[The numerus clausus system of the French medical training (1967-2009)].

Abstract

Medical schools in France are all state-owned or state-controlled. Prior to the 70's, admission is open to all "bacheliers", i.e. the teenagers who have successfully completed their secondary schooling. For various reasons, the number of these newcomers was soaring starting the mid-60's. About 6 years later, the boom reached those who were in residency and 2-3 years later the move became a "graduate boom". The fears of inundation were shared by both the hospitals (as the available posts for young doctors were not sufficient) and the ambulatory care sector (where the practitioners were fearful of severe competition from the newcomers). As a matter of fact, there was a strong oversupply of young doctors but everybody thought that oversupply was general. The numerus clausus was established in 1971 and the annual number of students admitted into medical schools started to decrease in 1978, until 1999. After two decades of decrease, a clear shortage of young doctors appeared and a volte-face was decided: starting 1999, the annual number of young students admitted to medical training followed an upward trend. This number reached 7400 in October 2009, from 3400 ten years earlier. This time, a second confusion was made: the shortage of young-doctors is now understood to be a general shortage of all the medical profession. Consequently, a strong policy for increasing the numerus clausus is implemented. As things are, in 15 years from now, the health system will be again in the situation it has known in the mid-70's.