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Education reform seen as key to doctor shortage

Medical training is to be overhauled

(Keystone)

The government and the medical profession are hoping that Europe-wide educational reforms will help to solve the shortage of doctors in Switzerland’s hospitals.

The country has plenty of doctors in private practice, but experts say hospitals have to rely on foreigners to fill vacant posts.

Switzerland has one of the highest numbers of doctors per inhabitant in the world with over 25,000 registered physicians for a population of seven million.

But in hospitals more than 30 per cent of doctors and some 80 per cent of psychiatrists are foreign, and experts say that without recruiting abroad hospitals would struggle to find enough personnel.

The Swiss Junior Doctors Association has even warned of a severe shortage of doctors in hospitals and says that many jobs are not being filled. It says that the foreign staff – mostly from Germany – are desperately needed.

And medicine faculties are expecting the number of foreign doctors in the country’s hospitals to rise even further.

Experts say a further problem is a shortage of doctors in rural areas.

Money

Many politicians complain that specialists in private practice are often too concerned with making money, and that the profession as a whole has a bad record in denouncing cases of abuse.

There have been calls for hospital work to be reassessed and given a better status. Those in favour of change also want clearly defined working hours for hospital staff, and the possibility of part-time work.

Other proposals call for General Practitioners’ (GPs) jobs and training to be made more attractive and more encouragement for the opening of rural practices.

But at the moment no concrete proposals exist for such reforms. Hopes are being pinned instead on the reform of medical studies.

Harmonise

Under the European Union’s Bologna Declaration, 40 countries - including Switzerland - have agreed to harmonise higher education across Europe and to encourage students to study in other countries.

Part of the impetus for Bologna is to enable Europe to better compete against the United States by 2010.

The reforms will also apply to medicine. Students will receive a Bachelor’s degree after three years of study, and a Masters after a further two to three years. A Doctorate will be gained after another three years of research-based study.

Under the Swiss system, students must spend a minimum of six years at university followed by further years of study and specialisation.

Under the Bologna system, would-be doctors and medical researchers will be grouped together for the first three years of university.

The second part of the training will cover specific themes such as patient contact and the economic aspects of certain treatments in more depth than at present.

The medical profession has been calling for such reforms for many years.

Reform

In the meantime, the Swiss interior minister, Pascal Couchepin, who has the health portfolio, has already pushed through some reforms to try and curb the number of new private practices.

In 2002, the government imposed a three-year freeze on the opening of practices by newly qualified doctors – to the outrage of doctors’ associations.

Once the freeze runs out in 2005, a new measure will be introduced allowing doctors and insurers more freedom to decide with whom they wish to work.

The government is also expected to fix the minimum and maximum number of doctors for the country and the cantons will establish the minimum number of specialists needed in each domain.

The government hopes that this will lead to a better distribution of doctors between rural and urban communities as well as an end to abuses of the system.

But critics say that the reforms have not been properly thought through and leave too many open questions.

swissinfo, Katrin Holenstein (translation: Isobel Leybold)

Key facts

Switzerland has 25,000 doctors serving a population of seven million.
11,000 doctors work in hospitals.
Some 30-40% of hospital doctors are foreign.
This rises to 80% in psychiatry.

end of infobox

In brief

Bologna aims to harmonise the length of degrees in European universities in a bid to make it easier for students to study and work abroad.

A bachelor’s degree will take three years, and a master’s degree a further two.

40 countries have signed up to the reforms, which are to come into force by 2010.

end of infobox


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