 31 W k d T l 12 k l

er

Internship Total 31 Weeks and some

days compulsory optional

Total 12 weeks non‐compulsory and some days compulsory

tie

days compulsory optional. and some days compulsory

optional

ont

optional.

mom

Presence of general practice within the university and academic

du

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y

lectures

.d

90% (F) & 81% (B) argue that the information

ie

90% (F) & 81% (B) argue that the information

given during the undergraduate curriculum don’t give

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given during the undergraduate curriculum don t give

incentive towards GP/FM

42% of French against 8% of Belgian students are absent from lectures.

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incentive towards GP/FM

medicine

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70

:

70 90

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60 80

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₅₀ 70

nt

60 40 50

on

50 60 No 40 % France

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40 50 % No Yes 30 % Belgium 30 40 Yes NR 20 g 20 30 NR 20 10 20 10 0 10 0 ₀ France Belgium 0

Absent Mentioned As present Present like other

France Belgium

80 Overview of students:

R l d i t 100

Are you seeing GP as an academic career?

70 _NO

74% of French and 51% of Role and importance

f i t hi i 90

100

Are you seeing GP as an academic career?

50 60

Belgians think that current of an internship in

graduate: 80 90

French 11% Belgian 8%

40 50 % YES

studies do not attract

t d l ti graduate: 60 70

French 11% Belgian 8%

Ph C B ll 30 40 % no

towards general practice. _{91% of French and 89%}

f B l i

50 60

% NO

Photo C. Bolly

20 answered of Belgians are

i i th 30 40 YES 100 0 10 recognizing the importance of training 20 30 90 0 France Belgium importance of training 0 10 80 90 0 France Belgium 70 80

Valuing general practice in g g p 60 70

within the faculty: 50 ₇₀ ₆₀

Devalued + poorly valued: 40 But, only 32% of 60 % 50 No

Devalued + poorly valued:

87.5% in F and 62% in B. % 30 France

, y

French students and 50 ₄₀ Yes

87.5% in F and 62% in B.

V l d 12 5% F d 35% i B 20

France

Belgium 62% of Belgians have ₄₀

30 40

Valued: 12.5% F and 35% in B.

10 made this famous

t if d i d 30 % NO YES 30 0 10 stage if desired. 20 30 _YES 20 0