For years, medical faculties have refused to pay general medicine internship supervisors. A circular was supposed to put an end to this situation.
The ReAGJIR (1), a union that brings together and represents young general practitioners (substitutes, young people installed and heads of clinics), shines its spotlight on an injustice. It concerns the internship supervisors of universities (MSU) of general medicine who train students (internal or external) by welcoming them to their practice.
For this, they normally receive educational fees from the Regional Health Agency (ARS) in compensation for their availability taken out of their working time. Except that since 2011, this operation has started to pose a problem. That year, a first university (Strasbourg) refused to pay a practitioner for this activity.
And if the problem may seem anecdotal to some, it actually goes much further than one imagines: “This illegal and disrespectful attitude has spread to the majority of medical schools.. », Says Dr Stéphane Munck of the ReAGJIR union. Contacted by Why actor, he describes this deadlock situation.
Who are the professionals involved?
Dr Stéphane Munck : This illegal treatment concerns heads of clinics, university lecturers and university professors. Initially, the phenomenon was quite isolated. It concerned an establishment. But in recent months, this practice has become widespread in the majority of French universities. These establishments have either stopped remunerations or threatened to do so. In total, we have counted between 10 and 15 universities which are considering no longer paying academics for the master’s internship.
Faced with this injustice, we asked the Ministry of Health, which assured us of its support. But the Secretary of State in charge of Higher Education has decided to play the clock by blocking the circular.
How much is the remuneration that escapes them?
Dr Stéphane Munck : It is a remuneration that can be paid to monomials, pairs or trinomials of internship supervisors. Each is paid 600 euros per month. That is to say that, if you are in a pair, each is paid 300 euros for the reception of an intern. In this case, that makes a remuneration of 1,800 euros per semester, or 3,600 per year.
Sometimes these amounts have not been received by academics for years. With losses of several thousand euros for some practitioners. Furthermore, we do not know where this money is going. It is also the problem of the current situation because this financing is done on the budget of the Health insurance. The CNAM now reimburses the Regional Health Agencies (ARS) and the faculties for internships which are carried out but which are not paid to the internship supervisors.
Isn’t there the risk that students will no longer find internships?
Dr Stéphane Munck : It is indeed the risk and it threatens general medicine more broadly. We know that internships are the best lever to encourage young general practitioners to settle down and fight against medical desertification. The internship mastery takes time and this pedagogical time is not taken up for care. The doctor who does not earn money when he trains a colleague therefore deserves a compensation salary.
Failure to recognize the work provided by internship supervisors will demotivate young doctors and students in the profession. This is very worrying when we know that general medicine is already understaffed, which leads to major difficulties in terms of training.
(1) The Autonomous Group of Young General Practitioners Installed and Replacements
According to ReAGJIR, the universities are defending themselves by arguing that the doctors concerned are refused this payment because of their status as head of clinic. A head of clinic is part-time installed doctor, in liberal exercise or employee, and part-time at the University for teaching and research activities.
It is within the framework of his care activity that he chooses whether or not to become an internship supervisor by welcoming students. But the University has decided to interpret the decree of July 28, 2008 relating to university teaching staff in a partial manner, without taking into account the rest of the law: the head of clinic must not receive any additional remuneration within the framework of his duties. that are teaching, research, care and participation in management functions.
Dr Sophie Augros, president of ReAGJIR, explains: “This interpretation is true but only in the context of her university activity, not in that of her care activity. If we go to the end of the interpretation made by the University, should we conclude that the head of the clinic should provide free care? We walk on the head. “
.