The Numerus clausus in medical studies is inadequate filter

The French regularly express their attachment to their health system to consider sometimes as the "best in the world." This rather positive report coexists with less favorable indicators. Access to care is a concern of many French and desertification of certain rural or peri-urban areas is a central issue and questioned the ability of the training system to provide people professionals it needs, where it needs . Social inequalities in health do not regress and probably reflect the highly curative and preventive weakly direction our health system.

Training, particularly physicians, is a long-term exercise and requires integrating future developments in any forward thinking. two major changes can be glimpsed: the explosion in the use of data from genome studies for the development of personalized medicine for patients, better informed and anxious to be involved in their care, but remind us of the importance they attach to social skills and empathy of health professionals towards them.
A major challenge for medical schools as recruitment and training of health professionals must adapt to the technological revolution and integrate societal emergence of chronic diseases with a corresponding priority given to the field of prevention. The dominant hospital training does not meet the challenges of primary care that is not consistent with the reality of the traditional family doctor "with her good old bag," as one tool and Viaticum.

Entry to medical school is considered a sometimes insurmountable obstacle by highly motivated and young bachelor graduates with honors. They result mainly of the most disadvantaged sections of our society and face a first year very selective contest, the PACES (First common year health studies) which now leads to four traditional courses (medicine, pharmacy, dentistry and midwifery) with, in the end, and at the end of a repetition for the majority of them, a high percentage of failure and exclusion from health studies.
Ineffective selection
Numerus clausus is inadequate because inefficient and convoluted filter. It is supposed to regulate the number and distribution of physicians in the area and has eliminated excellent students generations. The negative experiences of our citizens feeds a misunderstanding of policy choices in this area. Thus, in the field, so that lack of doctors, it promotes the recruitment of foreign doctors, some imperfectly francophones, whose skills have not been evaluated with selective requirement required for our national students. Moreover, it is possible to bypass the PACES by an entry in another European university and end of the study to pass the examination National Categorizing without eliminatory mark, and exercise the internal responsibility specialty.

The numerus clausus in its current form is no longer appropriate and should be abandoned. It is neither a reliable regulator of medical demography nor an efficient tool of territorial distribution of future physicians and appears to be unfair in light of its circumvention. Only the limitation of the number of students based on maintaining the quality of training and thus foster practical abilities is legitimate. The PACES be less specialized and broaden the base of educational programs by inserting common lessons to other university licensing programs in the logic of a true academic career Licence, Master, Doctorate. This should lead to smoother entry into 2nd year students of various licenses that do not incorporate traditional medicine health sectors, midwifery, pharmacy, dentistry. Selection may therefore be organized in a single academic year at the waning of which students can progress either by joining the traditional sectors, or by entering a university course giving them access to other professions of new health courses leading to new jobs. In the same spirit, we must promote the entry into traditional courses, students from other university courses to ensure a recruitment diversity of social backgrounds and so overall a professional wealth. Such fields must diversify and out of hospital for any form on the practice of general medicine. The training and development of tutors and positioning of multi-professional nursing homes to university qualification are territorial reconquest keys.
The national ranking examination (ECN) should not be single purpose, governing the goal of training the entire second cycle thus stifling the personalization possibilities of the student orientation. Training must ensure the ability to develop a multi-professional team with delegation of tasks. These requirements lead us to propose that domestic students, European, and international validate all the exam graduation Cycle 2 with oral, for the award of a certificate of clinical competence qualifying introduce ECN, thus preventing the students, wherever they come from, no competent, accessing the responsibility of patients.

Are these goals realistic? In fact, the medical faculties of the community and the students have never been closer to a coherent analysis and proposal. The first return of experiments on the diversity of input modes in the medical curriculum demonstrates feasibility. The societal expectation is such that it forces us to a dynamic response. The policy should thus stimulate the establishment of "health components" in universities. The age-old task of medical schools is of course to train doctors but their social vocation leads them to open their field of expertise by offering joint training partnerships with traditional and new health professions. Knowledge and expertise can not be separated from a life skills with what he requires of introduction to social sciences and training in ethical questions prior to any health profession. An opportunity opens, the National Health Conference must seize to give the cap a transverse project respectful of the specifics of the training of future health professionals at the service of citizens and patients.