For future doctors, the puzzle of choosing a specialty

This is the question they all ask themselves

For future doctors, the puzzle of choosing a specialty

This is the question they all ask themselves. At the end of June, 9,000 sixth-year medical students have an appointment for the national ranking tests. They will all work on a hundred questions relating to their last three years of studies. An essential examination since it allows access to boarding school and to choose one's specialty.

At the time of the most important choice of their career, how do future doctors make their decision? On March 1, 2023, on the occasion of "Demography Day 2023: free or assisted, what future for the practice of liberal doctors in the Ile-de-France? », organized by the URPS liberal doctors Île-de-France, Emanuel Loeb, president of Young Doctors, spoke about the determinants when choosing the specialties of future practitioners.

"Training in medicine tends to become obsolete, in particular because of a concentration on the public hospital", noted the Parisian psychiatrist. Dr. Loeb also highlights the importance of work/life balance for future physicians: "Now both people in a couple are working, so both have to adapt to each other, especially at the time of parenting and childcare. »

For several years, the most attractive specialties have remained the same. With plastic surgery in mind, followed by ophthalmology, dermatology, cardiology and then maxillofacial surgery. As Le Quotidien du Médecin details, the top tier of specialties shows non-commercial profits of more than 100,000 euros per year. If nephrology and anesthesia are also specialties that appeal to young people, others are struggling to convince.

Indeed, at the bottom of the pyramid, some specialties are less attractive. Occupational health, medical biology, public health and even psychiatry have many vacancies. What about GPs? For the year 2021, Le Quotidien du Médecin reported an attractiveness index for general medicine of 0.759. The closer the index is to 1, the less the specialty appeals to students. In 2021, all the positions offered in general medicine were taken while more than 200 remained vacant in 2017.

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“The prospect of compensation is not up to par. To encourage students to choose general medicine as a specialty, the lever for action is simple,” says Dr. Loeb.

In order to keep things moving and to fight against medical deserts, the government has made a decision for future doctors. From the start of the 2023 school year, interns will have four years to train as general practitioners, compared to three currently. This "year of consolidation" is mentioned in the Social Security budget for 2023. It must be carried out by future general practitioners outside the hospital and "as a priority in under-resourced areas, where the supply of care is insufficient or difficult to access. "I want to reassure you, this is of course a pedagogical reform, which is desirable, which was also desired by medical students until a short time ago, and which will improve the response to health needs. of tomorrow," assured François Braun, Minister of Health. Today, 8 million French people live in a medical desert.