In response to the interview given by Professor Didier Samuel, Dean of the Deans of the Faculties of Medicine, in which he proposes to revise the model of the general medicine diploma to include more internships in hospital, the InterSyndicale Nationale Autonome and representative of the medical interns they insisted that it was essential that their training be consistent with their professional projects.
It is a proposal that provokes debate. In an interview with Egora, Professor Didier Samuel, Dean of the Deans of the Faculties of Medicine, offered to take advantage of the addition of a fourth year of internship at DES * in general medicine to completely review the training model. “Perhaps the model, as designed, over-emphasized outpatient placements and I think it might be a good thing to add hospital placement to it. This is something that needs to be weighed up with the coordinators and interns “, He explained.
“It doesn’t exactly happen like that”, shouts Mathilde Renker, president of the autonomous national InterSyndicale and representative of general practitioners. In the current model, in fact, only two out of six internships are to be carried out as a liberal: the level 1 professional internship and the outpatient internship in primary care in supervised autonomy (Saspas). Two others are necessarily hospital, that of the emergency room and that of general medicine. Finally, women’s health and child health internships can be outpatient, inpatient, or coupled between the two – very often, it’s in the hospital. “In three years we have only one year on an outpatient basis… Even though we know very well that the vast majority of general practitioners in training will practice in the city. To encourage us even more to go to the hospital, when it already represents half of our model, it is not going in the right direction ”. continues Mathilde Renker.
The union, on the other hand, wants to go further. Indeed, Isnar-IMG aims to reflect on the possibility of carrying out a women’s health internship alongside a liberal midwife. “In the same way we could do internships with pediatricians in a private practice”, explains Mathilde Renker. Of course, the future general practitioner does not deny that the problems of access to care concern all types of territories and methods of exercise, hospitals in particular. “But let’s think about the training of future doctors and the consistency with their professional projects. The interest of the internships is to get closer to our future practice “.
The interns ask for a mobilization on the respect of working hours.
The president of Isnar-IMG also wishes to return to Professor Samuel’s observations on respecting the timetable of the 48 hours per week: “They must therefore have reasonable working hours, with the possibility of compensatory rest after on-call duty and the possibility of dedicating themselves to training and / or research activities”, assured the hepatologist. “We can’t talk about reasonable working hours when we know that interns work more than 48 hours a week. Especially when it comes to burnout interns, serious mental health consequences. I remember that 19% of medical students had suicidal thoughts last year. We know that working hours are an important risk factor “, he said, underlining the importance of the Deans’ commitment on this issue.
“I am surprised that we are talking about” reasonable “working hours”, notes the president of the national InterSydicale for interns. For Gaetan Casanova, the observation is however known to all: “the The answer we expect is therefore that working hours must be scrupulously respected. We want courses that do not respect the half-days of training and go beyond the regulatory framework to have their approval withdrawn “. he says. The union president also recalls that a strong commitment was made by Professor Samuel’s predecessor on the subject. “The Headmasters, like the Headmasters, signed a document in which they made commitments regarding working hours. In particular, they must put in place a system that makes it possible to guarantee the respect and faithful evaluation of the declaration “. He explains.
Finally, Mathilde Renker recalled that the phenomenon of degraded mental health is far from being a new topic, as Professor Samuel assures: “A survey we published in 2017 already showed this phenomenon, that of 2021 has shown its increase. There is a real awareness of these problems and we must put everything in place so that medical students are comfortable in their studies. ”
* DES: diploma of specialist studies