Medical Manpower in Belgium

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Medical Manpower in Belgium

• Numerus clausus

Alain De Wever
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Medicine
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A. Medical planning agents in Belgium
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Belgium
Federal State
Regions
Communities
Flemish
French
Dutch speaking
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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)

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2 Communities level

• Flemish Community
• Entrance exam
• (Decree of July 24, 1996)

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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)

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3 Difference between communities
Flemish Community
French Community
Examination
Entrance exam
Number of students lt quotas
Number of students quotas
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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

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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)

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B. Too much doctors in Belgium ?
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1 Past trend
Fig.1
Number
Medical acts / inhabitant
Plethora
Medical density
Time
Sources D. Deliège (SESA UCL)
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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.)

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2.1. a Ageing medical population
Ageing medical population 55-74 / 20-54
Source UCL Sesa Deliège D.
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2.1. b Retirements boom
French and Dutch speaking communities
Source UCL Sesa Deliège D.
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2.2. Feminization of the profession
Women doctors rate
Source UCL Sesa Deliège D.
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2.3. Consumption increase
Due to the ageing (22 ) Due to others agents
including the wealth (66 )
Source UCL Sesa Deliège D.
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3 Coming trend
Number
Medical acts / inhabitant
Shortage
Plethora
Medical density
Time
Sources D. Deliège (SESA UCL)
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• Demographic bump
• Feminization
• Working hours decrease (48 hours/ week
  European Directive Colla law)
• ? Possible shortage

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Physiotherapists
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• 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)

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• However, the French Community limits the access
  for the students who do not live in Belgium (30
  ) ? economical reasons (by lottery)

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• 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