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Medical Manpower in Belgium

Medical Manpower in Belgium. Numerus clausus. Alain De Wever. Medicine. A. Medical planning agents in Belgium. Belgium. Federal State. Regions. Communities. Flemish. French. Dutch speaking. 1° Federal level.

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Medical Manpower in Belgium

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  1. Medical Manpower in Belgium Numerus clausus Alain De Wever

  2. Medicine

  3. A. Medical planning agents in Belgium

  4. Belgium Federal State Regions Communities Flemish French Dutch speaking

  5. 1° Federal level • Establish the number of doctors who have access to the practice in the health insurance system • 1996 : Creation of the « Commission de planification » (Planning Commission)

  6. 2° Communities’ level • Flemish Community • Entrance exam (Decree of July 24, 1996)

  7. 2° Communities’ level • French community • End Bachelor examination – Third year (Decree of July 17, 1997) • End Master examination for the specialization – seventh year (Decree of July 27, 2003) • Examination at the end of the first year and at the entrance in the specialization training (Decree of July 1st, 2005)

  8. 3° Difference between communities Flemish Community French Community Examination Entrance exam Number of students < quotas Number of students = quotas

  9. The examinations in the French Community • At the end of the first year, classification of the best students per university • At the end of the seventh year, inter-universities commission • GP (43 %) • Specialists (57 %) Quotas per specialization

  10. Entrance exam in the Flemish Community The exam consists of 2 parts : • Exam assessing the scientific knowledge (physics, chemistry, biology, mathematics) • Comprehension tests (assessment of the ability to acquire & assimilate information through comprehension & restitution tests)

  11. B. Too much doctors in Belgium ?

  12. 1° Past trend Fig.1 Number Medical acts / inhabitant Plethora Medical density Time Sources : D. Deliège (SESA – UCL)

  13. 2° Current trend • Ageing medical population and increase of the retirement • Increase of the feminization of the medical population • Increase of the healthcare consumption • Diversification of the medical profession (pharma industry, civil agent, professor, etc.)

  14. 2.1. a Ageing medical population Ageing medical population : 55-74 / 20-54 Source : UCL – Sesa – Deliège D.

  15. 2.1. b Retirements’ boom French and Dutch speaking communities Source : UCL – Sesa – Deliège D.

  16. 2.2. Feminization of the profession Women doctors’ rate Source : UCL – Sesa – Deliège D.

  17. 2.3. Consumption increase Due to the ageing (22 %) Due to others agents including the wealth (66 %) Source : UCL – Sesa – Deliège D.

  18. 3° Coming trend Number Medical acts / inhabitant Shortage Plethora Medical density Time Sources : D. Deliège (SESA – UCL)

  19. Demographic bump • Feminization • Working hours’ decrease (48 hours/ week – European Directive – Colla law)  Possible shortage

  20. Physiotherapists

  21. Restriction by the federal level of the number of physiotherapists who can work in the health insurance reimbursement system • No restriction at communities’ level (training)

  22. However, the French Community limits the access for the students who do not live in Belgium (30 %)  economical reasons (by lottery)

  23. Examination organized by the Federal State : • Attitude test for the self-employed practice • Ability test for the self-employed practice • Knowledge test : • Laws about physiotherapists’ rights and duties • About the health insurance

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