How to become a doctor?

In France, medical studies are necessary to to become a doctor. The course is particularly long since it is necessary at least 9 years of training to become a general practitioner. In 2020, there were 15,000 medical students in France according to the Ministry of Higher Education and Research. What is the training course to become a doctor?

How many years of study to become a doctor?

In France, medical studies are among the longest higher education courses of all university courses combined. 9 years of training are indeed necessary to become a general practitioner. Health studies become MMOP studies: Medicine, Maieutics, Dentistry, Pharmacy. To access it, several voices are now possible:

► Major health license “Health Portal” via Parcoursup (60% of places): specific first year of higher education with a majority of health education (similar to PACES) + “minor” education in another discipline, in order to facilitate reorientation if the course of the selection is not passed. There is a possibility of continuing the studies in license of the minor education chosen.

► Licenses to “minor health” (40% of places): integrate a classic university degree (law, history, biology, etc.), with a “minor health” option. Then when the student feels ready in L1 L2 or L3, he can apply for admissions to the second year of medicine, pharmacy, odontology, Midwifery. Mainly used as a second chance for students who have failed the “Health Portal”. No repetition possiblebut if the student validates his license year, he can apply again at the end of L2 or L3.

► Pathway from paramedic to medicine : 3-year training leading to the diploma of medical assistant (as a nurse), then gateway to medical studies.

Undergraduate studies

The first cycle aims to provide the scientific knowledge necessary for the exercise of a medical profession and to study the healthy man and the sick man. On the program: semiology (study of the clinical signs and symptoms of diseases), physiology, anatomy, microbiology….

► First year, competition and numerus clausus. “The first year of health studies (PACES: First Year Common to Health Studies) is common to university studies in medicine, physiotherapist, pharmacy, odontology, and initial training as a midwife.“, explains Dr. Rachel Collignon-Portes, General Practitioner. Composed of two semesters, it combines theoretical courses (units common to the four courses) and guided courses (the number of which depends on each faculty). It ends with a competition specific to each sector. Admission to the second year depends on the candidate’s rank in the ranking produced at the end of the competition.. A numerus clausus (fixed number of students admitted) is imposed each year to limit admissions to second-year students. “From the start of the 2020 school year, as part of the “My Health 2022” reform, the first year of health studies will be modified, continues our interlocutor. For example, the numerus clausus will be abolished and replaced by the numerus apertus: the faculties of medicine will set the number of admissions in the 2nd year according to territorial needs and in connection with the ARS“, explains our interlocutor. Repetition will no longer be possible.

► Second and third year (DFGSM 2 and 3). Accessible on the basis of success in the competition, the second year of medicine includes:

• A four-week hospital internship (nursing internship). To be carried out between the 1st and 2nd year.
• Fundamental lessons : anatomy, biochemistry, histology, neuroanatomy, pharmacology, radiology, etc.
• Led lessons more numerous than in the first year.
• Beginning of hospital internships under observation from DFGSM 3 (3rd year)

Second cycle of studies (4-5-6 th year): Externship

The second cycle of medical studies includes three years: DFASM (Diploma of Advanced Training in Medical Sciences) 1/2/3. These three years include 11 so-called transversal teaching modules which correspond to the beginning of clinical learning. “In reality, the modules (musculoskeletal system, digestive system, etc.) can start from the 2nd year of medicine, i.e. DFGSM 2says Dr. Manuel Vincent, general practitioner. Over the years, the teaching is deepened in each module, then indeed new modules appear each year.“. These three years allow to apprehend different families of pathologies, and to consider the patient as a whole (support for human aspects). The theoretical lessons are interspersed with relatively long evaluated hospital internships (two to four months depending on the faculties), where the student becomes familiar with different sectors (paediatrics, geriatrics, emergencies, etc.). He assumes his first responsibilities as a practitioner under the control of the medical and paramedical team in which he is integrated (day school). “Each year of the cycle is sanctioned by examinations: the teaching of the 11 modules is thus validated“, says the doctor.

► National ranking tests (or ECN). Passing the “National Classifying Tests” (ex boarding school competition) punctuates the second cycle and allows access to a specialty (44 specialties including general medicine), the choice and region of affection of which are conditioned by the ranking rank.

Third cycle and diploma: Internship

This last phase of medical studies, which includes the exercise of hospital functions (boarding school) full-time work organized in remunerated six-month internships in various departments associated with theoretical teaching, is also called “third cycle of specialism”. Two pathways are possible:

• general medicine, with a three-year course.
• A specialtywith a course that lasts four years for most disciplines, or even five years for surgical disciplines, internal medicine or radiology.

This internship cycle culminates in Diploma of Specialized Studies (DES), which comes in about forty distinct DES. It can be supplemented by additional training prepared in two years (Diploma of complementary specialized studies, DESC). “With the 2017 reform, many DESCs have become DESs. These are no longer additional training, but specialties in their own right to choose following the ECN“, specifies Dr. Delphine Blanpied, general practitioner. Once the internship is successful, students must defend a thesis in front of a jury, to obtain the State Diploma of Doctor of Medicine.

Thanks to Dr Rachel Collignon-Portes, general practitioner and head of the department for initial medical training (FMI) within the SFMG (French Society of General Medicine), Dr Manuel Vincent, general practitioner and associate lecturer at the Faculty of medicine of Amiens and Dr Delphine Blanpied, substitute general practitioner.