Does Switzerland really need more medical students?

This article was exclusively written for the Sting by Jérémy Glasner & March Eich (swimsa Co-Vice-presidents for Medical Education 2015/16), both medical students from Switzerland. The translation was made by Federico Mazzola (swimsa President 2016/17). The writers are members of Swiss Medical Students’ Association (swimsa) Medical Education Committee, affiliated to the International Federation of Medical Students Associations (IFMSA). It is no secret – every patient seeking a Swiss hospital or a family doctor outside big cities notices it clearly. We do not have enough doctors. Due to this finding the federal council will invest 100 million Swiss francs (€ 91 million) over 4 years to increase the number of medical students. This sum attracts a lot of interest: the University of Zurich and Berne want to increase their capacity, the ETH Zurich has always dreamt of their own Bachelors degree in clinical medicine, whilst Fribourg, Ticino, Saint Gallen, and Lucerne would love to establish a Masters program (years 4-6 of Swiss university training of MDs). The Swiss Medical Students’ Association represents all Swiss medical students. Attentively we have compiled a policy paper on Quality Assurance and the Future of Medical Studies, serving as basis of this article. Naturally we support the initiative, which will allow more graduates to follow their dreams and enable Switzerland to be more independent from its neighbouring countries. This independence may also help to alleviate the shortage of doctors in surrounding countries caused by the import of foreign doctors into Switzerland. Firstly, this shortage has many influenceable factors. On the one hand, the doctor shortage is relative, since some specialities are more affected than others: family medicine and psychiatry as prime examples. On the other hand, rural areas suffer more than urban ones. Additionally, the divergence between the work-life-balance expectation of the current generation and the effective working conditions lead to many doctors quitting their profession. Secondly, creating a new medical course is hard work. In our experience the change of one system to another is difficult, especially since every university has their very own curriculum. Finally, a quick increase in the number of medical students may negatively impact academic quality, which currently enjoys a high reputation in Switzerland. Without any infrastructural development, lecture halls will reach capacity. More importantly, having a limited number of patients, facilities and medical educators it proves difficult to sustain small group learning, essential for clinical training. These obstacles can be overcome and provide a chance to bring innovation to the Swiss medical landscape: suffering specialities can be promoted and made attractive throughout the curriculum, in addition to ameliorating their working conditions and their salaries. Moreover, a better task distribution between different medical profession should be considered, next to creating a better working atmosphere, allowing every doctor to fully flourish at work and at home. The key to organising a new medical curriculum is cooperation and collaboration. The numerous institutions involved have to work as a team to secure that courses follow a clear concept. We plight for quality before quantity, especially for the safety and comfort of patients. Only universities with enough human, financial, and infrastructural resources are able to offer a student-centred education and conserve the individuality of each future doctor. Swimsa is delighted to be involved in the development of the best possible education for future doctors and therewith hopes to contribute to an excellent treatment for each and every patient. Visit swimsa.ch/de/ausbildung/stellungnahmen for the full policy statement (available in German and French).  About the authors Jérémy and Marc were the swimsa Vice-Presidents for Medical Education from 2014 to 2016. Together with the swimsa Medical Education Committee they have compiled numerous policy papers, giving Swiss medical students a strong voice. The policy paper on Quality Assurance and the Future of Medical Studies is one of their greatest successes, gaining support by the Union of Students of Switzerland and the according commission of the Swiss Federal Council. Jérémy currently sits in the commission working on the new Swiss Catalogue of Learning Objectives (SCLO), whilst Marc is the delegate to the resident and attending doctors’ association (VSAO).