IMPLEMENTATION OF THE BOLOGNA PROCESS IN

FRANCE

Prof B. CHARPENTIERHonorary Dean

FACULTY of MEDICINE-UNIVERSITY PARIS SOUTH 11Past President of the French Medical Deans’council

Member of the French Academy of Medicine

THE ANSWER IS NO ! WHY ? A levels # BaccalauréatBologna Process French Medical Training-L1 -PACES-L2 -P2-L3 -D1-M1 -D2-M2 -D3-D1 -D4-D2 -RESIDENCY: 3-5 Y-D3 -M D: 2+4+3/5= 9-11 YDOCTORATE 3+2+3=8 Y - Chef de Clinique: 2-4 Y

TWO PARTICULAR FEATURES OF

THE FRENCH EDUCATIONAL

SYSTEM : (1) Grandes Ecoles vs University: How to select the

Elites ?

CPGE1+1 High Schools Doctorate

X-ENS-Centrale less 40%

A Levels 4 Y 3Y

(Baccalauréat)

-650000 candidates University (85) L1 L3 ( -60%)

-50% filière G ( S-ES-L/A) M1 M2 ( -30%)

-25% filière T-V D1 D3

-25% filière P-V

-Success rate: 86%

TWO PARTICULAR FEATURES OF THE FRENCH EDUCATIONAL SYSTEM : (2) PACES

PACES(S1/S2– 2 inscriptions )

chemistry biology physics anatomy

social sciences

12000

54000 Students

Medicine 7500

Pharmacy 3595

Dentistry 1200

Midwife 1017

PhysiotherapySpeech therapy

42 000 L1 ?ECTS

FRENCH FACULTY OF MEDICINE

- Derogatory clause within University

- Competitive selection for entrance

-Professionnal School « we teach the job we are doing, we do the job we are teaching… », What’s about the applicated job of Professors of canon law, of sanskrit, of esperanto ?

-French Faculties of Medicine are linked to several teaching hospitals where all faculty members must teach, doing research and clinical/biological patient care.

FRENCH TRAINING TRENDS

- USUAL TRAINING: 3 steps

1) TRAINING 2) GUIDANCE 3)SELECTION

- FRENCH TRAINING: 2 steps

-1) TRAINING 2) SELECTION ( BUSINENESS-

ADMINISTRATION-MEDICINE )

- NO BY-PASS/BRIDGE

- CONCLUSION: eveything is done at 20 y.o. !!!

-

A STRONG EXAMPLE

FOREIGN STUDENTS/MD

-PACES: 8%----less 1% vs 17%

-D1---upon personal file examination

-D4

BY-PASS

- 500 seats- GRANDES ECOLES AFTER CURSUS COMPLETION ( 6 y)

- Ph D ( 8 y )

BASIC SCIENCES

- PACES anatomy

- -P2 physiology….

- -D1 semiology…

CLINICAL TRAINING

-D1: introduction with nursing care + semiology teaching at the bed side

-D2-D4: ½ time to the bed side + on call+teaching pathology/therapeutics

-RESIDENCY ( 3 y GP/ 4-5 Others): full time bed side+ on call+ teaching specialty

-Early contact at the bed side-strong clinical training

ECN ( National Ranking Examination )

7000 D4 1 specialty+location

-39 Faculties of Medicine/7 regions -All Faculties are ranked along with the students ranking-Location 1st choice: big campus ( Paris, Lyon, Marseille…)- GP 50%, second half

2 D. exam

9 clinical cases + questions

+ 2 paper analysis

7000

RESIDENCY

-GP: 3y training course mostly in GP office

-SPECIALTIES: 4-5 y in University Hospitals

-Courses must follow the national teaching program

-Examination: attendance+ thesis

------------------------

MD + specialist in… (+9/+11 y)

-Temporary seniorship: 2+1+1=4 - Job: teaching+researching+care - Located in University Hospitals - DESC validation ( subspecialty ) - Goals: Academic/public activity ( HP to PU-PH ) Private activity

CHEF de CLINIQUE-ASSISTANT

SPECIAL TRAINING FOR MD+PhD

-M2 during residency ( 1y in a research lab)

-Ph D during CCA ( 3y+X in a research lab)

-Post-Doc abroad ( 2-3 y, publish or perish )

-EXAMINATION: Habilitation à diriger des recherches

-National Competitive Examination to a full tenure track position (

PU-PH/MCU-PH):CV+Publications+teaching activity+oral test in front of

2 successive board of examiners (national+local): 38-40 yo !

FRENCH TRAINING COURSES FOR FOREIGN MEDICAL OFFICER

1 – Attestation de formation spécialisée ( AFS )

- Medical officer non UE: agreements of both Universities+french specialty coordinator+open post

- Gaining partial certificates of the specialty

- Duration: 1 or 2 y and back in the country

2 – AFS+A=AFSA

-Specialist qualification in their country:agreements of both Universities+french specialty coordinator+open post

-Gaining highly selective knowledge ( robotics, endovascular manip.

-6 or 12 months

BOLOGNA PROCESS AND FRENCH MEDICAL TRAINING

MOBILITY IN EUROPE

-1) Europe to France-2nd cycle D1-D4 Belgium-Germany-Netherlands-Spain-Switzerland-Italy -2) Europe to France- Residency ( part or full/special examination) Belgium-Germany-Netherlands-Spain-Switzerland-Italy -3) France to Europe-2nd cycle -Few ones ( languages limitation), except Belgium-Switzerland -4) France to Europe-1st cycle: PACES in Romania

BOLOGNA PROCESS AND FRENCH MEDICAL TRAINING

ADVANTAGES

-Master grade level at the end of D4 ( 5vs6 y) ?for « escaping » medicine with a diploma

-ECTS for European mobility ( Socrates, Erasmus…)

-validation of different courses in Europe for medical training

-European Doctoral Schools ( Masters and Doctorates/thesis in co-supervision)

BOLOGNA PROCESS AND FRENCH MEDICAL TRAINING

DRAWBACKS-TIME OF THE CURSUS VERY DIFFERENT ( 8 vs 9-14 y), French cursus too long ?

-FEW GATEWAYS ( Phd----D1)

-Intensive clinical training vs less basic training

-Tight control of the government ( teaching hours, program, numerus clausus, specialties volume, training of foreign students,…)

-weak french mobility in Europe ( the goal is to pass an exam in order to have a job…)

BOLOGNA PROCESS: Last Minute !

«  the european higher education space is not a model to be exported, Africa, Asia, Norh/South America have their own specificities and needs »

EUA Lesley Wilson, General Secretary- 16/04/2012, address to the European Higher Education Ministies for the Bucarest meeting (26-27/04/2012)

EUROPEAN DREAMS IN AN O.R. !

The Reasons for my existence have not yet been established…but