Medical education in France
The training takes a minimum of ten years after the baccalauréat and concludes with a clinical thesis defence.
Upon the successful presentation of their thesis, the medical student is awarded a diplôme d'études spécialisées (DES), based on their specialty.
[2] Under the Ancien Régime, medicine was one of four faculties and generally only accessible through the Faculté des Arts de Paris.
[6] The university system was abolished in 1793 and replaced the following year by four medical schools in Paris, Montpelier, Bordeaux and Strasbourg.
These students would have begun their studies in universities, but would live at and serve internships from then in hospitals and go on to make up the medical elite.
[10] The law of 19 Ventôse année XI (March 10, 1803) reorganized the profession and stipulated that "no one can henceforth practice medicine or surgery without having been a doctor" except for health officers (Officier de santé [fr]) in rural, medically under-served areas.
Gradually, a hierarchy evolved with prestigious doctors directing important services at the apex above specialists in private practice, with the general practitioners at the base.
Practical and theoretical training were finally combined into a single course, based on the 1958 ideal of the Centre Hospitalier Universitaire en France [fr][13] Following the Faure reform, medical colleges were integrated into universities as UER (from 1984, research and teaching centres "UFR").
This reform, along with the general population increase, led to a large surge in student numbers[vague].
In 1971 this resulted in a fixed number of training places in exams at the end of the first year of medical studies, a Numerus clausus system.
The result was a two-speed medical system, divided between THESE graduates and “former interns” and “former senior hospital registrars”.
In 2004, a new reform was applied, stating that all medical students must pass the national classifying examination.
[24] It takes place during the holidays preceding the re-entry by the students admitted in second year of medicine or odontology.
The first cycle of the medical studies follows a national plan, but the organization between the two years varies between the universities.
These modules are the classifying official program of the national examination (see low), and include a numbered list of items which correspond either to pathologies, or with clinical or therapeutic situations.
This term of everyday usage (which is a survival of the old contest of the externat removed following the demonstrations of 1968) does not officially exist.
Certain universities replaced the half-time (mornings) permanent by one full-time by alternation: the external ones are then present all the day but only 6 weeks over 3 months, the 6 remaining weeks being devoted to the lesson, the examinations, the preparation of the ECN… During the externat, lecturing, is replaced more and more by directed work; the lectures are held in alternation with hospital training courses: this teaching is that of a true trade-guild, where the external one approaches by “clinical cases” of true situations lived in the services.
[27] Module 11 of the second cycle is the old certificate of clinical and therapeutic, essential synthesis to replace a general doctor.
Students able to reach the third cycle of medical studies (TCEM): Tests are organized for the candidates quoted above.
They act more than one initial track records that real studies (more especially as France is one of the rare countries to regard the interns as students).
It consists of six month training courses during which time they are remunerated, associated with a hospital, but also associated with a general doctor, or of an extra-hospital structure of care.
Depending on the speciality chosen, the student must take a minimum number of training courses in hospital services where their role is similar to the paid trainees in general medicine described above.
