1. What is a general practitioner?
A general practitioner is a doctor who after having completed his 3 years of Bachelor degree and his 3 years of master degree(only in FWB either at UCLouvain or at ULB or at ULiège) has carried out a specialization in general medicine. The UNamur currently offers the bachelors degrees in FWB. The UNamur requested authorization for specialization in general medicine, which was accepted by ARES in December 2022.
2.Why did the UNamur ask for authorization to offer a specialization in general medicine?
One of the ambitions is to bring university training closer to the shortage areas of the Provinces of Namur and Luxembourg. Doctors specializing in general medicine spend more than 2/3 of their time on internship, that is to say in the places of practice of their internship supervisor. The rest of the time is divided between university training, seminars and scientific work. Given that these doctors attach great importance to their private life/professional life balance, bringing together places of training and places of practice can make it possible to better reconcile this balance. The distances and time to reach their place of training are indeed considerably reduced. The objective is to attract more young doctors to rural practices and beyond that, more permanent installations in these regions. As a reminder, currently, training only takes place at ULiège, ULB (Brussels) and UCLouvain (Brussels site!). We know that the shortage is a complex problem and that there is no point in training more doctors if they do not settle where there is a shortage.
3. Is this the only advantage of this training?
No! The UNamur also wants to bring educational innovations:
- Simulation training that allows students to integrate learning by improving reflective and communication skills, without risk to patients.
- Mentoring: our formula which consists of “pairing” an experienced general practitioner with a young doctor during the 3 years of training is an innovation without real comparison. It is done in collaboration with McGill University in Canada. Here, too, it is a way of integrating the practice of a young colleague into the local fabric.
- UNamur has a psychology department whose area of excellence concerns communication skills.
4. Is there evidence that such a program can help with a better distribution of new installations?
Yes !
First, in a survey by the Health Observatory in the Province of Luxembourg in 2016 [1], 93.5% of doctors who take on an assistant declare that they have become internship supervisors, among other things, in order to guarantee the future of medicine. Nearly 9 doctors aged under 50, out of ten (86%) planned to become a training supervisor.
Secondly, the AEQES [2] supports the creation of a specialized master's degree in general medicine at UNamur in its report of November 19, 2022 [3]. In 2017, the Federal Center for Health Care Expertise (KCE) already warned about this geographical distribution [4].
Finally, several foreign studies go in the same direction, including a very recent one [5] which indicates the following: investment in training and exposure via an internship in the 3rd cycle in a rural environment, reinforce the installation in this environment. Another American study[6] indicated that there is a linear gradient between increasing levels of “rural exposure” in the 3rd cycle and subsequent rural work.
5. What cost does the opening of this specialty in general medicine in Namur represent for the FWB?
Nothing !
Indeed, the training is part of a closed cohort. Our collaboration with UCL plans to “collect” Brussels students to direct them to UNamur. The FWB will therefore fund students in Namur instead of funding them in Brussels. Not to mention that the FWB only finances 2 of the 3 years of the master (!) while the 6 basic years are all financed by the FWB.
6. Doesn't the creation of the specialization in general medicine presage a desire on the part of UNamur to have a master’s degree in medicine?
No !
The creation of a possible Master (2d cycle) would require the backing of a university hospital, the recruitment of a heavy structure and the creation of premises which the University does not have. In addition, UNamur does not think it can provide additional advantages compared to the master's training currently provided by the three complete French-speaking universities, which is of high quality.
Conclusion
The creation of the specialty in general medicine therefore meets a societal need without costing anything to the FWB!
[1] Results of the descriptive survey on the conditions of exercise and practice of general practitioners 2016 – Health Observatory – Province of Luxembourg
[2] AEQES is an independent public service agency that carries out formative evaluation of higher education programs organized in the Wallonia-Brussels Federation; it reports on the quality of higher education and strives for its constant improvement. In doing so, it aims to encourage the development of a quality culture in establishments
[3] https://www.aeqes.be/documents/RE_medecine_UNamur.pdf
[4] https://kce.fgov.be/sites/default/files/2021-11/KCE_290Bs_Modele_de_pro…
[5] McGrail MR, Nasir BF, Chater AB, et al The value of extended short-term medical training placements in smaller rural and remote locations on future work location: a cohort study BMJ Open 2023;13:e068704. doi:10.1136/bmjopen-2022-068704 [6] Russell DJ, Wilkinson E, Petterson S, Chen C, Bazemore A. Family Medicine Residencies: How Rural Training Exposure in GME Is Associated With Subsequent Rural Practice. J Grad Med Educ. 2022 Aug;14(4):441-450. doi: 10.4300/JGME-D-21-01143.1. PMID: 35991106; PMCID: PMC9380633.
