1. Northern State Medical University (Arkhangelsk) Tempus IV159328 Seminar on Quality Control Standards in Higher Medical School Student’s mobility in European faculties Pr Sylvain Meuris Faculté de Médecine Université Libre de Bruxelles

2. Why to promote mobility ?  Public Role of Faculty of Medicine ???  To offer to local population, with their money health workers able to understand, communicate and cure their health problems  To locally educate and train local students for local patients...  But...

3. To fullfill quantitative and qualitative objectives  Geographic distribution ? Local, National, European, International  Equal competences ? Adequate curriculum Evidence based medicine University attractivity & ranking Economical attractivity

4. World Distribution of Physicians Total Number - 7’500’000 (WHO stats, 2007)

5. Geographical distribution

6. Density in the world Industrialized countries : 1/500 India : 1/2500 25 poorest countries : 1/25000  Governments face problems of Education infrastructure Health Budget Health coverage  Hospitals  Equipment

7. National solutions & restrictions  Since the seventies First oil shock  Budget objectives To maintain health expenses To balance supply and demand  Restrictions Decrease supply Limiting medical education

8. Consequences of restrictions  Decrease in care offer  Discontent of people Unexpected aging population  Desertified rural areas  Disorganisation of hospitals  Solutions To attract physicians from other countries To produce more health workers

9. Migration policies  Unfair competition between hospitals and countries Attractive salaries  Unrecognized physicians from outside UE Difficult to evaluate  at least 6000 clandestines in France !!! Underpayed No rights !!!

10. Consequences  Cost evaluation of training : 60000 dollars / physician  Rapt of more than 500 millions dollars per year from developed countries to industrialized countries  Exporting countries : More diploma than local needs UE : Poland, Hungary, Bulgaria, Romania, Spain, Italy Outside UE : Cuba, Egypt, Israel, Philippines

11. Political resonsability  From a wild to a structured mobility for health workers

12. Migration policy inside Europe  Free movement of health workers since >30 years (EU 1975) Mutual recognition of professional competences  Results for France 2500 physicians educated in another UE country among 200000 french doctors !!!  Since 2004 : UE 15 => 27 countries migration wave of young physicians from Poland, hungary, lituania, Romania,... => France, Germany, UK, Ireland, Belgium,...  Insufficient solutions to maintain health coverage

13. Relaxation of numerus clausus

14. EU promotion of student mobility  Pilot phase (1987) Initiated by the Commission  Inner Circle Medicine Group Limited number of Faculties  Managed by convinced Academic staff Administrative staff  No available statistics

15. Why to make statistics ?  To improve internal visibility of mobility  To convince Academic staff Academic authorities Students  To identify and understand obstacles and successes

16. In - Out (n)

17. How to make statistics simple  Up to date useful information Made at faculty level (coordinator, secretary, students...) Accessible on a website  To introduce mobility data on line  To receive immediate pertinent data

18. Tracks for solutions  To Increase training capacity  To Promote short-term mobility During medical studies During specialization Life-long learning  To Promote networking Between universities, hospitals, scientific societies Between diaspora and local physicians