To fight against “medical deserts”, the solution of a fourth year of internship for young general practitioners is debated


It is a flammable measure. It has also aroused strong reactions, in the circles of interns and general practitioners, even before we know the exact outlines. “The government will propose to Parliament in the Social Security financing bill for 2023 [qui doit être présenté en conseil des ministres, lundi 26 septembre] the addition of a fourth year to the diploma of specialized studies in general medicine”, announced the Ministers of Health and Higher Education, François Braun and Sylvie Retailleau, in a press release on Sunday 25 September.

The one-year extension of the studies of interns in general medicine will have to be done in “encouraging” – this is the word retained in this common message – the installation in the territories “less endowed” in doctors. In other words, in the “medical deserts”, according to the somewhat hackneyed formula; them “under-dense areas”, practitioners prefer to say.

Read the interview: Article reserved for our subscribers Medical deserts: “The major problem remains the distribution of doctors on the territory”

A red rag? All weekend, social networks saw the reactions bloom, after the Sunday newspaperFriday September 24, then the AFP, Saturday 25, deflowered the project. “The addition of this consolidation phase to the diploma of specialized studies in general medicine, which would be exercised exclusively in outpatient practice [autrement dit, en ville], would aim to complete the training, thus aligned with the other diplomas of specialized studies »justify the two ministers in a mission letter that The world was able to consult. What irks doctors, young and old, comes next: “Given the medical demographics and the distribution of professionals in the territory, this year of consolidation will be intended to take place as a priority in under-dense areas”, they also write.

Send “Massive Reinforcement”

The idea is actually not entirely new: it figured among the campaign commitments of the candidate Macron, who mentioned, in the spring, the possibility of establishing this fourth year of boarding school, medium ” among others ” to send a “massive reinforcement in the medical deserts”. She was also agitated by other presidential candidates, on the right and on the left. The reform of the third cycle of medical studies, in 2017, created a single “diploma of specialized studies” in four years, but general medicine had, until now, a derogatory status to the year of consolidation .

Change of direction ? The objective put forward by the government, at this stage, and the speed of the start of the measure, for entry into force at the start of the 2023 academic year – but an effective implementation probably in the fall of 2026 or 2027 -, upsets the occupation.

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